Reviewer’s report
Title: Association between type 1 diabetes and female sexual dysfunction
Version: 1 Date: 05 Jan 2020
Reviewer: M. I. Maiorino
Reviewer's report:
The study by Zampone et al explored the prevalence and the correlates of female sexual dysfunction in
a population of pre-menopausal women with type 1 diabetes. The topic is interesting, although the
design of the study is similar to other published papers. The strenghts of the article mainly referer to the
contemporary evaluation of different clinical features with sexual function. The principal limitation
regards the methodology used to explore the sexual function in this selected population.
1)It  is  well  known  that  the  diagnosis  of  FSD  cannot  be  based  only  on  the  self-reported
questionnaire FSFI, requiring also the demonstration of the sex-related distress. This can be obtained
using specific validated scales (i.e. the FSDS). Indeed, diabetic women in the study showed lower FSFI
score  than  controls,  except  those  related  to  sexual  satisfaction.  Moreover,  the  authors  used  the
abbreviated form FSFI-6, that has to be used mainly as a screening tool. When the FSFI-6 total score is
lower than 19 it would be appropriate exploring the female sexuality domains with the full FSFI score.
2)The pshycho-relational component of the female sexuality was not investigated, nor any aspect
related to the quality of life. 
3)The sample size is very small, although it fits with the sample size calculation
4)References 15 and 27 are the same
5)Legend to the table 4, change multi drug infusion to multiple daily injections.
Are the methods appropriate and well described?
If not, please specify what is required in your comments to the authors.
Yes
Does the work include the necessary controls?
If not, please specify which controls are required in your comments to the authors.
Yes
Are the conclusions drawn adequately supported by the data shown?
If not, please explain in your comments to the authors.
Yes
Are you able to assess any statistics in the manuscript or would you recommend an additional
statistical review?
If  an  additional  statistical  review  is  recommended,  please  specify  what  aspects  require  further
assessment in your comments to the editors.
I am able to assess the statistics
Quality of written English
Please indicate the quality of language in the manuscript:
Needs some language corrections before being published
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