The prevalence of diabetes‐specific emotional distress in people with Type 2 diabetes: a systematic review and meta‐analysis
Open accessAbstract
Aims: Psychological comorbidity, such as depression and/or diabetes‐specific emotional distress (diabetes distress), is widespread in people with Type 2 diabetes and is associated with poorer treatment outcomes. Although extensive research into the prevalence of depression has been conducted, the same attention has not been given to diabetes distress. The aim of this systematic review was to determine the overall prevalence of diabetes distress in people with Type 2 diabetes. Methods: Seven databases were searched to identify potentially relevant studies; eligible studies (adult population aged > 18 years with Type 2 diabetes and an outcome measure of diabetes distress) were selected and appraised independently by two reviewers. Multiple fixed‐ and random‐effects meta‐analyses were performed to synthesize the data; with primary analyses to determine the overall prevalence of diabetes distress in people with Type 2 diabetes, and secondary meta‐analyses and meta‐regression to explore the prevalence across different variables. Results: Fifty‐five studies ( n = 36 998) were included in the meta‐analysis and demonstrated an overall prevalence of 36% for diabetes distress in people with Type 2 diabetes. Prevalence of diabetes distress was significantly higher in samples with a higher prevalence of comorbid depressive symptoms and a female sample majority. Conclusions: Diabetes distress is a prominent issue in people with Type 2 diabetes that is associated with female gender and comorbid depressive symptoms. It is important to consider the relationship between diabetes distress and depression, and the significant overlap between conditions. Further work is needed to explore psychological comorbidity in Type 2 diabetes to better understand how best to identify and appropriately treat individuals.
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Daily self-management imposes a significant burden on patients with T2DM, often leading to increased emotional distress and feelings of being overwhelmed.
“However, the demanding character of daily self-management imposes a significant burden on patients with T2DM. Adopting new healthier habits, along with the need for constant blood glucose monitoring and medication adherence, often leads to increased emotional distress and feelings of being overwhelmed [6,11-13].”
From Evaluation of the Impact of Mobile Health App Vitadio in Patients With Type 2 Diabetes: Randomized Controlled Trial (2025) · cites this paper as [11]
The Introduction (p. 1) describes diabetes distress in people with Type 2 diabetes as including feeling overwhelmed by the demands of diet, exercise, and medication adherence. It does not identify constant blood glucose monitoring as a source of distress or establish that these demands often lead to increased distress. (LLM, conf=0.84)
Experimental — accuracy not yet measuredPeople with diabetes are more likely to suffer from clinically significant psychological disorders than those without the disease.
“People with diabetes are more likely to suffer from clinically significant psychological disorders than those without the disease 1 , 2 , 3 , 4 .”
From Effects of mindfulness-based intervention on glycemic control and psychological outcomes in people with diabetes: a systematic review and meta-analysis (2021) · cites this paper as [2]
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- Authors
- Perrin, N. E., Davies, M. J., Robertson, N., Snoek, F. J., & Khunti, K.
- Affiliations
- University of Leicester (GB)
- Amsterdam UMC Location Vrije Universiteit Amsterdam (NL)
- Corresponding author
- Perrin, N. E.
- Venue
- Diabetic Medicine
- Publisher
- Wiley
- Published
- 2017-08-31
- Volume
- 34
- Issue
- 11
- Pages
- 1508-1520
- ISSN
- 0742-3071 (ISSN-L)
- 1464-5491
- OpenAlex
- W2742497804
- Cited by
- 495
- References
- 54
- Citations by year
- 2026: 62 · 2025: 62 · 2024: 73 · 2023: 68 · 2022: 70 · 2021: 64 · 2020: 52 · 2019: 31 · 2018: 11 · 2017: 1 · 2013: 1
- FWCI
- 3.79
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Diabetic Medicine (publishedVersion)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Figshare (submittedVersion, cc-by)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (submittedVersion)
- Funders
- University Hospitals of Leicester NHS Trust
- National Institute for Health and Care Research
- University of Leicester
- Loughborough University
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Keywords
- diabetes distress, type 2 diabetes, prevalence, depression, psychological comorbidity, depressive symptoms, sex differences, female gender
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Depression, Diabetes Mellitus, Type 2, Humans, Middle Aged, Stress, Psychological, Prevalence, Young Adult
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