Psychological distress often occurs in patients with diabetes, resulting in poorer therapeutic outcomes. The Problem Areas in Diabetes (PAID) questionnaire covers frequently reported diabetes related emotional problems. Utilizing PAID to identify distressed diabetic patients would be beneficial. OBJECTIVES: PAID was originally developed for the American population. Cross-cultural differences in health perceptions are well documented; thus it is necessary to verify the validity and reliability of PAID in Singapore. Design: Cross-sectional study. PARTICIPANTS: Patients with Type 2 diabetes, 21-65 years old, English-speaking, without obvious cognitive impairment and visited the Diabetes Clinic at National University Hospital. METHODS: Validity of the scale was evaluated by factor analysis, known group (defined by socio-demographics and clinical variables), convergent/divergent and concurrent validity. Reliability (internal consistency) was evaluated by Cronbach’s alpha. RESULTS: Exploratory factor analysis revealed three factors. All items loaded onto one factor (distress related problems). A few items loaded onto multiple factors. PAID scores were significantly higher in patients with HbA1c 7.5% (p=0.02) and living in HDB 5-room or smaller flats (p=0.01), supporting known group validity. Other hypothesized known group differences were not observed. PAID correlated significantly with Kessler10 (K10) and World Health Organization Quality of Life (WHOQOL-BREF), thus demonstrating convergent and concurrent validity. PAID correlated weakly with WHOQOL-BREF’s physical domain, thus demonstrating divergent validity.  Internal consistency was high (Cronbach’s alpha=0.96). CONCLUSIONS: PAID is a valid and reliable scale to evaluate diabetes-related emotional distress in the Singaporean Type 2 diabetes population. Further evidence on known group validity needs to be accumulated in future studies.