Diabetes-Related Distress, Psychosocial Predictors, and Glycemic Control in Jordanian Adults: A Cross-Sectional Study

Background: Diabetes-related distress (DRD) represents a significant emotional burden for individuals living with diabetes mellitus; however, its relationship with glycemic control has received comparatively limited attention in clinical populations across the Middle East. The present study investigated the association between DRD and glycated hemoglobin (HbA1c), alongside the contributory roles of self-management adherence, social support, and self-efficacy. Methods: We conducted a cross-sectional study of 201 adults with diabetes. DRD was measured using a seven-item Likert scale (1-6), with higher scores indicating greater distress. We also assessed social support (seven items), self-efficacy (five items), and self-management adherence across six behavioral domains. Glycemic control was assessed by HbA1c, with a value below 7% considered adequate. Pearson correlations and multiple linear regression were used to analyze the data. Results: The mean HbA1c was 7.93 ± 2.01%; only 36.8% of participants reached adequate glycemic control. DRD was positively correlated with HbA1c (r = 0.344, p < 0.001), while self-management adherence (r = −0.313, p < 0.001), social support (r = −0.180, p = 0.011), and self-efficacy (r = −0.143, p = 0.043) were each inversely associated with it. Participants in the high DRD group had a mean HbA1c of 8.83%, compared with 7.15% in the low DRD group. The regression model explained 24.2% of the variance in HbA1c (R² = 0.242, adjusted R² = 0.219), with DRD emerging as the strongest positive predictor (β = 0.313) and self-management adherence as the strongest negative predictor (β = −0.295); diabetes duration also made a significant independent contribution (β = 0.208, p = 0.002). No significant gender difference in DRD was observed (p = 0.429). Conclusions: Diabetes-related distress was the strongest independent predictor of poor glycemic control, with self-management adherence and diabetes duration also making significant independent contributions. Social support and self-efficacy showed bivariate associations with HbA1c that were not sustained after multivariate adjustment, suggesting their effects operate indirectly through distress and self-management pathways rather than as direct glycemic predictors. These findings support integrating routine distress screening and multidisciplinary psychosocial care into outpatient diabetes management.