© The Author(s) 2018. Background: Diabetes distress, also referred to as diabetes-related emotional distress, has been shown to contribute to worsening diabetes status over time as well as increased depressive symptoms. Other psychosocial factors, including perceived discrimination, are also related to poorer diabetes outcomes. This study explores the relationships between diabetes distress and several psychosocial variables relevant to health disparities (i.e., race, cognition, social support, physician trust, and perceived discrimination) among older adults with type 2 diabetes mellitus. Design and Method: Structured telephone interviews were conducted with 148 African American and White adults (age ≥65) with type 2 diabetes mellitus. Results: Perceived discrimination and physician trust partially explain the relationship between African American race and diabetes distress. Younger age, less satisfaction with social support, and lower physician trust were associated with higher levels of diabetes distress. Conclusion: These results highlight the need to address unique stressors, such as perceived discrimination, among racial/ethnic minorities to improve diabetes-related outcomes.