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38 Jazan, Saudi Arabia (22.3%) 15 and Thailand (8.9%). 34 The higher prevalence in the present study could be due to poor quality of diabetes care service, lower level of education, the measurement tool used to quantify the level of diabetic distress, and other forms of stressors. Several studies among diabetic patients had found higher prevalence of DRD than the present study. Studies that were done in Bangladesh 13 using the DDS-17 scale showed that almost half of patients with T2DM had DRD. Studies in Ghana 19 reported that 44.7% and 51.9% of patients had high levels of DRD, respectively. This discrepancy between the previously reported DRD magnitude and the current prevalence might result from better family and social support implemented in our societies and patients might have under-rated their level of distress. The difference might also be due to variation in coexisting medical problems besides diabetes among study participants. A number of studies have ....