Behavior-Analytic Approaches to the Management of Diabetes Mellitus: Current Status and Future Directions

Abstract

Diabetes mellitus is the seventh leading cause of death in the United States, requiring a series of complex behavior changes that must be sustained for a lifetime (e.g., counting carbohydrates, self-monitoring blood glucose, adjusting insulin). Although complex, all of these tasks involve behavior, making them amenable targets for behavior analysts. In this article, the authors describe interventions that have focused on antecedent, consequent, multicomponent, and alternate procedures for the management of diabetes, highlighting ways in which technology has been used to overcome common barriers to the use of these intensive, evidence-based interventions. Additional variables relevant to poorly managed diabetes (e.g., delay discounting) are also discussed. Future research and practice should focus on harnessing continued advances in information technology while also considering underexplored behavioral technologies for the effective treatment of diabetes, with a focus on identifying sustainable, long-term solutions for maintaining proper diabetes management. Practical implementation of these interventions will depend on having qualified behavior analysts working in integrated primary care settings where the interventions are most likely to be used, which will require interdisciplinary training and collaboration.

Leveraging applied behavior analysis research and practice in the service of public health

“…In addition to the special series on public health in this journal, a 2019 special issue of Perspectives on Behavior Science focused on addictions, and showcased substantial basic, translational, applied, and public health contributions of behavior analysis (Washington & Galizio, 2019). Recent conceptual and empirical work has focused on diabetes prevention and management (Raiff et al, 2020), disease transmission in the workplace (Gravina et al, 2020) injury prevention in sports (Quintero et al, 2020;Harris et al, 2020), physical activity (Nieto & Wiskow, 2020;Stedman-Falls & Dallery, 2020), cigarette smoking (Dallery et al, 2021), and health and wellness coaching (Finn & Watson, 2017;Normand & Bober, 2020). The strengths of behavior analysis (e.g., rigorous experimental methods, conceptual account of the causes of health behavior) increase the chances, but do not guarantee, that behavioral technology may lead to public health impact (Hantula, 2019).…”

The effectiveness of digital twins in promoting precision health across the entire population: a systematic review

“…Firstly, these studies have demonstrated significant improvements in primary outcome measures. Secondly, improving health-related outcomes in chronic diseases is an ongoing, complex process heavily influenced by changes in health behaviors 31 , 32 . While digital twins can provide personalized health guidance based on individual health data, their impact on actual behaviors warrants further investigation.…”