The importance of addressing depression and diabetes distress in adults with type 2 diabetes
Open accessAbstract
People with type 2 diabetes often experience two common mental health conditions: depression and diabetes distress. Both increase a patient's risk for mortality, poor disease management, diabetes-related complications, and poor quality of life. The American Diabetes Association and the U.S. Preventive Services Task Force recommend routine evaluations for these conditions in adults for optimal disease management and prevention of life-threatening complications. However, barriers exist within primary care and specialty settings that make screening for depression and diabetes distress challenging. Depression and diabetes distress influence diabetes self-care and diabetes control and barriers in clinical care practice that can hinder detection and management of psychosocial issues in diabetes care. This paper highlights opportunities to increase mental health screenings and provides strategies to help providers address depression and diabetes distress in patients with type 2 diabetes.
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High levels of diabetes distress are known to negatively affect self-care behaviors, medication adherence, and glycemic control.
“This finding is clinically important, as high levels of diabetes distress are known to negatively affect self-care behaviors, medication adherence, and glycemic control [40-42].”
From Evaluation of the Impact of Mobile Health App Vitadio in Patients With Type 2 Diabetes: Randomized Controlled Trial (2025) · cites this paper as [42]
Weight loss through lifestyle or drug approaches improves obstructive sleep apnea.
“Weight loss whether via lifestyle intervention or pharmacologic approaches also has been shown to result in improvements of OSA.1628–1630,1632–1636”
From American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan-2022 Update. (2022) · cites this paper as [1629]
The sections on diabetes self-care and collaborative care discuss depression, diabetes distress, and diabetes outcomes, not obstructive sleep apnea. Searches for OSA and for weight loss through lifestyle or pharmacologic approaches found no passage addressing the claimed effect. Page numbers were not available in our copy. (LLM, conf=0.76)
Experimental — accuracy not yet measuredContinuous positive airway pressure treatment for obstructive sleep apnea in people with prediabetes or diabetes improves obstructive sleep apnea symptoms.
“Treatment of OSA in persons with prediabetes and DM with continuous positive airway pressure (CPAP) improves OSA symptoms.1623,1628–1631”
From American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan-2022 Update. (2022) · cites this paper as [1629]
The Abstract and Conclusion discuss depression and diabetes distress in people with type 2 diabetes, not obstructive sleep apnea. Searches of our copy for CPAP, obstructive sleep apnea, and prediabetes found no passage addressing whether CPAP improves OSA symptoms. (LLM, conf=0.76)
Experimental — accuracy not yet measured
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- Authors
- Owens-Gary, M. D., Zhang, X., Jawanda, S., Bullard, K. M., Allweiss, P., & Smith, B. D.
- Affiliations
- Centers for Disease Control and Prevention (US)
- Oak Ridge Institute for Science and Education (US)
- Corresponding author
- Owens-Gary, Michelle D.
- Venue
- Journal of General Internal Medicine
- Published
- 2018-10-22
- Volume
- 34
- Issue
- 2
- Pages
- 320-324
- ISSN
- 0884-8734 (ISSN-L)
- 1525-1497
- PMC
- PMC6374277
- OpenAlex
- W2896722775
- Cited by
- 194
- References
- 35
- Citations by year
- 2026: 18 · 2025: 35 · 2024: 51 · 2023: 38 · 2022: 28 · 2021: 16 · 2020: 7 · 2019: 1
- FWCI
- 0.92
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Journal of General Internal Medicine (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Centers for Disease Control and Prevention
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Keywords
- type 2 diabetes, depression, diabetes distress, mental health screening, primary care, diabetes self-care, glycemic control, psychosocial barriers, diabetes complications, quality of life
- MeSH terms
- Adult, Depression, Diabetes Mellitus, Type 2, Humans, Mass Screening, Self Care, Stress, Psychological, United States
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