Pathways for the relationship between diabetes distress, depression, fatalism and glycemic control in adults with type 2 diabetes

Diabetes distress serves as a pathway through which depressive symptoms and fatalism impact both glycemic control and self-care. In addition, pathways between diabetes distress and both self-care behaviors and glycemic control in patients with type 2 diabetes remained separate, suggesting the need to address both psychological and behavioral factors in standard diabetes care, rather than focusing on psychological care primarily through support for self-management and treatment of depression.