Table 1—

Principles that should motivate future development of diabetes-focused IBCT

Look before you leap (but do not forget to leap). Diabetes-focused IBCT research must include an active exchange between observational studies identifying key barriers to self-management and intervention trials identifying potential solutions.
One size does not fit all. A portfolio of tailored technologies will be required to address the needs of diverse populations, including patients without computers, non-English speakers, and those with health literacy deficits.
Beware of “cool apps” (applications). Technology per se is not a therapeutic service, and interventions must be based on strong behavioral theory.
IBCT is most effective when it supports human contact. New interventions should support patients' primary care. Services that are seen as extraneous will not be maintained over time by either clinicians or patients with diabetes.
Diabetes self-management is rarely patients' primary life concern. New services should be based on a holistic patient-centered model that takes patients' full range of chronic conditions and the patient's own agenda into account.
Not all patients need IBCT. Some patients do not need the added support IBCT can provide, while targeting patients with the poorest outcomes may not be the most effective way to allocate these resources.
Translating innovations into new services requires collaborations between researchers, managers, clinicians, and people living with diabetes. To move new interventions from bench to community, researchers should work with health system leaders to support program dissemination.