The Impact of Emotional Distress on Self-Management Among Patients With Type 2 Diabetes Mellitus in Hamadan City, Iran

Background: Diabetes-related emotional distress is increasingly recognized as a barrier to effective self-management in individuals with type 2 diabetes mellitus (T2DM). This study aimed to assess the impact of emotional distress on self-management among patients with T2DM. Methods: This cross-sectional study consisted of 250 patients with T2DM who attended the Endocrinology Specialty Clinic in Hamadan, western Iran, between 2023 and 2024. 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 reported engaging in self-care behaviors more frequently. The PAID-5 showed a positive correlation with the overall DSMQ score (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 highlight the importance of integrating routine psychological assessment and targeted interventions into 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.