Peran Diabetes Distress Terhadap Self-Management, Kepatuhan Terapi, Dan Outcome Klinis Pada Pasien Diabetes Mellitus: Literatur Review

Diabetes mellitus (DM) is a chronic disease requiring long-term management and may impose a psychological burden known as diabetes distress. This condition is associated with self-management, treatment adherence, and clinical outcomes. This literature review aimed to synthesize evidence regarding the association of diabetes distress with three primary outcomes: self-management, treatment adherence, and clinical outcomes among people with DM. An integrative review was conducted using 12 research articles published between 2022 and 2024 and retrieved from Google Scholar, PubMed, and ScienceDirect. Articles were screened using predefined inclusion and exclusion criteria and narratively synthesized according to study design, measured constructs, outcomes, and major findings. The synthesis indicated that higher diabetes distress was generally associated with poorer self-management and lower treatment adherence. Several studies also reported associations with glycemic control and, in specific studies, clinical complications. Interventions such as Diabetes Self-Management Education (DSME) and cognitive behavior therapy were reported to reduce diabetes distress; evidence for improved treatment adherence and HbA1c should be distinguished from evidence for distress reduction. Overall, diabetes distress should be considered in diabetes management, while interpretation should account for study design and limitations of causal evidence.