The DOI matches its Crossref record; 23 of the 23 references it cites were found in a registry or an index.
The Impact of Continuous Glucose Monitoring on Markers of Quality of Life in Adults With Type 1 Diabetes: Further Findings From the DIAMOND Randomized Clinical Trial
Abstract
OBJECTIVE Continuous glucose monitoring (CGM) improves glycemic control, but data are inconclusive about its influence on quality of life (QOL). We investigated the impact of 24 weeks of CGM use on QOL in adults with type 1 diabetes (T1D) who use multiple daily insulin injections. RESEARCH DESIGN AND METHODS DIAMOND (Multiple Daily Injections and Continuous Glucose Monitoring in Diabetes) was a prospective randomized trial that assessed CGM versus self-monitoring of blood glucose (SMBG) only in 158 adults with poorly controlled T1D. At baseline and study end, participants completed QOL measures that assessed overall well-being (WHO-5), health status (EQ-5D-5L), diabetes distress (DDS), hypoglycemic fear (worry subscale of the HFS-II), and hypoglycemic confidence (HCS). At study end, CGM participants completed the CGM Satisfaction Survey. Linear regression analyses compared treatment group changes in QOL outcomes over time. Associations between CGM satisfaction and change in QOL outcomes and in glycemic control indices were assessed. RESULTS The CGM group demonstrated a greater increase in hypoglycemic confidence (P = 0.01) and a greater decrease in diabetes distress (P = 0.01) than the SMBG group. No significant group differences in well-being, health status, or hypoglycemic fear were observed. CGM satisfaction was not significantly associated with glycemic changes but was associated with reductions in diabetes distress (P < 0.001) and hypoglycemic fear (P = 0.02) and increases in hypoglycemic confidence (P < 0.001) and well-being (P = 0.01). CONCLUSIONS CGM contributes to significant improvement in diabetes-specific QOL (i.e., diabetes distress, hypoglycemic confidence) in adults with T1D, but not with QOL measures not specific to diabetes (i.e., well-being, health status). CGM satisfaction was associated with most of the QOL outcomes but not with glycemic outcomes.
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“Numerous studies have demonstrated significant clinical benefits of CGM use in people with diabetes regardless of insulin delivery method (1-15).”
From Clinical Targets for Continuous Glucose Monitoring Data Interpretation: Recommendations From the International Consensus on Time in Range (2019) · cites this paper as [5]
In the citing paper
“Integration of continuous glucose monitoring (CGM) into the treatment plan soon after diagnosis improves glycemic outcomes, decreases hypoglycemic events, and improves quality of life for individuals with type 1 diabetes (18-23).”
From 9. Pharmacologic Approaches to Glycemic Treatment: Standards of Care in Diabetes—2025 (2025) · cites this paper as [23]
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BackgroundLayered Meta-Learning Algorithm for Predicting Adverse Events in Type 1 Diabetes
D’Antoni, F., Petrosino, L., Marchetti, A., Bacco, L., Pieralice, S., Vollero, L., Pozzilli, P., Piemonte, V., & Merone, M. (2023) · IEEE Access · doi:10.1109/access.2023.3237992 · Cited by 21
“The quality of life of people with diabetes improves considerably by preventing the blood glucose levels from exceeding the euglycemic range [11], [12].”
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McGill, D. E., Volkening, L. K., Butler, D. A., Harrington, K. R., Katz, M. L., & Laffel, L. M. (2018) · Diabetes Technology & Therapeutics · doi:10.1089/dia.2018.0037 · Cited by 21
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“Nevertheless, randomized controlled trials (RCTs) have delivered mixed results about impact of rtCGM on quality of life [4,6,14] and other patient-reported outcomes such as fear of hypoglycemia or hypoglycemia awareness [5,9,15,16].”
BackgroundMethodInfluentialAli, N., Hamdaoui, S. E., Nefs, G., Schmidt, J. W. J. W., Tack, C. J., & de Galan, B. E. (2023) · Diabetic Medicine · doi:10.1111/dme.15167 · Cited by 18
Continuous Glucose Monitoring: A Transformative Approach to the Detection of Prediabetes
Liu, X., & Zhang, J. (2024) · Journal of Multidisciplinary Healthcare · doi:10.2147/jmdh.s493128 · Cited by 18
“28 This direct connection between actions and consequences fosters stronger internal motivation to adhere to recommended lifestyle modifications, including dietary adjustments and increased physical activity.”
Automated Insulin Delivery: Easy Enough to Use in Primary Care?
HEILE, M. K., Hollstegge, B., Broxterman, L., Cai, A., & Close, K. L. (2020) · Clinical Diabetes · doi:10.2337/cd20-0050 · Cited by 19
Lorenzen, J. T., Madsen, K. P., Cleal, B. R., Joensen, L. E., Nørgaard, K., Pedersen‐Bjergaard, U., Schmidt, S., Rytter, K., & Willaing, I. (2024) · BMJ Open · doi:10.1136/bmjopen-2023-080053 · Cited by 19
Alshannaq, H. A., Isitt, J. J., Pollock, R. F., Norman, G. J., Cogswell, G., Lynch, P. M., & Roze, S. (2023) · Journal of Comparative Effectiveness Research · doi:10.57264/cer-2023-0075 · Cited by 19
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Nefs, G., Bazelmans, E., Marsman, D. E., Snellen, N., Tack, C. J., & de Galan, B. E. (2019) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2019.107910 · Cited by 17
Xu, Y., Xu, L., Zhao, W., Li, Q., Li, M., Lu, W., Zeng, H., Yan, J., Yang, D., Wu, W., et al. (2021) · Diabetes Metabolic Syndrome and Obesity · doi:10.2147/dmso.s299070 · Cited by 17
“A previous study showed that CGM could positively influence glucose control and help adolescent patients with T1D to enhance their quality of life.(23) DQOL domains usually refer to treatment satisfaction, family relationships, self-efficacy, lifestyle flexibility, anxiety, fear of glucose fluctuations, fear of diabet…”
BackgroundThomas, M. G., Avari, P., Godsland, I. F., Lett, A. M., Reddy, M., & Oliver, N. S. (2021) · Diabetes Obesity and Metabolism · doi:10.1111/dom.14498 · Cited by 21
“This review did not include any participant reported outcomes and, as such, only provides a picture of changes to glycaemia and may not be representative of QOL.”
MethodInfluentialAuzanneau, M., Eckert, A. J., Meyhöfer, S. M., Heni, M., Gillessen, A., Schwettmann, L., Jehle, P. M., Hummel, M., & Holl, R. W. (2023) · Frontiers in Endocrinology · doi:10.3389/fendo.2023.1191138 · Cited by 16
The Performance of Continuous Glucose Monitoring During the Intraoperative Period: A Scoping Review
Lim, H. A., Kim, M.-J., Kim, N. J., Huh, J., Jeong, J.-O., Hwang, W., & Choi, H. (2024) · Journal of Clinical Medicine · doi:10.3390/jcm13206169 · Cited by 16
van Beers, C. A. J., de Wit, M., Kleijer, S. J., Geelhoed-Duijvestijn, P. H. L. M., DeVries, J. H., Kramer, M. H. H., Diamant, M., Serné, E. H., & Snoek, F. J. (2017) · Diabetes Technology & Therapeutics · doi:10.1089/dia.2017.0141 · Cited by 15
Tanenbaum, M. L., Ngo, J., Hanes, S. J., Basina, M., Buckingham, B. A., Hessler, D., Maahs, D. M., Mulvaney, S. A., & Hood, K. K. (2021) · Diabetes Technology & Therapeutics · doi:10.1089/dia.2021.0198 · Cited by 17
Hochfellner, D. A., Simic, A., Taucher, M. T., Sailer, L. S., Kopanz, J., Pöttler, T., & Mader, J. K. (2022) · Biosensors · doi:10.3390/bios12020106 · Cited by 15
Discordance between postprandial plasma glucose measurement and continuous glucose monitoring
Barua, S., Wierzchowska-McNew, R. A., Deutz, N. E. P., & Sabharwal, A. (2022) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/nqac181 · Cited by 16
Twigg, S. M., Lim, S. K., Yoo, S.-H., Chen, L., Bao, Y., Kong, A. P. S., Yeoh, E. C. K., Chan, S. P., Robles, J., Mohan, V., et al. (2023) · Journal of Diabetes Science and Technology · doi:10.1177/19322968231176533 · Cited by 15
Grancini, V., Alicandro, G., Porcaro, L., Zazzeron, L., Gramegna, A., Morlacchi, L. C., Rossetti, V., Gaglio, A., Resi, V., Daccò, V., et al. (2023) · Frontiers in Endocrinology · doi:10.3389/fendo.2023.1228153 · Cited by 15
Patient‐reported outcomes in studies of diabetes technology: What matters
Liarakos, A. L., Crabtree, T. S. J., & Wilmot, E. G. (2024) · Diabetes Obesity and Metabolism · doi:10.1111/dom.15858 · Cited by 16
Roze, S., Isitt, J. J., Smith-Palmer, J., & Lynch, P. (2021) · ClinicoEconomics and Outcomes Research · doi:10.2147/ceor.s304395 · Cited by 15
“90 was assumed, based on findings of the DIAMOND trial.(12) Disutilities associated with long-term diabetesrelated complications and hypoglycemic events were sourced from the literature (Table 2).”
BackgroundMethodInfluentialThe Role of Glucagon in Glycemic Variability in Type 1 Diabetes: A Narrative Review
Guo, K., Tian, Q., Yang, L., & Zhou, Z. (2021) · Diabetes Metabolic Syndrome and Obesity · doi:10.2147/dmso.s343514 · Cited by 19
Polonsky, W. H., Fisher, L., Hessler, D., Liu, J., Fan, L., & McAuliffe‐Fogarty, A. H. (2020) · Journal of Diabetes and its Complications · doi:10.1016/j.jdiacomp.2020.107606 · Cited by 15
“, contributing to a greater sense of safety) and reduce avoidance behaviors, while not necessarily alleviating anxiety.(13,14) Building on the work of Gonder-Frederick and her colleagues in the development of the HFS and HFS-II,(3,4) the first subscale of the HABS (Anxiety) was originally developed to capture signific…”
Charleer, S., Gillard, P., Vandoorne, E., Cammaerts, K., Mathieu, C., & Casteels, K. (2020) · Pediatric Diabetes · doi:10.1111/pedi.13128 · Cited by 14
Benioudakis, E. S., Karlafti, E., Kalaitzaki, A. E., Kaiafa, G. D., Savopoulos, C. G., & Didangelos, T. (2021) · Current Diabetes Reviews · doi:10.2174/1573399818666211103163208 · Cited by 17
Reducing the Cost of Diabetes Care with Telemedicine, Smartphone, and Home Monitoring
Kesavadev, J., & Mohan, V. (2023) · Journal of the Indian Institute of Science · doi:10.1007/s41745-023-00363-y · Cited by 14
“The use of these systems has also significantly improved glycemic control, treatment adherence, and quality of life 35 , 36 .”
BackgroundFranceschi, R., Pertile, R., Marigliano, M., Mozzillo, E., Maffeis, C., Morotti, E., Candia, F. D., Fedi, L., Iafusco, D., Zanfardino, A., et al. (2024) · Diabetic Medicine · doi:10.1111/dme.15307 · Cited by 14
“These findings are consistent with studies indicating improvements in youth and parent QoL after CGM use, 5,7,8 but different from previous research reporting satisfaction in using CGM but no significant changes in overall TABLE 2 KINDL and CGM-SAT scores in young people with diabetes and their…”
ResultPersonalized Blood Glucose Forecasting From Limited CGM Data Using Incrementally Retrained LSTM
Shen, Y., & Kleinberg, S. (2024) · IEEE Transactions on Biomedical Engineering · doi:10.1109/tbme.2024.3494732 · Cited by 14
“Second, higher confidence in the AP supported by robust BG forecasting may reduce patients’ anxiety about managing their condition, which in turn can lead to an improved overall quality of life [53].”
Narasaki, Y., Park, E., You, A. S., Daza, A. C., Peralta, R. A., Guerrero, Y., Novoa, A., Amin, A., Nguyen, D. V., Price, D. A., et al. (2021) · Seminars in Dialysis · doi:10.1111/sdi.13009 · Cited by 14
Role of Continuous Glucose Monitoring in Insulin-Requiring Patients with Diabetes
Welsh, J. B. (2018) · Diabetes Technology & Therapeutics · doi:10.1089/dia.2018.0100 · Cited by 14
MacLeish, S. A., Hood, K. K., Polonsky, W. H., Wood, J., Bode, B. W., Forlenza, G. P., Laffel, L. M., Buckingham, B. A., Criego, A. B., Schoelwer, M. J., et al. (2024) · Diabetes Obesity and Metabolism · doi:10.1111/dom.15906 · Cited by 13
“38 Because missing data were minimal and no meaningful differences existed between analysis results with or without data imputation, only the results of the initial analysis with no imputation are reported.”
COVID-19 and Diabetes: Could Diabetes Technology Research Help Pave the Way for Remote Healthcare?
Fuchs, J., & Hovorka, R. (2020) · Journal of Diabetes Science and Technology · doi:10.1177/1932296820929714 · Cited by 13
“5 Easy data viewing on handheld devices empowers patients to make independent and frequent changes to their insulin dosing as well as decreasing diabetes distress, 10,11 and it allows healthcare providers to quickly access data when giving advice.”
Weber, D. R. (2021) · Current Opinion in Endocrinology Diabetes and Obesity · doi:10.1097/med.0000000000000638 · Cited by 12
“Advances in diabetes care, including the development of improved insulin analogs, subcutaneous insulin pumps, and continuous glucose sensors, have improved the health and quality of life of people with T1D [1,2].”
BackgroundEhrmann, D., Eichinger, V., Vesper, I., Kober, J., Kraus, M., Schäfer, V., Hermanns, N., Kulzer, B., & Silbermann, S. (2022) · Trials · doi:10.1186/s13063-022-06248-2 · Cited by 15
Alshannaq, H. A., Pollock, R. F., Joubert, M., Ahmed, W., Norman, G. J., Lynch, P. M., & Roze, S. (2024) · Journal of Comparative Effectiveness Research · doi:10.57264/cer-2023-0174 · Cited by 13
Zhang, L., Sun, X., & Tian, Q. (2024) · Acta Diabetologica · doi:10.1007/s00592-024-02241-0 · Cited by 12
“Researchers have also reported reduced diabetes-related distress and increased confidence in managing hypo-glycemia among rtCGM users [21].”
Perera, R., Oliver, N. S., Wilmot, E. G., & Marriott, C. (2018) · Diabetic Medicine · doi:10.1111/dme.13766 · Cited by 12
Chaugule, S., Oliver, N. S., Klinkenbijl, B., International Access, D. O. L., & Graham, C. (2017) · touchREVIEWS in Endocrinology · doi:10.17925/ee.2017.13.02.81 · Cited by 12
Forlenza, G. P., Vigers, T., Berget, C., Messer, L. H., Lal, R., Basina, M., Maahs, D. M., Hood, K. K., Buckingham, B. A., Wilson, D. M., et al. (2021) · Diabetes Technology & Therapeutics · doi:10.1089/dia.2021.0326 · Cited by 12
Alshannaq, H. A., Cogswell, G., Pollock, R. F., Ahmed, W., Norman, G. J., Lynch, P. M., & Roze, S. (2023) · Diabetes Obesity and Metabolism · doi:10.1111/dom.15158 · Cited by 14
“90 for T1D with no complications was assumed for the base case analyses.(17,18) Disutilities associated with long-term complications were sourced from a literature review by Beaudet et al.”
MethodPylov, D., Polonsky, W. H., Imberg, H., Holmer, H., Hellman, J., Wijkman, M. O., Bolinder, J., Heise, T., Dahlqvist, S., Nyström, T., et al. (2023) · Journal of Diabetes Science and Technology · doi:10.1177/19322968231183974 · Cited by 11
Kim, J. Y., Ilham, S., Alshannaq, H. A., Pollock, R. F., Ahmed, W., Norman, G. J., Jin, S., & Kim, J. H. (2024) · Journal of Medical Economics · doi:10.1080/13696998.2024.2405293 · Cited by 11
“A utility value representing a reduction in fear of hypoglycemia (FoH) of 0.02536 29 was applied to the rt-CGM arm, in combination with the utility benefit associated with avoidance of fin-gerstick testing (yielding a final annual utility benefit of 0.05536).”
InfluentialBarnard-Kelly, K. D., Gonder-Frederick, L. A., Weissberg-Benchell, J. A., & Wisk, L. E. (2024) · Journal of Diabetes Science and Technology · doi:10.1177/19322968241276550 · Cited by 12
DiabetesWise : An innovative approach to promoting diabetes device awareness
Wong, J. J., Addala, A., Hanes, S. J., Krugman, S., Naranjo, D. M., Nelmes, S., Rose, K. J., Tanenbaum, M. L., & Hood, K. K. (2023) · Journal of Diabetes · doi:10.1111/1753-0407.13401 · Cited by 11
CHANG, N. T., Banca, R. O. L., Alula, J. L., Durazo-Arvizú, R., & Chao, L. C. (2023) · Journal of Diabetes Science and Technology · doi:10.1177/19322968231178284 · Cited by 10
Sadeghi, D., Motlagh, M. K., Darvish, A., Daryaafzoon, M., Mohamadnejad, E., Molaei, A., Montazerlotf, P., & Hosseini, R. S. S. (2024) · BMC Endocrine Disorders · doi:10.1186/s12902-024-01598-1 · Cited by 11
“Therefore, in the case of correct psychological training and a health-promoting lifestyle for these patients, such problems can be reduced to a large extent [27, 28].”
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“34 In T1D and insulin-treated T2D, there is a solid evidence base for the use of CGM. 35,36 Recently, there has been growing interest in the use of CGM among adults with T2D including those not using insulin.”
Gonzalez, J. S., Hoogendoorn, C. J., Hernandez, R., Schneider, S., Mustafiz, F., Siddhanta, M., & Pyatak, E. A. (2025) · Diabetes Care · doi:10.2337/dc25-0559 · Cited by 13
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Hypoglycemic Confidence in the Partners of Adults with Type 1 Diabetes
Polonsky, W. H., Fortmann, A. L., Johnson, K. E., Nguyen, A. P., & Beebe, C. (2019) · Diabetes Technology & Therapeutics · doi:10.1089/dia.2019.0313 · Cited by 9
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“Usually, CGM serves as a management decision-aid that optimises behavioural and pharmacological interventions with evidence that it improves glycemic control, hypoglycemic confidence and diabetes distress in people with type 1 diabetes [32,34].”
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“We identified the following six themes (Table 6): (1) direct instruction and experiential learning are common methods of instruction and were felt to best be used sequentially, (2) fellows highly value opportunities for experiential learning, (3) diabetes technology curricula were felt to be informal or absent and fel…”
Losonczi, A., Kazinczi, C., Fehervari, F., Illenyi, M., Herold, Z., Palmai, D., Rigó, A., Varga, É. K., Zemplenyi, Z. M., Vincze, Á., et al. (2025) · Diabetology · doi:10.3390/diabetology6030019 · Cited by 12
“Among T1D patients using CGM, an improvement of HbA1c levels [26–29], of diabetes-specific QoL [30], treatment satisfaction [26], elevated overall well-being [26], reductions in DD [27,29,30], improvement of hypoglycemic confidence [26,30], and self-efficacy [27] was found compared to SMBG users…”
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The impact of diabetes technology advances on quality of life: addressing the barriers to uptake
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“In patients with type 1 diabetes, use of CGM has also been shown to increase hypoglycemic confidence and reduce feelings of disease-related and interpersonal distress [15].”
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“Low deprivation (1-3) 19 (30) 10 (30) 9 (29)”
BackgroundHakala, T. A., Zschaechner, L. K., Vänskä, R. T., Nurminen, T. A., Wardale, M., Morina, J., Boeva, Z. A., Saukkonen, R., Alakoskela, J.-M. I., Pettersson-Fernholm, K., et al. (2022) · Scientific Reports · doi:10.1038/s41598-022-21424-9 · Cited by 7
Owusu, B., Bivins, B. L., Juste, J., Francis, L., Itambo, J., Akomah, J., Yorukoglu, N., Gbaba, S., Hinneh, T. K., Ajibewa, T. A., et al. (2024) · Journal of Advanced Nursing · doi:10.1111/jan.16277 · Cited by 6
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Straton, E., Inverso, H., Moore, H. R., Anifowoshe, K., Washington, K., Streisand, R. M., Datye, K. A., & Jaser, S. S. (2023) · Journal of Diabetes Science and Technology · doi:10.1177/19322968231186428 · Cited by 7
Jenkins, M., Simpson, J., Ursuy, T., Hanks, J., & Burroughs, T. (2024) · The Science of Diabetes Self-Management and Care · doi:10.1177/26350106241268479 · Cited by 6
Hayek, A. A., Mashali, M. A., & Dawish, M. A. A. (2025) · Journal of Diabetes & Metabolic Disorders · doi:10.1007/s40200-025-01569-w · Cited by 6
“Continuous glucose monitoring (CGM) devices have revolutionized glucose management for people living with T1D [4, 5], leading to better metabolic control, improved quality of life, and fewer long-term adverse health outcomes [6–16].”
USA Vs Europe: Who Is Leading the Diabetes Tech Race?
Acosta, G. J., Brown, S. J., Zand, A., Kansara, A., & Sadhu, A. (2019) · Current Diabetes Reports · doi:10.1007/s11892-019-1237-z · Cited by 6
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A Qualitative Analysis of Provider‐Level Barriers to Prescribing Diabetes Technology
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“…years, including insulin pumps, continuous glucose monitors (CGMs), and arti fi cial insulin delivery (AID) systems, have revolutionized diabetes care and resulted in improved HbA1c, time in range (TIR), rates of hypoglycemia, and quality of life among people with insulin-dependent diabetes [1 – 4].”
Metadata
- Authors
- Polonsky, W. H., Hessler, D., Ruedy, K. J., & Beck, R. W.
- Affiliations
- University of California San Diego (US)
- University of California, San Francisco (US)
- Jaeb Center for Health Research (US)
- Corresponding author
- Polonsky, William H.
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2017-04-07
- Volume
- 40
- Issue
- 6
- Pages
- 736-741
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- OpenAlex
- W2604156892
- Cited by
- 346
- References
- 22
- Citations by year
- 2026: 41 · 2025: 35 · 2024: 50 · 2023: 45 · 2022: 39 · 2021: 33 · 2020: 33 · 2019: 35 · 2018: 30 · 2017: 5
- FWCI
- 22.25
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetes Care (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Keywords
- continuous glucose monitoring, type 1 diabetes, quality of life, diabetes distress, self-monitoring of blood glucose, multiple daily insulin injections, glycemic control, adults with diabetes
- MeSH terms
- Adult, Aged, Anxiety, Blood Glucose, Diabetes Mellitus, Type 1, Female, Follow-Up Studies, Glycated Hemoglobin, Humans, Hypoglycemia, Hypoglycemic Agents, Insulin, Male, Middle Aged, Prospective Studies, Quality of Life, Blood Glucose Self-Monitoring, Biomarkers, Linear Models
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