Of the secondary variables , the Patient Health Questionnaire-9 ( 1.7 [ 95 % CI 0.2-3 .2 ] , P = 0.023 ) , Problem Areas in Diabetes scale ( 8.2 [ 95 % CI 3.1-13 .3 ] , P = 0.002 ) , and Diabetes Distress Scale scores ( 0.3 [ 95 % CI 0.1-0 .5 ] , P = 0.012 ) displayed significant treatment effects .