Diabetes Related Distress is the specific distress that arises from managing the demands of

diabetes. Despite the high prevalence of DRD in non-Western countries and ethnic minority

communities, there is a lack of understanding of the effectiveness of psychological

interventions in culturally diverse settings. Part one of this portfolio includes a systematic and

narrative synthesis to explore the impact of psychological interventions in culturally diverse

settings. We found that interventions targeting current distress (Cognitive behavioural

therapy, Motivational intervening and standalone Progressive muscle relaxation) reported

more consistent effects compared to third wave therapies. Several patterns emerged including

therapeutic modality, combining interventions with diabetes education/targeted adherence

and group delivery that may have contributed to the interventions’ effectiveness. Overall,

studies ranged from weak to moderate quality with significant heterogeneity across studies

limiting conclusions. Part two includes an empirical paper that utilised a cox regression

model to measure the combined effect of depressive symptoms/allostatic load on diabetes

incidence over a 14-year period. We found that moderate and high allostatic load with and

without depressive symptoms were associated with increased diabetes incidence.