Objective  To investigate the status of diabetes distress of type 2 diabetes patients and analyze its influencing factors.

  Methods  Demographic and sociological data as well as disease treatment related data were collected by questionnaire survey. The Ruminative Responses Scale (RRS), Connor-Davidson Resilience Scale (CD-RISC) and Diabetes Distress Scale (DDS) were used to assess patients′ruminative responses, mental resilience and diabetes distress status.

  Results  In 223 patients, 217 patients (97.3%) had mild diabetes distress, 5 patients (2.2%) had moderate distress, and 1 patient (0.4%) had severe distress. The DDS 4-dimension results by variance analysis showed that life-related distress was the highest, followed by emotional burden-related distress, and finally interpersonal relationship-related distress and doctor-related distress (P < 0.05). Univariate analyses showed that DDS scores were higher among patients aged over 70 years, with smoking and three kinds of comorbidities or more, hypoglycemia, fasting blood glucose≥10.0 mmol/L, high ruminative responses, and low mental resilience (P < 0.05). Multivariate Logistic regression analysis showed that smoking (P=0.048) and high ruminative responses (P=0.029) were independent influencing factors for patients with moderate to severe diabetes distress.

  Conclusion  Type 2 diabetes patients with diabetes distress have higher proportion of diabetes distress, and life-related distress is the highest, followed by emotional burden-related distress. Patients with diabetes distress are affected by many factors, especially smoking and ruminative responses.