The purpose of this study was to validate the Brazilian version of the Problem Areas in Diabetes Scale (B-PAID) in a sample of outpatients with type 2 diabetes (DM2) and to identify the characteristics of individuals at high risk for emotional distress. A cross-sectional study was conducted in a sample of 146 patients randomly selected among those attending outpatient clinics at a University Hospital in Porto Alegre, Brazil. Information was collected regarding age, gender, known duration of diabetes, type of treatment and level of schooling, and a blood sample was taken to measure HbA1c. B-PAID was compared with the already validated Brazilian versions of Satisfaction with Life (SWL) and WHO Quality of Life-Brief (WHOQOL) Scales. One-hundred forty-six DM2 patients (48% males, 59.7+/-9 years, BMI: 29.7+/-5.2kg/m(2), mean duration: 8.63+/-8 years, HbA(1c): 7.2+/-1.7%) were included. There were significant correlations between B-PAID and SWL (r(p)=0.55, p<0.001) and WHOQOL (r(p)=-0.33, p<0.05) Scales. In a multiple regression analysis the B-PAID Scale was associated with younger age (p=0.006) and lower education level (p=0.05). In conclusion, B-PAID is a reliable, valid outcome measure for Brazilian DM2 patients and identifies patients at increased risk for emotional distress who should be prioritized in psychosocial intervention.