J Diabetes Metab Disord. 2026 Feb 24;25(1):78. doi: 10.1007/s40200-026-01898-4. eCollection 2026 Jun.
ABSTRACT
PURPOSE: Diabetes distress (DD) represents significant emotional burden that hinders self-management in individuals with Type 2 Diabetes Mellitus (T2DM). In Pakistan, where T2DM is rapidly increasing, evidence on the magnitude and determinants of DD remains limited and fragmented. This systematic review aimed to estimate the pooled prevalence of DD and identify its associated factors among adults with T2DM in Pakistan.
METHODS: Seven electronic databases: PubMed, EMBASE, Scopus, Web of Science, PsycInfo, PakMediNet, and Google Scholar were systematically searched. Studies reporting DD prevalence using validated tools such as Diabetes Distress Scale (DDS) or Problem Areas in Diabetes (PAID) were included. Two reviewers independently extracted data and appraised quality using the Joanna Briggs Institute checklist. A random-effects model estimated pooled prevalence, with heterogeneity assessed using I² and Q statistics.
RESULTS: Seven studies, published between 2013 and 2024, involving 1560 adults with T2DM were included. The pooled prevalence of DD was 66.8% (95% CI: 52.3%-79.8%), with substantial heterogeneity (I² = 96.96%), likely due to variations in the study settings and sample characteristics. Funnel plot showed slight asymmetry; however, Egger’s test (p = 0.21) and trim-and-fill analysis indicated no publication bias. Narrative synthesis highlighted key factors, including suboptimal glycemic control, longer disease duration, complications, female gender, low education, low income, limited social support, low self-efficacy and inadequate self-care.
CONCLUSION: About two-thirds of adults with T2DM in Pakistan experience DD, influenced by clinical, psychosocial, and behavioral factors. Integrating psychosocial screening, culturally tailored education, and support into T2DM care can enhance emotional well-being and adherence..
PMID:41757382 | PMC:PMC12932764 | DOI:10.1007/s40200-026-01898-4
