There was a relationship between diabetes distress and economic status (PR=2.3; 95% CI: 1.3 - 4.1; p <0.01), the severity of diabetes (PR=2.7; 95% CI: 1.8 - 4.1; p <0.001), and treatment method (PR=1.7; 95% CI: 1.2 - 2.3; p <0.01).