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The Emotional Distress Substudy enrolled 1,739 GRADE participants (mean [SD] age 58.0 [10.2] years, 32% female, 56% non-Hispanic White, 18% non-Hispanic Black, 17% Hispanic) and assessed diabetes distress and depressive symptoms every 6 months. Analyses examined differences at 1 year and over the 3-year follow-up.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n Across treatments, diabetes distress (\u22120.24, P &lt; 0.0001) and depressive symptoms (\u22120.67, P &lt; 0.0001) decreased over 1 year. Diabetes distress was lower at 1 year for the glargine group than for the other groups combined (\u22120.10, P = 0.002). Diabetes distress was also lower for liraglutide than for glimepiride or sitagliptin (\u22120.10, P = 0.008). Over the 3-year follow-up, there were no significant group differences in total diabetes distress; interpersonal diabetes distress remained lower for those assigned to liraglutide. No significant differences were observed for depressive symptoms.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n Contrary to expectations, this randomized trial found no evidence for a deleterious effect of basal insulin on emotional distress. Glargine lowered diabetes distress modestly at 1 year rather than increasing it. Liraglutide also reduced diabetes distress at 1 year. Results can inform treatment decisions for adults with early T2DM.<\/jats:p>\n <\/jats:sec>","DOI":"10.2337\/dc23-2459","type":"journal-article","created":{"date-parts":[[2024,2,28]],"date-time":"2024-02-28T18:37:01Z","timestamp":1709145421000},"page":"610-619","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":14,"title":["Differential Effects of Type 2 Diabetes Treatment Regimens on Diabetes Distress and Depressive Symptoms in the Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness Study (GRADE)"],"prefix":"10.2337","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8252-2077","authenticated-orcid":false,"given":"Jeffrey S.","family":"Gonzalez","sequence":"first","affiliation":[{"name":"1Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY"},{"name":"2Division of Endocrinology and Fleischer Institute for Diabetes and Metabolism, Department of Medicine, Albert Einstein College 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