Aim This study aimed to analyze the association between emotional distress and glycated hemoglobin (HbA1c) values in adolescents and young adults with type 1 diabetes mellitus (T1DM), with respect to dental anxiety, microvascular diabetes chronic complications, demographic conditions. Method The cross‐sectional study design included 100 adolescents and young adults with T1DM, from regional diabetes reference center. The clinical and laboratory data were obtained from medical records. Distress and dental anxiety scales were produced from questionnaires that were validated for emotional distress (DDS) and dental anxiety (Corah Scale). Multiple analyses estimated odds ratios and their respective 95% confidence intervals using a binary logistic regression model (P < .05). Results The mean participants age was 20.7 ± 5.5 years, and 52% were female. Of the patients, 19% presented with chronic microvascular diabetes complications (nephropathy, retinopathy, neuropathy). Regarding the distress scale, 53% of the patients presented with high DDS and 83% had little to slight anxiety with dental procedures. There were statistically significant differences when variables were adjusted in the model, such as that of microvascular diabetes chronic complications and female gender with emotional distress. Conclusions Our results showed that female sex and microvascular diabetes chronic complications are associated with greater emotional distress in patients with T1DM.