Background <p>Coping with the diagnosis and treatment of type 2 diabetes can be very stressful and could lead to difficulty in emotion regulation and poor mental health. Mindfulness facilitates adaptive emotional experiences and promotes mental health. The current study aimed to investigate the relationship between mindfulness, emotion regulation difficulty and mental health outcomes.</p> Method <p>This cross-sectional study was carried out among 283 individuals living with type 2 diabetes selected from two tertiary healthcare institutions. They completed relevant self-report measures. Hayes PROCESS for SPSS was used for data analysis.</p> Results <p>Results showed that emotion regulation difficulties was associated with increased depressive symptoms, increased Negative Affect, lower Positive Affect and lower sense of meaning in life only among patients with low levels of mindfulness, but not among those with average and high levels of mindfulness. Additionally, emotion regulation difficulty was associated with decreased life satisfaction and wellbeing only among patients with low and average, but not among those with high levels of mindfulness.</p> Conclusion <p>These findings highlight the protective nature of mindfulness in alleviating difficulty with emotion regulation and promoting mental health in people living with type 2 diabetes. Interventions to enhance mindfulness may improve mental health among individuals with type 2 diabetes.</p>