{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T22:47:50Z","timestamp":1793746070774,"version":"4.6.1"},"reference-count":38,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100031584","name":"Deutsches Zentrum f\u00fcr Diabetesforschung","doi-asserted-by":"publisher","award":["82DZD01102"],"award-info":[{"award-number":["82DZD01102"]}],"id":[{"id":"10.13039\/100031584","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100031584","name":"Deutsches Zentrum f\u00fcr Diabetesforschung","doi-asserted-by":"publisher","award":["82DZD11E03"],"award-info":[{"award-number":["82DZD11E03"]}],"id":[{"id":"10.13039\/100031584","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Otto-Friedrich-Universit\u00e4t Bamberg","id":[{"id":"https:\/\/ror.org\/01c1w6d29","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Diabetologia"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims\/hypothesis<\/jats:title>\n                    <jats:p>The aims were to: (1) analyse the day-to-day mechanisms through which daily diabetes-specific negative emotional experiences (burdens) accumulate and potentially affect emotional well-being; and (2) identify the specific triggers of these dynamics in people with type 1 and type 2 diabetes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data were derived from three prospective observational studies employing ecological momentary assessment for up to 17 days. Multilevel vector autoregression models were used to estimate within-person temporal networks of nine daily diabetes-specific burdens. Out-strength and in-strength indices quantified each variable\u2019s role as a trigger (i.e. influencing others) or receiver (i.e. being influenced by others). Individual network density was computed to characterise how strongly daily burdens predicted one another. Logistic regression models tested whether these dynamic features predicted questionnaire-assessed incidence and remission of elevated diabetes distress and depressive symptoms at follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 741 participants (50.1% with type 2 diabetes, 50.7% male, aged [mean \u00b1 SD] 50.4\u00b114.2 years, HbA\n                      <jats:sub>1c<\/jats:sub>\n                      [mean \u00b1 SD] 65\u00b118.6 mmol\/mol [8.1\u00b11.7%]), \u2018feelings of guilt\u2019 regarding suboptimal self-management emerged as the most significant trigger of other negative emotional experiences\/burdens. In type 1 diabetes, greater \u2018feelings of guilt\u2019 on one day were temporally associated with increased levels of \u2018feeling alone\u2019 (\u03b2=0.09,\n                      <jats:italic>p<\/jats:italic>\n                      &lt;0.001), \u2018feeling overwhelmed\u2019 (\u03b2=0.05,\n                      <jats:italic>p<\/jats:italic>\n                      =0.016), \u2018feeling restricted\u2019 (\u03b2=0.05,\n                      <jats:italic>p<\/jats:italic>\n                      =0.015) and \u2018feeling burdened by hyperglycaemia\u2019 (\u03b2=0.05,\n                      <jats:italic>p<\/jats:italic>\n                      =0.030) on the following day. In type 2 diabetes, \u2018feelings of guilt\u2019 functioned primarily as a receiver. Greater \u2018feelings of guilt\u2019 on one day were predicted by \u2018feeling alone\u2019 (\u03b2=\u22120.07,\n                      <jats:italic>p<\/jats:italic>\n                      =0.016) and \u2018feeling burdened by hypoglycaemia\u2019 (\u03b2=0.04,\n                      <jats:italic>p<\/jats:italic>\n                      =0.017) on the previous day. Higher individual network density predicted greater odds of incident elevated diabetes distress (OR 1.50,\n                      <jats:italic>p<\/jats:italic>\n                      =0.025) and depressive symptoms (OR 2.08,\n                      <jats:italic>p<\/jats:italic>\n                      &lt;0.001), with \u2018feelings of guilt\u2019 and \u2018feeling restricted\u2019 as the most relevant predictors.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions\/interpretation<\/jats:title>\n                    <jats:p>The results provide evidence of how daily diabetes-specific burdens can accumulate and potentially affect the course of emotional well-being. Feeling guilty regarding diabetes self-management may play a central role and represent an important clinical target as well as outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>ClinicalTrials.gov NCT03811132, NCT04438018, NCT05548699.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00125-026-06869-1","type":"journal-article","created":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T11:14:45Z","timestamp":1789989285000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Temporal dynamics of daily diabetes-specific burdens using intensive longitudinal data: the central role of feelings of guilt within a multilevel network analysis"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5794-5596","authenticated-orcid":false,"given":"Dominic","family":"Ehrmann","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2903-2677","authenticated-orcid":false,"given":"Norbert","family":"Hermanns","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5913-1457","authenticated-orcid":false,"given":"Andreas","family":"Schmitt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9484-3257","authenticated-orcid":false,"given":"Laura Y.","family":"Klinker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4030-5744","authenticated-orcid":false,"given":"Dominik","family":"Bergis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9120-4479","authenticated-orcid":false,"given":"Bernhard","family":"Kulzer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,21]]},"reference":[{"issue":"Supplement_1","key":"6869_CR1","doi-asserted-by":"publisher","first-page":"S89","DOI":"10.2337\/dc26-S005","volume":"49","author":"American Diabetes Association Professional Practice Committee for D","year":"2025","unstructured":"American Diabetes Association Professional Practice Committee for D (2025) 5. Facilitating positive health behaviors and well-being to improve health outcomes: standards of care in diabetes\u20142026. Diabetes Care 49(Supplement_1):S89\u2013S131. https:\/\/doi.org\/10.2337\/dc26-S005","journal-title":"Diabetes Care"},{"issue":"1","key":"6869_CR2","doi-asserted-by":"publisher","first-page":"e14628","DOI":"10.1111\/dme.14628","volume":"39","author":"CS Kelly","year":"2022","unstructured":"Kelly CS, Berg CA, Lee Tracy E, Staylor K, Thomas A, Helgeson VS (2022) Daily experiences of type 1 diabetes stress across adulthood. Diabet Med 39(1):e14628. https:\/\/doi.org\/10.1111\/dme.14628","journal-title":"Diabet Med"},{"issue":"2","key":"6869_CR3","doi-asserted-by":"publisher","first-page":"215","DOI":"10.1177\/0272989X12464824","volume":"33","author":"S Kamble","year":"2012","unstructured":"Kamble S, Weinfurt KP, Schulman KA, Reed SD (2012) Patient time costs associated with sensor-augmented insulin pump therapy for type 1 diabetes: results from the STAR 3 randomized trial. Med Decis Making 33(2):215\u2013224. https:\/\/doi.org\/10.1177\/0272989X12464824","journal-title":"Med Decis Making"},{"issue":"8","key":"6869_CR4","doi-asserted-by":"publisher","first-page":"970","DOI":"10.1111\/dme.13832","volume":"36","author":"A Icks","year":"2019","unstructured":"Icks A, Haastert B, Arend W et al (2019) Time spent on self-management by people with diabetes: results from the population-based KORA survey in Germany. Diabet Med 36(8):970\u2013981. https:\/\/doi.org\/10.1111\/dme.13832","journal-title":"Diabet Med"},{"issue":"4","key":"6869_CR5","doi-asserted-by":"publisher","first-page":"572","DOI":"10.1016\/j.jdiacomp.2015.01.012","volume":"29","author":"L Fisher","year":"2015","unstructured":"Fisher L, Polonsky WH, Hessler DM et al (2015) Understanding the sources of diabetes distress in adults with type 1 diabetes. J Diabetes Complications 29(4):572\u2013577. https:\/\/doi.org\/10.1016\/j.jdiacomp.2015.01.012","journal-title":"J Diabetes Complications"},{"issue":"4","key":"6869_CR6","doi-asserted-by":"publisher","first-page":"337","DOI":"10.1016\/S2213-8587(25)00397-3","volume":"14","author":"F Pouwer","year":"2026","unstructured":"Pouwer F, Ehrmann D, Strandberg RB et al (2026) Diabetes and mental health. Lancet Diabetes Endocrinol 14(4):337\u2013355. https:\/\/doi.org\/10.1016\/S2213-8587(25)00397-3","journal-title":"Lancet Diabetes Endocrinol"},{"issue":"6","key":"6869_CR7","doi-asserted-by":"publisher","first-page":"450","DOI":"10.1016\/S2213-8587(15)00135-7","volume":"3","author":"FJ Snoek","year":"2015","unstructured":"Snoek FJ, Bremmer MA, Hermanns N (2015) Constructs of depression and distress in diabetes: time for an appraisal. Lancet Diabetes Endocrinol 3(6):450\u2013460. https:\/\/doi.org\/10.1016\/S2213-8587(15)00135-7","journal-title":"Lancet Diabetes Endocrinol"},{"issue":"11","key":"6869_CR8","doi-asserted-by":"publisher","first-page":"2589","DOI":"10.2337\/dci21-0043","volume":"44","author":"RIG Holt","year":"2021","unstructured":"Holt RIG, DeVries JH, Hess-Fischl A et al (2021) The management of type 1 diabetes in adults. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care 44(11):2589\u20132625. https:\/\/doi.org\/10.2337\/dci21-0043","journal-title":"Diabetes Care"},{"issue":"3","key":"6869_CR9","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1055\/s-0033-1335785","volume":"8","author":"B Kulzer","year":"2013","unstructured":"Kulzer B, Albus C, Herpertz S et al (2013) Psychosoziales und Diabetes (Teil 1). S2-Leitlinie Psychosoziales und Diabetes - Langfassung. Diabetologie und Stoffwechsel 8(3):198\u2013242","journal-title":"Diabetologie und Stoffwechsel"},{"key":"6869_CR10","doi-asserted-by":"publisher","first-page":"379","DOI":"10.1146\/annurev-clinpsy-081423-022947","volume":"21","author":"EL Hamaker","year":"2025","unstructured":"Hamaker EL (2025) Analysis of intensive longitudinal data: putting psychological processes in perspective. Ann Rev Clin Psychol 21:379\u2013405. https:\/\/doi.org\/10.1146\/annurev-clinpsy-081423-022947","journal-title":"Ann Rev Clin Psychol"},{"key":"6869_CR11","doi-asserted-by":"publisher","unstructured":"Ehrmann D, Litterbach E, Deschenes S et al (2026) From narratives to numbers and back: assessing the psychosocial aspects of diabetes in the era of high technology with emerging qualitative and quantitative methodologies. Diabet Med e70206. https:\/\/doi.org\/10.1111\/dme.70206","DOI":"10.1111\/dme.70206"},{"key":"6869_CR12","doi-asserted-by":"publisher","first-page":"108745","DOI":"10.1016\/j.diabres.2021.108745","volume":"174","author":"S Nam","year":"2021","unstructured":"Nam S, Griggs S, Ash GI et al (2021) Ecological momentary assessment for health behaviors and contextual factors in persons with diabetes: a systematic review. Diabetes Res Clin Pract 174:108745. https:\/\/doi.org\/10.1016\/j.diabres.2021.108745","journal-title":"Diabetes Res Clin Pract"},{"issue":"8","key":"6869_CR13","doi-asserted-by":"publisher","first-page":"1453","DOI":"10.2337\/dc25-0559","volume":"48","author":"JS Gonzalez","year":"2025","unstructured":"Gonzalez JS, Hoogendoorn CJ, Hernandez R et al (2025) Diabetes-related distress and glycemic dysregulation in everyday life with type 1 diabetes: which comes first? Diabetes Care 48(8):1453\u20131460. https:\/\/doi.org\/10.2337\/dc25-0559","journal-title":"Diabetes Care"},{"issue":"1","key":"6869_CR14","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1111\/dom.15983","volume":"27","author":"N Hermanns","year":"2025","unstructured":"Hermanns N, Ehrmann D, Kulzer B, Klinker L, Haak T, Schmitt A (2025) Somatic and mental symptoms associated with dysglycaemia, diabetes-related complications and mental conditions in people with diabetes: assessments in daily life using continuous glucose monitoring and ecological momentary assessment. Diabetes Obes Metab 27(1):61\u201370. https:\/\/doi.org\/10.1111\/dom.15983","journal-title":"Diabetes Obes Metab"},{"issue":"7","key":"6869_CR15","doi-asserted-by":"publisher","first-page":"1522","DOI":"10.2337\/dc21-2339","volume":"45","author":"D Ehrmann","year":"2022","unstructured":"Ehrmann D, Schmitt A, Priesterroth L, Kulzer B, Haak T, Hermanns N (2022) Time with diabetes distress and glycemia-specific distress: new patient-reported outcome measures for the psychosocial burden of diabetes using ecological momentary assessment in an observational study. Diabetes Care 45(7):1522\u20131531. https:\/\/doi.org\/10.2337\/dc21-2339","journal-title":"Diabetes Care"},{"issue":"1","key":"6869_CR16","doi-asserted-by":"publisher","first-page":"195","DOI":"10.1177\/19322968211035451","volume":"17","author":"A Shapira","year":"2023","unstructured":"Shapira A, Volkening LK, Borus JS, Laffel LM (2023) Ecological momentary assessment of positive and negative affect and associations with blood glucose in teens with type 1 diabetes. J Diabetes Sci Technol 17(1):195\u2013200. https:\/\/doi.org\/10.1177\/19322968211035451","journal-title":"J Diabetes Sci Technol"},{"issue":"7","key":"6869_CR17","doi-asserted-by":"publisher","first-page":"1345","DOI":"10.2337\/dc22-2008","volume":"46","author":"EA Pyatak","year":"2023","unstructured":"Pyatak EA, Spruijt-Metz D, Schneider S et al (2023) Impact of overnight glucose on next-day functioning in adults with type 1 diabetes: an exploratory intensive longitudinal study. Diabetes Care 46(7):1345\u20131353. https:\/\/doi.org\/10.2337\/dc22-2008","journal-title":"Diabetes Care"},{"issue":"10","key":"6869_CR18","doi-asserted-by":"publisher","first-page":"2160","DOI":"10.1007\/s00125-024-06233-1","volume":"67","author":"U S\u00f8holm","year":"2024","unstructured":"S\u00f8holm U, Broadley M, Zaremba N et al (2024) The impact of hypoglycaemia on daily functioning among adults with diabetes: a prospective observational study using the Hypo-METRICS app. Diabetologia 67(10):2160\u20132174. https:\/\/doi.org\/10.1007\/s00125-024-06233-1","journal-title":"Diabetologia"},{"issue":"11","key":"6869_CR19","doi-asserted-by":"publisher","first-page":"2433","DOI":"10.1007\/s00125-024-06239-9","volume":"67","author":"D Ehrmann","year":"2024","unstructured":"Ehrmann D, Hermanns N, Schmitt A, Klinker L, Haak T, Kulzer B (2024) Perceived glucose levels matter more than CGM-based data in predicting diabetes distress in type 1 or type 2 diabetes: a precision mental health approach using n-of-1 analyses. Diabetologia 67(11):2433\u20132445. https:\/\/doi.org\/10.1007\/s00125-024-06239-9","journal-title":"Diabetologia"},{"issue":"8","key":"6869_CR20","doi-asserted-by":"publisher","first-page":"1044","DOI":"10.1037\/abn0000311","volume":"126","author":"AJ Fisher","year":"2017","unstructured":"Fisher AJ, Reeves JW, Lawyer G, Medaglia JD, Rubel JA (2017) Exploring the idiographic dynamics of mood and anxiety via network analysis. J Abnorm Psychol 126(8):1044\u20131056. https:\/\/doi.org\/10.1037\/abn0000311","journal-title":"J Abnorm Psychol"},{"key":"6869_CR21","doi-asserted-by":"publisher","first-page":"e70269","DOI":"10.1111\/dme.70269","volume":"43","author":"AM McInerney","year":"2026","unstructured":"McInerney AM, Schmitz N, Matthews M, Desch\u00eanes SS (2026) The impact of sleep and movement behaviour on daily mood in people with type 2 diabetes: a smartphone-based digital phenotyping study. Diabet Med 43:e70269. https:\/\/doi.org\/10.1111\/dme.70269","journal-title":"Diabet Med"},{"issue":"6","key":"6869_CR22","doi-asserted-by":"publisher","first-page":"754","DOI":"10.2337\/diacare.18.6.754","volume":"18","author":"WH Polonsky","year":"1995","unstructured":"Polonsky WH, Anderson BJ, Lohrer PA et al (1995) Assessment of diabetes-related distress. Diabetes Care 18(6):754\u2013760. https:\/\/doi.org\/10.2337\/diacare.18.6.754","journal-title":"Diabetes Care"},{"issue":"3","key":"6869_CR23","doi-asserted-by":"publisher","first-page":"469","DOI":"10.1007\/s00125-005-0094-2","volume":"49","author":"N Hermanns","year":"2006","unstructured":"Hermanns N, Kulzer B, Krichbaum M, Kubiak T, Haak T (2006) How to screen for depression and emotional problems in patients with diabetes: comparison of screening characteristics of depression questionnaires, measurement of diabetes-specific emotional problems and standard clinical assessment. Diabetologia 49(3):469\u2013477. https:\/\/doi.org\/10.1007\/s00125-005-0094-2","journal-title":"Diabetologia"},{"issue":"9","key":"6869_CR24","doi-asserted-by":"publisher","first-page":"606","DOI":"10.1046\/j.1525-1497.2001.016009606.x","volume":"16","author":"K Kroenke","year":"2001","unstructured":"Kroenke K, Spitzer RL, Williams JB (2001) The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med 16(9):606\u2013613. https:\/\/doi.org\/10.1046\/j.1525-1497.2001.016009606.x","journal-title":"J Gen Intern Med"},{"issue":"8","key":"6869_CR25","doi-asserted-by":"publisher","first-page":"1368","DOI":"10.1017\/S0033291719001314","volume":"50","author":"Y Wu","year":"2020","unstructured":"Wu Y, Levis B, Riehm KE et al (2020) Equivalency of the diagnostic accuracy of the PHQ-8 and PHQ-9: a systematic review and individual participant data meta-analysis. Psychol Med 50(8):1368\u20131380. https:\/\/doi.org\/10.1017\/S0033291719001314","journal-title":"Psychol Med"},{"key":"6869_CR26","doi-asserted-by":"publisher","unstructured":"Margraf J, Cwik JC (2018) Mini-DIPS Open Access: Diagnostisches Kurzinterview bei psychischen St\u00f6rungen. Forschungs- und Behandlungszentrum f\u00fcr psychische Gesundheit, Ruhr-Universit\u00e4t Bochum, Bochum. https:\/\/doi.org\/10.13154\/rub.102.91","DOI":"10.13154\/rub.102.91"},{"issue":"1","key":"6869_CR27","doi-asserted-by":"publisher","first-page":"195","DOI":"10.3758\/s13428-017-0862-1","volume":"50","author":"S Epskamp","year":"2018","unstructured":"Epskamp S, Borsboom D, Fried EI (2018) Estimating psychological networks and their accuracy: a tutorial paper. Behav Res Methods 50(1):195\u2013212. https:\/\/doi.org\/10.3758\/s13428-017-0862-1","journal-title":"Behav Res Methods"},{"issue":"4","key":"6869_CR28","doi-asserted-by":"publisher","first-page":"453","DOI":"10.1080\/00273171.2018.1454823","volume":"53","author":"S Epskamp","year":"2018","unstructured":"Epskamp S, Waldorp LJ, M\u00f5ttus R, Borsboom D (2018) The Gaussian graphical model in cross-sectional and time-series data. Multivariate Behav Res 53(4):453\u2013480. https:\/\/doi.org\/10.1080\/00273171.2018.1454823","journal-title":"Multivariate Behav Res"},{"key":"6869_CR29","doi-asserted-by":"publisher","first-page":"1492","DOI":"10.3389\/fpsyg.2014.01492","volume":"5","author":"EL Hamaker","year":"2015","unstructured":"Hamaker EL, Grasman RPPP (2015) To center or not to center? Investigating inertia with a multilevel autoregressive model. Front Psychol 5:1492. https:\/\/doi.org\/10.3389\/fpsyg.2014.01492","journal-title":"Front Psychol"},{"issue":"9","key":"6869_CR30","doi-asserted-by":"publisher","first-page":"1591","DOI":"10.1002\/jclp.22957","volume":"76","author":"DG Jordan","year":"2020","unstructured":"Jordan DG, Winer ES, Salem T (2020) The current status of temporal network analysis for clinical science: considerations as the paradigm shifts? J Clin Psychol 76(9):1591\u20131612. https:\/\/doi.org\/10.1002\/jclp.22957","journal-title":"J Clin Psychol"},{"key":"6869_CR31","doi-asserted-by":"publisher","first-page":"113160","DOI":"10.1016\/j.diabres.2026.113160","volume":"233","author":"S Passanisi","year":"2026","unstructured":"Passanisi S, Bombaci B, Longo A, Alibrandi A, Salzano G, Lombardo F (2026) The psychological impact of time in tight range in adolescents with type 1 diabetes: insights from real-life clinical practice. Diabetes Res Clin Pract 233:113160. https:\/\/doi.org\/10.1016\/j.diabres.2026.113160","journal-title":"Diabetes Res Clin Pract"},{"issue":"12","key":"6869_CR32","doi-asserted-by":"publisher","first-page":"e15423","DOI":"10.1111\/dme.15423","volume":"41","author":"ML Tanenbaum","year":"2024","unstructured":"Tanenbaum ML, Pang E, Tam R et al (2024) \u201cWe\u2019re taught green is good\u201d: perspectives on time in range and time in tight range from youth with type 1 diabetes, and parents of youth with type 1 diabetes. Diabet Med 41(12):e15423. https:\/\/doi.org\/10.1111\/dme.15423","journal-title":"Diabet Med"},{"issue":"1","key":"6869_CR33","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1016\/S2213-8587(23)00347-9","volume":"12","author":"J Speight","year":"2024","unstructured":"Speight J, Holmes-Truscott E, Garza M et al (2024) Bringing an end to diabetes stigma and discrimination: an international consensus statement on evidence and recommendations. Lancet Diabetes Endocrinol 12(1):61\u201382. https:\/\/doi.org\/10.1016\/S2213-8587(23)00347-9","journal-title":"Lancet Diabetes Endocrinol"},{"issue":"2","key":"6869_CR34","doi-asserted-by":"publisher","first-page":"216","DOI":"10.2337\/ds21-0062","volume":"35","author":"E Solomon","year":"2022","unstructured":"Solomon E, Salcedo VJ, Reed MK, Brecher A, Armstrong EM, Rising KL (2022) \u2018I\u2019m going to be good to me\u2019: exploring the role of shame and guilt in patients with type 2 diabetes. Diabetes Spectrum 35(2):216\u2013222. https:\/\/doi.org\/10.2337\/ds21-0062","journal-title":"Diabetes Spectrum"},{"issue":"11","key":"6869_CR35","doi-asserted-by":"publisher","first-page":"1353","DOI":"10.1007\/s00127-017-1436-3","volume":"52","author":"E Asselmann","year":"2017","unstructured":"Asselmann E, Wittchen HU, Lieb R, Beesdo-Baum K (2017) A 10-year prospective-longitudinal study of daily hassles and incident psychopathology among adolescents and young adults: interactions with gender, perceived coping efficacy, and negative life events. Soc Psychiatry Psychiatr Epidemiol 52(11):1353\u20131362. https:\/\/doi.org\/10.1007\/s00127-017-1436-3","journal-title":"Soc Psychiatry Psychiatr Epidemiol"},{"issue":"S1","key":"6869_CR36","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1111\/bjc.12295","volume":"61","author":"KE Shin","year":"2022","unstructured":"Shin KE, Newman MG, Jacobson NC (2022) Emotion network density is a potential clinical marker for anxiety and depression: comparison of ecological momentary assessment and daily diary. Br J Clin Psychol 61(S1):31\u201350. https:\/\/doi.org\/10.1111\/bjc.12295","journal-title":"Br J Clin Psychol"},{"issue":"12","key":"6869_CR37","doi-asserted-by":"publisher","first-page":"2182","DOI":"10.2337\/dc16-1657","volume":"39","author":"JS Gonzalez","year":"2016","unstructured":"Gonzalez JS, Kane NS, Binko DH, Shapira A, Hoogendoorn CJ (2016) Tangled up in blue: unraveling the links between emotional distress and treatment adherence in type 2 diabetes. Diabetes Care 39(12):2182\u20132189. https:\/\/doi.org\/10.2337\/dc16-1657","journal-title":"Diabetes Care"},{"issue":"5","key":"6869_CR38","doi-asserted-by":"publisher","first-page":"1205","DOI":"10.1007\/s00125-026-06666-w","volume":"69","author":"G Lehmann","year":"2026","unstructured":"Lehmann G, Ehrmann D, Olesen B et al (2026) Uncovering distinct predictors of diabetes distress and depressive symptoms in a longitudinal survival analysis of incidence and remission: indication for diverging aetiological paths. Diabetologia 69(5):1205\u20131215. https:\/\/doi.org\/10.1007\/s00125-026-06666-w","journal-title":"Diabetologia"}],"container-title":["Diabetologia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00125-026-06869-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00125-026-06869-1","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00125-026-06869-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T11:14:47Z","timestamp":1789989287000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00125-026-06869-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,21]]},"references-count":38,"alternative-id":["6869"],"URL":"https:\/\/doi.org\/10.1007\/s00125-026-06869-1","relation":{},"ISSN":["0012-186X","1432-0428"],"issn-type":[{"value":"0012-186X","type":"print"},{"value":"1432-0428","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,21]]},"assertion":[{"value":"31 March 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 July 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 September 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"We thank I. Hartung Rapp, J. Gutwein and M. Haberzettl (all of the University of W\u00fcrzburg, W\u00fcrzburg, Germany) for their invaluable contribution in conducting the clinical interviews. We also thank C. Vogel and R. Pryss (both University of Wuerzburg) for developing the pro-mental EMA app and their continuing support.","order":1,"name":"Ethics","label":"Acknowledgements","group":{"name":"EthicsHeading","label":"Ethics"}},{"value":"Open Access funding enabled and organized by Projekt DEAL. The DIA-LINK1 and DIA-LINK2 studies were supported by the German Center for Diabetes Research (DZD) under grant number 82DZD01102. The PRO-MENTAL study was supported by the DZD under grant number 82DZD11E03. The sponsor played no role in study design, data collection, analysis, interpretation of data or the writing of the report, or in the decision to submit the paper for publication.","order":2,"name":"Ethics","label":"Funding","group":{"name":"EthicsHeading","label":"Ethics"}},{"value":"The authors declare that there are no relationships or activities that might bias, or be perceived to bias, their work.","order":3,"name":"Ethics","label":"Authors\u2019 relationships and activities","group":{"name":"EthicsHeading","label":"Ethics"}},{"value":"DE analysed the data and wrote the initial draft of the manuscript. All authors contributed to the discussion and revised the manuscript for important intellectual content. AS and LYK collected the data. DE, AS, LYK, BK and NH designed the study. DB contributed to the interpretation of data. All authors approved the final version of the manuscript. DE and NH are the guarantors of this work and, as such, had full access to all of the data and take responsibility for the integrity and the accuracy of the data.","order":4,"name":"Ethics","label":"Contribution statement","group":{"name":"EthicsHeading","label":"Ethics"}}]}}