A new international review [1] estimates how common elevated diabetes distress is in T1D and what it is linked with
By Emmanuel Ekpor [2]
Living with type 1 diabetes (T1D) takes constant effort. Every day, people with T1D need to manage insulin, food, physical activity, glucose levels, and more. They fit these tasks around their studies, work, family and other parts of life. These daily demands take an emotional toll. This is known as diabetes distress. It can include feelings of worry, frustration, or being overwhelmed by the demands of diabetes. Most people with T1D experience some diabetes distress. For some, these feelings can become elevated and have a negative impact on daily life.
Diabetes distress is a common part of living with type 1 diabetes (T1D). But how many people experience elevated levels of distress? And what factors are associated with it? To find out, researchers reviewed studies across the world.
What did the study involve?
A multidisciplinary team of researchers, including the ACBRD’s Emmanuel Ekpor [2], undertook this research.
We searched for published studies up to April 2026. We included seventy-two studies involving 32,555 children, adolescents and adults with T1D. We looked at the prevalence of elevated diabetes distress and associated factors. The factors examined spanned clinical, behavioural, and psychological health outcomes.
What did the study show?
We found that 39% of people with T1D had elevated diabetes distress. Rates were higher among females than males.
People reporting higher diabetes distress tended to also report:
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- higher levels of anxiety symptoms, depressive symptoms and fear of hypoglycaemia (low glucose)
- lower confidence (self-efficacy) in their ability to manage their diabetes
- lower engagement in their diabetes self-management
- higher HbA1c levels
- lower quality of life
What does this mean for T1D care?
This review shows that elevated diabetes distress is common, affecting almost two in five people with T1D. Elevated diabetes distress may also affect how people manage their diabetes and their health overall.
But it is easy to miss if no one asks about it. The review supports routine checks for diabetes distress in T1D care. This is called for in the EASD guideline [3] on diabetes distress, which also states that a check must lead to talks about next steps and to support that fits the person’s needs.
Where can people find support and guidance?
For health professionals:
The following programs and resources, developed by the ACBRD, can help you identify and respond to the emotional needs of people with diabetes during consultations.
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- Diabetes Distress E-learning [4]
A brief online learning program that explains what diabetes distress is, why it matters, and how to identify and respond to it in routine care.
- Diabetes Distress E-learning [4]
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- LISTEN: Supporting emotional wellbeing in diabetes care [5]
An online course that helps health professionals support emotional wellbeing using the evidence-based LISTEN programme and Problem-Solving Therapy approaches.
- LISTEN: Supporting emotional wellbeing in diabetes care [5]
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- NDSS: Diabetes and emotional health practical guide [6]
This guide supports health professionals to identify, address and communicate about common emotional health problems during consultations with adults living with diabetes.
- NDSS: Diabetes and emotional health practical guide [6]
For adults living with diabetes:
The following NDSS Factsheets, developed by the ACBRD, can help you to better understand diabetes distress and where to seek support.
Reference:
Peprah Osei, E., Ekpor, E., Akyirem, S., Olanrewaju, F., Osei, G. Y., Kusi, V. B., Adawudu, E. A., Boahen, D. A., & Boakye, M. D. S. (2026). Global prevalence and correlates of diabetes distress in type 1 diabetes: A systematic review and meta-analysis. Diabetes research and clinical practice, 239, 113452.