{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T05:55:47Z","timestamp":1781330147293,"version":"3.54.1"},"reference-count":20,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,1,18]],"date-time":"2026-01-18T00:00:00Z","timestamp":1768694400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,18]],"date-time":"2026-01-18T00:00:00Z","timestamp":1768694400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabet Med"],"published-print":{"date-parts":[[2026,3]]},"abstract":"Abstract<\/jats:title>\n \n Aims<\/jats:title>\n This study aimed to evaluate the association of stigma related to type 1 diabetes with CGM\u2010derived data and psychological outcomes in adults with type 1 diabetes.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n In this cross\u2010sectional study, 104 adults with type 1 diabetes undergoing continuous glucose monitoring (CGM) completed the Type 1 Diabetes Stigma Assessment Scale (DSAS\u20101), Patient Health Questionnaire\u20109 (PHQ\u20109), generalized anxiety disorder\u20107 (GAD\u20107), and Diabetes Distress Scale (DDS). Thirty\u2010day standard CGM data with \u226570% sensor wear time of CGM was analysed. Linear regression was used to evaluate the potential relationship between the DSAS\u20101 scores and CGM\u2010derived hypoglycaemia metrics.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Higher\n DSAS<\/jats:styled-content>\n \u20101 total score was independently associated with increased time below range <3.0\u2009mmol\/L (adjusted\n \u03b2<\/jats:italic>\n \u2009=\u20090.011 per point; 95%\n CI:<\/jats:styled-content>\n 0.0018,0.0202;\n p<\/jats:italic>\n \u2009=\u20090.019) but not with <3.9\u2009mmol\/L. Elevated stigma associated with anxiety (adjusted\n OR<\/jats:styled-content>\n , 1.086; 95%\n CI:<\/jats:styled-content>\n , 1.035,1.152;\n p<\/jats:italic>\n \u2009=\u20090.002) with no significant link to depression. Item\u2010level analyses identified\n DSAS<\/jats:styled-content>\n \u20101 items related to differential treatment (items 15 and 19) and blame\/judgement (items 11, 14, and 17) as being significantly associated with clinically significant hypoglycaemia. Associations were consistent across subgroups, especially among participants with a longer diabetes duration and a higher coefficient of variation of\n CGM<\/jats:styled-content>\n glucose levels, calculated as glucose standard deviation divided by mean glucose and expressed as a percentage.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n In adults with type 1 diabetes using CGM, perceived stigma was significantly correlated with more time spent in hypoglycaemia and greater anxiety. Further studies are needed to identify causal relationships between stigma and clinically significant hypoglycaemia in people with type 1 diabetes.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/dme.70204","type":"journal-article","created":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T02:36:01Z","timestamp":1768790161000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association of perceived diabetes stigma with time below range <3.0\u2009mmol\/L and anxiety in adults with type 1 diabetes using continuous glucose monitoring"],"prefix":"10.1111","volume":"43","author":[{"given":"Seohyun","family":"Kim","sequence":"first","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center Sungkyunkwan University School of Medicine Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soojin","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences and Technology Sungkyunkwan University Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sang\u2010Man","family":"Jin","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center Sungkyunkwan University School of Medicine Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5001-963X","authenticated-orcid":false,"given":"Jae Hyeon","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center Sungkyunkwan University School of Medicine Seoul Republic of Korea"},{"name":"Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences and Technology Sungkyunkwan University Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gyuri","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center Sungkyunkwan University School of Medicine Seoul Republic of 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WooKJKJAN.Validity and reliability of the Korean version of the type 1 diabetes stigma assessment scale.2022;34.","DOI":"10.7475\/kjan.2022.34.6.579"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/dme.13507"},{"key":"e_1_2_12_16_1","first-page":"47","article-title":"Standardization of the Korean version of screening tool for depression (patient health Questionnaire\u20109, PHQ\u20109)","volume":"19","author":"An JY","year":"2013","journal-title":"J Korean Soc Biol Ther Psychiatry"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2019.00127"},{"key":"e_1_2_12_18_1","first-page":"298","article-title":"Effects of physical activity on glycemic control in type 2 diabetics","volume":"23","author":"Choi EJ","year":"2011","journal-title":"Korean J Adult 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