Diabetes distress, the mediator of the poor glycemic control and depression: A meta-analysis

Core Tip

Core Tip: Literature on the effects of diabetes distress is scarce, the available meta-analyses focused on interventions to tackle diabetes (to improve glycemic control) distress instead of investigating the direct influence of diabetes distress on the same. However, the association of depression with glycemic control was touched before. However, this is the first meta-analysis to compare the effects of diabetes distress and depression on glycated hemoglobin (HbA1c). We found an association between diabetes distress, depression, and HbA1c with a higher impact of distress arm compared to depression. Due to the overlap between the symptoms of diabetes distress and depression, diabetes distress could mediate the association between depression and HbA1c. Although the reverse could be true, diabetes distress is commoner than depression. The current findings challenged the scientific community and recommended screening for both diabetes distress and depression among patients with diabetes mellitus and poor glycemic control. In addition, we suggested future studies using continuous glucose monitoring and ecological momentary assessment to evaluate the association of diabetes distress, depression, and glycemic control.