Complexity of Psychological and Behavioral Science in Diabetes: The 2025 Richard R. Rubin Award Lecture

Complexity was a strong and persistent theme in Richard Rubin’s work on psychology and behavior science in diabetes. That complexity began with his recognizing that, as challenging or horrible as diabetes may be, we can also manage to live good lives with it. With his many contributions along the way, this article will review the growth of our field to include 1) recognition of the psychological problems and challenges of diabetes; 2) developing ways both to raise up the very real challenges of diabetes and to promote leading good lives with it; 3) understanding how psychological problems may have roots in those challenges in the course and complications of diabetes; 4) addressing the many contexts affecting living with diabetes—families, organizations, communities; 5) the major roles among those contexts of social influence and social support; 6) community and peer approaches to creating environments and cultures that support management, enhance quality of life, reduce distress, and promote emotional well-being; 7) the importance of intentional variety of program features—many good practices, not one or a few best practices—in order to reach the millions at risk for and living with diabetes; and 8) to meet the needs of varied groups and settings, flexibility in implementation and evaluation with standardization according to key functions of interventions, not procedural details. In reflection, addressing the psychological and behavioral aspects of diabetes has provided opportunities for contributions amidst support and affection of colleagues.