Psychological Burden in Diabetes: Understanding Distress and Its Clinical Impact

Ye-Fong DuTaiwan Speaker Psychological Burden in Diabetes: Understanding Distress and Its Clinical ImpactDiabetes distress represents the emotional burden arising from the daily demands of diabetes self-management and is conceptually distinct from major depressive disorder. Large-scale epidemiological studies indicate that 20–40% of people with diabetes experience clinically significant distress, making it one of the most prevalent psychological complications of diabetes. A growing body of longitudinal evidence demonstrates that diabetes distress is strongly associated with poor glycemic control, reduced treatment adherence, unhealthy dietary and physical activity patterns, and lower engagement with healthcare services. Importantly, diabetes distress predicts future deterioration in HbA1c independent of depressive symptoms, suggesting that it is a direct and modifiable determinant of metabolic outcomes rather than a mere emotional comorbidity. Interventional studies show that structured diabetes education, psychosocial counseling, and digital health–based self-management support can significantly reduce diabetes distress and are accompanied by improvements in glycemic control and self-efficacy. These findings highlight the bidirectional relationship between psychological burden and metabolic regulation. In the era of precision medicine and digital diabetes care, systematic screening and targeted management of diabetes distress should be integrated into routine clinical practice to optimize both psychological well-being and long-term cardiometabolic outcomes.