Abstract
Background: Diabetes-related emotional distress is increasingly recognized as a barrier to effective self-management in individuals with type II diabetes mellitus (T2DM). The aim of this study was to assess the impact of emotional distress on self-management among patients with type II diabetes mellitus. Methods: In this cross-sectional study, 250 patients with type 2 diabetes who attended the Endocrinology Specialty Clinic in Hamadan, western Iran, between 2023 and 2024 were included. Participants completed validated Persian versions of the Problem Areas in Diabetes Scale (PAID-5) and the Diabetes Self-Management Questionnaire (DSMQ). Results: A total of 250 patients (mean age: 57.23 12.00, 51.60% female) were included in the analysis. Patients under 60 years and those with a high school education or diploma engaged in self-care behaviors more frequently. The PAID-5 showed a positive correlation with overall DSMQ (correlation coefficient = 0.22, p < 0.001)! glucose management (0.16, p = 0.01), dietary control (0.21, p < 0.001), physical activity (0.08, p = 0.21), and use of healthcare services (0.08, p = 0.22). Regression analysis indicated that after controlling for age and education, each one-unit increase in PAID-5 was associated with a 0.19-unit increase in the mean overall DSMQ score (β [95% CI] = 0.19 [0.06, 0.32], p = 0.005). Conclusion: These findings emphasize the importance of integrating routine psychological assessment and targeted interventions in diabetes care. Addressing emotional distress through education, psychological support, and skill development can enhance self-management and improve clinical outcomes for patients with T2DM in Iran and similar regions.