Female gender was associated with increased risk of diabetes distress after adjustment for potential confounding factors such as age, insulin use, HbA1c, smoking status, interpreter use, medication adherence, diet difficulty, physical activity, glucose monitoring, likely depression, use of antidepressant medications or counselling and own health rating [1.59 (1.11–2.27), p = 0.012]. The gene discussed is INS; the disease is major depressive disorder.