TOPLINE:

In African Americans with poorly controlled type 2 diabetes (T2D), having feelings of anger, defeat, and hopelessness related to their diabetes was associated with decreased mental health-related quality of life. Greater emotional distress was associated with higher A1c levels and poor physical and mental health outcomes.

METHODOLOGY:

• Diabetes fatalism is characterized by feelings of despair, hopelessness, and powerlessness about managing diabetes, and such beliefs may negatively affect both physical and mental well-being.
• This study assessed the effects of diabetes fatalism on clinical outcomes and quality of life using data from a year-long randomized controlled trial conducted across four sites in the Southeast United States, which included 200 African American adults (mean age, 56 years; 67% female) with poorly controlled T2D and average A1c levels of 10.
• Participants in the trial were randomly assigned either to receive education on diabetes and support over the phone along with a telehealth system and glucose test strips for daily testing or to a usual care group.
• Researchers measured A1c levels, blood pressure, and health-related quality of life at multiple timepoints.
• Diabetes fatalism was assessed using the 12-item Diabetes Fatalism Scale, which evaluates emotional distress, coping strategies, and perceived self-efficacy. Its emotional distress subscale assessed feelings of anger, frustration, and challenges related to diabetes.

TAKEAWAY:

• Higher total diabetes fatalism scores were significantly associated with lower mental summary scores for health-related quality of life over time (β = -0.10; P = .004).
• After adjusting, higher scores on the emotional distress subscale were linked to higher A1c levels (P = .02) and to reduced physical and mental health-related quality of life (P = .002 and P < .001, respectively).

IN PRACTICE:

“Screening for diabetes fatalism may help inform actions taken to support individuals with diabetes over time, and interventions aimed at addressing diabetes fatalism and emotional distress could potentially enhance glycemic management and quality of life in African Americans with diabetes,” the authors of the study wrote.

SOURCE:

This study was led by Sandra Iregbu, PhD, RN, School of Nursing, University of Wisconsin-Milwaukee. It was published online on October 30, 2025, in the Journal of General Internal Medicine.

LIMITATIONS:

The study’s findings may not be generalizable to other populations. The sample characteristics, such as low income and high rates of current smokers, may have influenced the outcomes. The study did not directly address diabetes fatalism.

DISCLOSURES:

The study was supported by grants from the National Institute of Diabetes and Digestive and Kidney Diseases and the National Institute on Minority Health and Health Disparities. The authors reported having no potential conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.