The role of depression and diabetes distress in glycemic control: A meta-analysis.

AIMS: This study evaluated the associations between depression, diabetes distress, glycemic control (HbA1c), and self-care behaviours in individuals with diabetes. Findings on these relationships have been inconsistent, highlighting the need for systematic evaluation. METHODS: Data from 61 studies involving 19,537 participants conducted between 2001 and 2024 were analysed using random-effects models. Subgroup analyses examined variations by diabetes type, geographic location, and measurement tools. Heterogeneity was assessed using I2 statistics. RESULTS: Depression and diabetes distress were significantly associated with poorer glycemic control (r = 0.23, 95 % CI [0.15 to 0.31], p < 0.001) and reduced self-care behaviours (r = -0.19, 95 % CI [-0.28 to -0.10], p < 0.001). Stronger correlations were observed in mixed diabetes populations (r = 0.35, 95 % CI [0.30 to 0.40], I2 = 0 %) and in studies conducted in Europe (r = 0.28) and North America (r = 0.34). High heterogeneity (I2 = 97.24 %) was identified. CONCLUSIONS: Depression and diabetes distress are associated with poorer glycemic control and reduced self-care behaviours. Findings highlight the need for standardized measures and longitudinal studies to explore mechanisms underlying these associations.