Steno Tech Explore: A Multisite Exploratory Study of People With Type 1 Diabetes on Insulin Pump Therapy
Conditions: Diabetes Mellitus, Type 1
Sponsor: Steno Diabetes Center Copenhagen

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The Steno Tech Explore study – research protocol 
Contents 
0. Cover page ....................................................................................................................................... 2 
1. Introduction ...................................................................................................................................... 3 
2. Aim................................................................................................................................................... 4 
3. Methods ............................................................................................................................................ 4 
3.1 Study groups/cohorts.................................................................................................................. 4 
3.2 Participant eligibility and selection ............................................................................................ 4 
3.3 Survey recruitment procedure .................................................................................................... 4 
3.4 Data collection procedure .......................................................................................................... 5 
3.5 Survey content............................................................................................................................ 5 
3.6 Register and EMR data .............................................................................................................. 8 
3.7 Data analysis .............................................................................................................................. 8 
3.8 Ethics .......................................................................................................................................... 8 
4. Results .............................................................................................................................................. 9 
5. References ...................................................................................................................................... 10 
6. Appendices ..................................................................................................................................... 13 
6.1 Appendix 1: The Steno Tech Survey ....................................................................................... 13 
 
 
 
 

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0. Cover page 
 
Official title: Steno Tech Explore: A Multisite Exploratory Study of People with Type 1 Diabetes 
on Insulin Pump Therapy 
 
NTC number: NCT04311164 
 
Document date: January 22, 2021 
 

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1. Introduction 
Optimal diabetes self-management in people with type 1 diabetes is important to minimize the risk 
of developing long-term microvascular and macrovascular complications (1, 2). However, only 21% 
of US adults with type 1 diabetes achieve the recommended target glycated hemoglobin level 
(HbA1c) of < 7.0% (53 mmol/mol) (3) and recent Danish  data show success rates of approximately 
25% (4). 
One way to improve self-management and thus prevent or delay complications is to introduce 
diabetes technologies such as continuous subcutaneous insulin infusion (CSII) and/or continuous 
glucose monitoring (CGM) into individuals’ treatment regimens. An estimated 40-62% of adults with 
type 1 diabetes in the US and 5-15% of those in Europe use CSII with or without CGM (5). Recent 
observational data from the type 1 diabetes Exchange registry show that while not reaching HbA1c 
target on average, people using CSII achieve improved metabolic outcomes compared to people using 
multiple daily injections, and that combining CSII with CGM substantially improves outcomes (3). 
However, it is recognized that reaping the benefits of these technologies requires high levels of 
engagement from users and health care professionals (HCPs), and that outcomes vary greatly among 
individuals (6-8). 
To ensure optimal use of CSII and/or CGM, it is recommended that people with type 1 diabetes 
receive structured and recurring education (6, 7, 9). Yet, there is currently no consensus on which 
educational practice is best for a given patient (9, 10), and the literature indicates a paucity of high 
quality comparative studies regarding the effectiveness of technology-specific education (11, 12). 
Studies involving technology-specific education have shown that people with type 1 diabetes treated 
with CSII often do not use advanced pump functions or benefit substantially (13-15). These 
observations are concerning, particularly when combined with findings that using advanced functions 
can lead to improved HbA1c (16-19). It is frequently found that device-specific satisfaction is a good 
predictor of device utilization (20-23); however, preferences for device properties have seldomly been 
investigated or linked to outcomes and treatment goals of the individual (24). Whereas research 
mostly has focused on device-specific preferences and satisfaction (20-24), only little research has 
been conducted into individuals’ needs and preferences for technology-specific education (12). 
However, meeting the needs and integrating the preferences of the individual in new interventions is 
considered integral to ensuring patient-centered and effective care (25-27). Accordingly, taking the 
target group’s needs and preferences into account is essential to developing effective educational 
strategies (11, 25). 
There are other barriers to treatment success than acquiring and maintaining the necessary skills 
to successfully manage CSII. For example, factors such as age and baseline HbA1c at treatment 
initiation have been identified as important predictors of treatment success in CSII-users (28-33).  
Only a modest amount of literature has examined how psychosocial factors predict success (34, 
35), with one study finding that psychological determinants, especially self-efficacy and locus of 
control, account for 50% of observed variation in HbA1c in people with type 1 diabetes using CSII 
(34). Likewise, an important known psychosocial predictor of poor diabetes outcomes is diabetes 
distress. One study found that a high level of diabetes distress was associated with higher HbA1c and 
less time in range compared to moderate or low levels of diabetes distress in people with type 1 
diabetes using CSII; however, the high diabetes distress group did not perform less pump-specific 

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self-management activities (e.g., use of bolus wizard) suggesting that other mechanisms than 
technology-specific behavior may drive differences in outcomes (36). Thus, alongside demographic, 
socioeconomic and health status factors, psychological and psychosocial predictors may play a 
significant yet underexplored part in the successful use of diabetes technology. 
 
2. Aim 
The present study is part of an overarching study being conducted in Denmark at Steno Diabetes 
Center Copenhagen (SDCC) and Nordsjællands Hospital Hillerød (NOH), Steno Tech, that aims to 
develop and ultimately, in a randomized controlled trial (RCT), test approaches that can assist people 
with type 1 diabetes in obtaining optimal outcomes using CSII. Through a large-scale, questionnaire-
based online survey enriched with data from national registers, this sub-study contributes to this 
overarching aim by exploring the importance of individual differences across a wide range of factors, 
including demographic, socioeconomic, health status, psychosocial and preference structures, for 
optimal use of CSII in people with type 1 diabetes. 
 
3. Methods 
3.1 Study groups/cohorts 
The study population consists of two groups/cohorts: 
1. Steno Tech Survey Respondents: A cohort of individuals with type 1 diabetes treated with 
CSII at either SDCC or NOH participating in the Steno Tech Survey. 
2. General Type 1 Diabetes Population: A cohort consisting of the entire population of people 
with type 1 diabetes in Denmark not included in the Steno Tech Survey cohort (ca. 25.000 
individuals). 
 
3.2 Participant eligibility and selection 
All adults (18+ years) with type 1 diabetes using CSII attending SDCC or NOH was invited to 
participate in the survey (N = 1,592); however, people who were not fluent in Danish were excluded 
as the survey was only available in Danish. The general type 1 diabetes group will be identified via 
the National Patient Registry (NPR) once data are ready for analysis (see section 3.6). 
 
3.3 Survey recruitment procedure 
Beginning in quarter 3 of 2019, eligible survey participants were approached by their primary HCP 
in conjunction with a consultation at SDCC or NOH and invited to participate in the survey. If they 
agreed to participate, they received, upon survey-opening, an invitation in e-Boks1 with a link to the 
survey and a standardized, mandatory document containing information on how their data would be 
stored and used. Before answering the survey, participants were prompted to provide written consent. 
 
 
1 e-Boks is an electronic mailbox designed to provide a digital and secure communication path between Danish citizens, 
companies and public authorities. As of quarter 2 of 2019, 91.5% of all Danish citizens have an e-Boks. 

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3.4 Data collection procedure 
The survey was designed and administered in REDCap, an online browser-based data and survey 
management tool. The REDCap server is encrypted, logged and administered by the Capital Region 
of Denmark. Thus, the tool is cleared for storing and handling person-sensitive information according 
to Danish law. 
The survey data are to be merged with outcome and other input data from electronic medical 
records (EMRs) and national Danish registers and stored and analyzed on a secure server at Statistics 
Denmark (figure 1). 
 
Figure 1: Overview of data sources 
 
 
 
3.5 Survey content 
The survey consisted of multiple elements as per the study aim (table 1 presents an overview, 
appendix 1 presents the survey in full). Importantly, this sub-study is preceded by a qualitative part 
of the Steno Tech Explore study that explored: 1) possibilities and barriers to effective daily insulin 
pump management, 2) specific circumstances and contexts in relation to the possibilities and barriers 
such as availability and appropriateness of structured education and other support, and 3) needs and 
preferences in overcoming barriers and optimizing possibilities for implementing and managing 
technology in daily life. The content of the survey is partly inspired by concepts and themes identified 
in that study and partly by systematic literature reviews (11, 12, 37, 38) and professional experience.
Survey 
responses
EMR data
Register 
data
Full 
data set

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Table 1: Overview of survey content 
Survey parts 
Single survey items 
Survey questionnaire scales 
Survey 
page 
nrs.* 
1) Insulin pump and 
sensor-specific 
characteristics and 
behavior 
 Type(s) of device(s) 
 Reason(s) for device 
start 
 Device functions used 
 Data upload practices 
Insulin Device Satisfaction Survey (IDSS)(22): consists of 13 items has three 
subscales: 1) perceived effectiveness, 2) burden, and 3) inconvenience. 
 
 
Glucose Monitoring System Satisfaction Survey (GMSS)(39): consists of 15 items 
and has four subscales: 1) openness, 2) emotional burden, 3) behavioral burden, 4) trust. 
 
New insulin pump attitude scale compiled of questions from validated scales(40, 41): 
included 8 items specifically about wearing an insulin pump (e.g., the degree to which it 
makes one feel less attractive) and everyday challenges (e.g., the degree to which it is a 
problem during sex). 
 
 
 
2-5, 10-12 
2) Experience with insulin 
pump education 
 Received education 
(group/individual) 
 Desired education 
(group/individual) 
 Insulin pump-knowledge 
and support needs 
 
6-8 
3) Carbohydrate counting 
exercise 
 Chocolate (6 images) 
 Pasta (6 images) 
 Grapes (6 images) 
 Bread rolls (5 images) 
Respondents were asked to indicate if they ate the presented food items 1) never, 2) 
occasionally or 3) often. If occasionally or often, they were shown an image and asked 
to pick the serving size they would usually eat and to eyeball the amount of 
carbohydrates in that serving size. 
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4) Health-management 
behavior 
 Physical activity 
 Diet 
 Alchol intake 
 Smoking status 
Items about physical activity, diet, alcohol intake, and smoking status were based on 
recommended guidelines from the Danish Health Authority. 
13 

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5) General and diabetes-
specific psychosocial 
health 
 
Well-Being Index (WHO5)(42): consists of 5 items. 
 
Hypoglycemia Fear Survey short-form (HFS-SF)(43): consists of 11 items and has  a 
worry and a behavior subscale. 
 
Type 1 Diabetes Distress Scale (T1-DDS)(44): consists of 28 items and has seven 
subscales: 1) powerlessness, 2) management distress, 3) hypoglycaemia distress, 4) 
negative social perceptions, 5) eating distress, 6) physician distress, and 7) friend/family 
distress. 
 
DAWN Support for Diabetes Self‐Management Profile (DSDSP) (extended)(45): this 
version of the DSDSP consists of 6 items. 
 
The COVID-19 Impact on Quality of Life Profile(46): The COVID-19 Impact on 
Quality of Life Profile is a newly-designed scale, inspired by the ‘DAWN Impact of 
Diabetes Profile (DIDP)’ scale and consists of 9 items. 
14-16, 19-
20 
6) Personality factors and 
goal-setting 
 Self-efficacy 
 Time preferences 
 Risk aversion 
 Treatment goals 
General Self-Efficacy Scale (GSE)(47): consists of 10 items. 
 
 
17-18, 21-
27 
7) Self-rated health status 
and satisfaction with life 
 Health status VAS 
 Life satisfaction VAS 
 
Both VAS scales ranged from 0-10, with 10 respresenting the best thinkable health 
status/satisfaction and 0 the worst. 
19 
Abbreviations: N/A = not applicable; VAS = visual analog scale. *Page numbers refer to actual order in the survey and correspond to appendix XX including all 
survey items.

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3.6 Register and EMR data 
Register data will be obtained via Statistics Denmark and include variables from several registers, 
including the following population registries: The National Population Registry, the Civil 
Registration System, the Education Registry, the Income Registry and the Address Registry, and the 
following health registries: the National Patient Registry, the National Prescription Registry, the 
Hospital Medicine Registry, and the Health Insurance Registry. A data extraction agreement with 
Statistics Denmark has been made and is currently being processed. 
Key population variables extracted for both study groups include, but are not limited to, gender, 
age, education, occupation and income (socioeconomic status), as well as household composition, all 
encounters with the health care system in the survey period (e.g., if the participant has been admitted 
to the hospital with a ketoacidosis), redeemed prescriptions from hospitals and pharmacies, and 
distance to health care services from private address. 
Diabetes-specific clinical outcomes in both study groups will be extracted from registers, and from 
survey respondents’ EMRs. Register-extracted outcomes include all blood and urine test measures 
taken at the annual ‘check-up’, including HbA1c, hemoglobin, eGFR, UACR, cholesterol total, HDL, 
LDL, VLDL, triglycerides, diabetes-related complications and other somatic and psychiatric 
comorbidities. EMR-extracted outcomes (available only for the survey group) include BMI, blood 
pressure and hypoglycemia awareness status, which are not tracked in national registers. 
 
3.7 Data analysis 
The overall data analysis approach is based on descriptive, non-parametric and parametric 
statistical methods. Descriptive statistics will include amounts/counts (n), shares (%), means and 
variable distributions (standard deviations and percentiles). Non-parametric hypothesis tests will 
include the Chi-squared test, Fisher’s exact test and Wilcoxon rank test depending on variable 
distributions. Parametric hypothesis tests will center on Student’s unpaired and paired t-tests as well 
as general and generalized regression analyses. Model error structures will depend on the specific 
objective but, in general, take the following form: 
 
𝑌𝑖= 𝛽0 + 𝛽1𝑋1𝑖+ 𝛽2𝑋2𝑖+ ⋯+ 𝛽𝑛𝑋𝑛𝑖+ 𝑒𝑖 
where Y is the dependent variable (e.g., HbA1c) for individual i, βn is the effect on Yi given Xn, 
where Xn indicates demographic, socioeconomic, behavioral and psychosocial factors, and 𝑒𝑖 
indicates residual error (i.e., unexplained variance). 
Furthermore, quasi-experimental procedures such as propensity score or coarsened exact 
matching and machine-learning algorithms such as random forest will be employed to maximize data 
usage and to foster meaningful comparisons within and between the two study groups. 
 
3.8 Ethics 
The study was approved by the Danish Data Protection Agency (P-2019-812) and exempted from 
review by the Capital Region of Denmark’s Research Ethics Committee (19080899). The study was 
also registered on ClinicalTrials.gov (NCT04311164).

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4. Results 
Data collection for this study is currently in progress. Survey data collection was initiated on May 
15, 2020 and completed on October 15, 2020. In total, 770 individuals responded to the survey. EMR 
and register data are currently being extracted and prepared for merge with survey data by Statistics 
Denmark. 
 

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Statement by the American Association of Clinical Endocrinologists/American College of 
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Jayasekara RS, Munn Z, Lockwood C. Effect of educational components and strategies 
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Payk M, Robinson T, Davis D, Atchan M. An integrative review of the psychosocial 
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Ehrmann D, Kulzer B, Schipfer M, Lippmann-Grob B, Haak T, Hermanns N. Efficacy of an 
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Joubert M, Morera J, Vicente A, Rod A, Parienti JJ, Reznik Y. Cross-sectional survey and 
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Mameli C, Scaramuzza AE, Ho J, Cardona-Hernandez R, Suarez-Ortega L, Zuccotti GV. A 7-
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Walsh J, Roberts R, Bailey T. Guidelines for optimal bolus calculator settings in adults. J 
Diabetes Sci Technol 2011; 5: 129-135.  

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O'Connell MA, Donath S, Cameron FJ. Poor adherence to integral daily tasks limits the 
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Walsh J, Roberts R, Weber D, Faber-Heinemann G, Heinemann L. Insulin Pump and CGM 
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Heinemann L, Freckmann G, Ehrmann D, Faber-Heinemann G, Guerra S, Waldenmaier D, et 
al. Real-time continuous glucose monitoring in adults with type 1 diabetes and impaired 
hypoglycaemia awareness or severe hypoglycaemia treated with multiple daily insulin injections 
(HypoDE): a multicentre, randomised controlled trial. Lancet 2018; 391: 1367-1377.  
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Perard R, Orme M. A Discrete Choice Experiment to Evaluate Blood Glucose Meter 
Preferences in People with Type 1 and Type 2 Diabetes in the UK. Intern Med 2014; S6: S6:008.  
25. 
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Education Interventions: An Exploration. Health 2017; 9: 1569-1588.  
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evidence-based and patient-centered care. Worldviews Evid Based Nurs 2006; 3: 116-123.  
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review. Can J Nurs Res 2009; 41: 52-67.  
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Shalitin S, Gil M, Nimri R, de Vries L, Gavan MY, Phillip M. Predictors of glycaemic control 
in patients with Type 1 diabetes commencing continuous subcutaneous insulin infusion therapy. 
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the effectiveness of insulin pump therapy on glycemic control in clinical practice: a retrospective 
study of patients with type 1 diabetes from 10 outpatient diabetes clinics in Sweden over 5 years. 
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aspects in continuous subcutaneous insulin infusion: a retrospective study. J Psychol 2009; 143: 
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behaviours and outcomes: a systematic review. Diabet Med 2019; 36: 1336-1348.  
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of qualitative literature. Practical Diabetes 2017; 34: 281-287.  
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Assessing Glucose Monitoring Device-Related Treatment Satisfaction and Quality of Life. Diabetes 
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Bergis D, Roos T, Ehrmann D, Schmitt A, Schipfer M, Haak T, et al. Perceived Benefits and 
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derived short form of the Hypoglycaemia Fear Survey II. Diabet Med 2017; 34: 500-504.  
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Fisher L, Polonsky WH, Hessler DM, Masharani U, Blumer I, Peters AL, et al. Understanding 
the sources of diabetes distress in adults with type 1 diabetes. J Diabetes Complications 2015; 29: 
572-577.  
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Mikkelsen EG, Schwarzer R, Jerusalem M. Danish Version of the General Self-Efficacy 
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 6

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6. Appendices 
6.1 Appendix 1: The Steno Tech Survey 
In the following questionnaire (see next page), the IDSS and GMSS were translated from English 
to Danish using the internationally recognized forward-backward translation procedure (48). Two 
experienced native Danish diabetes researchers fluent in English independently forward translated 
each scale (i.e., from English to Danish). The forward translations were then compared by a third 
researcher and analyzed for discrepancies, which were then discussed among all three researchers 
until consensus was reached. This was followed by a similar procedure, only backwards, by two other 
researchers, one of whom is a native English speaker fluent in Danish. 
Face validity of the translated questionnaires was ensured through one-to-one interviews in the 
survey testing phase where, for example, the item on cost was removed from the IDSS due to 
irrelevance in the Danish publicly funded health care setting. 
 

14 
 
Steno Tech Explore survey 
 
Page 1 of 28 
 
Introductory page including information described in section 3.3. 
 
Page 2 of 28 
 
Scale/item [branching 
logic] 
Question 
Response categories 
The first part of the questionnaire is about your insulin pump usage. There are also questions about your use 
of sensor, if applicable. 
 
When you are done answering all the questions on a page, press “next page” at the bottom of the page in order 
to continue. 
 
It takes about 30-40 minutes to complete the entire questionnaire. You can take a break along the way and 
continue the questionnaire later by simply shutting down the page and using the link in e-Boks again – 
disregard the “save and return later” button. 
pumptype 
What insulin pump are you currently using? 
You will be shown a picture of the insulin 
pump below when you click on the name of the 
insulin pump. 
1. MiniMed 640G 
2. MiniMed 670G 
3. MiniMed Paradigm/VEO 
4. Accu-Chek Combo 
5. Accu-Chek Insight 
6. Omnipod 
7. Medtrum 
8. Tandem t:slim X2 
9. YpsoPump 
10. Animas Vibe 
11. Other 
12. I use a hybrid closed-loop 
system that I built myself with an 
open-source software such as 
OPENAPS, AndroidAPS or Loop. 
 
pumptype_other [if 
pumptype = 11] 
 
What other insulin pump are you currently 
using? 
Open-ended response 
diabetesdebut 
In which year were you diagnosed with type 1 
diabetes? If you do not remember the exact 
year, please provide an approximate estimate. 
Open-ended response 
pumpyear 
In which year did you get your first insulin 
pump? If you do not remember the exact year, 
please provide an approximate estimate. 
Open-ended response 

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pumpindication 
What was the reason that you were initially 
offered an insulin pump by your healthcare 
provider? Feel free to choose several reasons. 
1. I had too high long-term blood 
glucose (HbA1c) 
2. I had major fluctuations in my 
blood sugar 
3. I could not feel low blood-sugars 
4. Other 
5. Do not know/do not remember 
pumpindication_other [if 
pumpindication = 4] 
What other reasons were behind you being 
offered an insulin pump? 
Open-ended response 
pumpwhy 
What was(were) the reason(s) you initially 
agreed to use the insulin pump? Feel free to 
choose several reasons. 
 
1. To improve long-term blood 
glucose (HbA1c) 
2. To achieve a more stable blood 
sugar (fewer fluctuations) 
3. To reduce the number of high 
blood sugars 
4. To reduce the number of low 
blood sugars 
5. To get better sleep 
6. To be able to eat more flexibly 
7. To be able to exercise more 
spontaneously 
8. To make it easier to take and 
dose insulin 
9. To avoid injecting myself 
several times a day 
10. My healthcare provider 
recommended it to me 
11.Other insulin pump users 
recommended it to me 
12. To make my diabetes fill less in 
my life 
13. Other 
14. Do not know/do not remember 
pumpwhy_other [if 
pumpwhy = 13] 
What other reasons were there, for you to agree 
to start insulin pump treatment? 
Open-ended response 
 
 
 

16 
 
Page 3 of 28 
 
Scale/item [branching logic] 
Question 
Response categories 
The following questions are about how you are using your current insulin pump. 
bolus 
How do you usually take bolus 
insulin? 
1. Bolus calculator/bolus guide 
2. Manual bolus (including fast 
bolus) 
3. I use both equally 
4. I very rarely take bolus insulin 
bolus_whynot [if bolus = 4] 
 
Why do you not typically use the bolus 
guide to calculate bolus insulin? 
1. It is too difficult to use 
2. I did not learn it at pump start and 
have not started doing it since 
3. I do not trust the bolus guide's 
calculations 
4. I calculate bolus myself, as my 
experience is that this works best 
5. Other 
6. Do not know 
bolus_whynot_other [if 
bolus_whynot = 5] 
What other reasons are there for why 
you do not typically use the bolus 
guide to calculate bolus insulin? 
 
Open-ended response 
bolususe_intro [if pumptype ≠ 11 or 
12 and bolus ≠ 4] 
How often do you use your bolus 
calculator to… 
 
bolususe1 [if pumptype ≠ 11 or 12 
and bolus ≠ 4] 
… calculate bolus for food? 
1. Never/rarely 
2. Occasionally 
3. Often 
4. Always/almost always 
bolususe2 [if pumptype ≠ 11 or 12 
and bolus ≠ 4] 
… calculate correction-insulin for 
elevated blood sugar? 
1. Never/rarely 
2. Occasionally 
3. Often 
4. Always/almost always 
bolusbasalfunctions_intro [if 
pumptype ≠ 2, 11 or 12] 
How often do you use these insulin 
pump functions when they are 
relevant? [stand-alone pump users] 
 
bolus1 [if pumptype ≠ 2, 11 or 12 
and bolus ≠ 4] 
Combined bolus when it is 
relevant (e.g., for fast food) 
 
1. Never/rarely 
2. Occasionally 
3. Often 
4. Always/almost always 
bolus2 [if pumptype ≠ 2, 11 or 12 
and bolus ≠ 4] 
Extended bolus when it is 
relevant (e.g., low blood sugar 
before a meal) 
 
1. Never/rarely 
2. Occasionally 
3. Often 
4. Always/almost always 
basal1 [if pumptype ≠ 2, 11 or 12] 
Temporary basal up when it is 
relevant (e.g., in the case of illness) 
 
1. Never/rarely 
2. Occasionally 
3. Often 
4. Always/almost always 
basal2 [if pumptype ≠ 2, 11 or 12] 
Temporary basal down when it is 
relevant (e.g., exercise) 
1. Never/rarely 
2. Occasionally 
3. Often 

17 
 
4. Always/almost always 
[manuelfunctions_intro] 
How often do you use these insulin 
pump functions when they are 
relevant, and you are in manual mode? 
[Medtronic 670G users] 
1. I am almost never in manual 
mode besides when I change 
infusion set. 
bolus1_670G [if pumptype = 2 and 
manuelfunctions_intro ≠ 1] 
Combined bolus when it is 
relevant (e.g., fast food) 
 
1. Never/rarely 
2. Occasionally 
3. Often 
4. Always/almost always 
bolus2_670G [if pumptype = 2 and 
manuelfunctions_intro ≠ 1] 
Extended bolus when it is 
relevant (e.g., low blood sugar 
before a meal) 
 
1. Never/rarely 
2. Occasionally 
3. Often 
4. Always/almost always 
basal1_670G [if pumptype = 2 and 
manuelfunctions_intro ≠ 1] 
Temporary basal up when it is 
relevant (e.g., in the case of illness) 
 
1. Never/rarely 
2. Occasionally 
3. Often 
4. Always/almost always 
basal2_670G [if pumptype = 2 and 
manuelfunctions_intro ≠ 1] 
Temporary basal down when it is 
relevant (e.g., exercise) 
1. Never/rarely 
2. Occasionally 
3. Often 
4. Always/almost always 
autofunctions_intro [if pumptype = 
2] 
How often do you use temporary 
target-blood sugar when relevant (e.g., 
exercise) and you are in auto-mode? 
1. Never/rarely 
2. Occasionally 
3. Often 
4. Always/almost always 
insulindosehow [if pumptype ≠ 2, 
11 or 12 and bolus ≠ 4] 
When do you typically take bolus 
insulin for meals? 
 
1. Before the meal (10 minutes or 
more) 
2. Just before the meal 
3. During the meal 
4. After the meal 
missedbolus [if pumptype ≠ 2, 11 
or 12 and bolus ≠ 4] 
How often do you forget bolus insulin 
for meals? 
1. Never 
2. Once a month or less 
3. Once a week or less 
4. Twice a week 
5. 3-4 times a week 
6. 5-6 times a week 
7. At least once a day 
carbhow [if pumptype ≠ 2, 11 or 12 
and bolus ≠ 4] 
How do you typically enter 
carbohydrates into the insulin pump? 
 
1. I typically enter the 
estimated/calculated amount of 
carbohydrates 
2. I typically enter the same amount 
of carbohydrates regardless of small 
variations in the meal 
3. I never enter carbohydrates in the 
insulin pump 
carbhow_intro [if pumptype ≠ 2, 11 
or 12 and bolus ≠ 4 and carbhow ≠ 
3] 
How often do you do the following 
when entering carbohydrates into the 
insulin pump? 
This does not include intake of 
carbohydrates at low blood sugar or as 
 

18 
 
a preventative measure before 
exercise. 
maincourse [if pumptype ≠ 2, 11 or 
12 and bolus ≠ 4 and carbhow ≠ 3] 
I enter at main meals 
 
1. Never/rarely 
2. Occasionally 
3. Often 
4. Always/almost always 
snack1 [if pumptype ≠ 2, 11 or 12 
and bolus ≠ 4 and carbhow ≠ 3] 
I enter anything over 10 g 
carbohydrates 
 
1. Never/rarely 
2. Occasionally 
3. Often 
4. Always/almost always 
snack2 [if pumptype ≠ 2, 11 or 12 
and bolus ≠ 4 and carbhow ≠ 3] 
I enter anything over 5 g carbohydrates 
1. Never/rarely 
2. Occasionally 
3. Often 
4. Always/almost always 
allmeals1 [if pumptype ≠ 2, 11 or 
12 and bolus ≠ 4 and carbhow ≠ 3] 
I deliberately enter more carbohydrates 
than the calculated amount 
 
1. Never/rarely 
2. Occasionally 
3. Often 
4. Always/almost always 
allmeals2 [if pumptype ≠ 2, 11 or 
12 and bolus ≠ 4 and carbhow ≠ 3] 
I deliberately enter less carbohydrates 
than the calculated amount 
1. Never/rarely 
2. Occasionally 
3. Often 
4. Always/almost always 
 
 
 

19 
 
Page 4 of 28 
 
Scale/item [branching logic] 
Question 
Response categories 
The following questions are about how you use data upload from your insulin pump to your computer and 
how you adjust the functions of your insulin pump. 
pumpdata 
How often do you transfer data from your 
insulin pump to your computer? 
1. Never 
2. Once a year or less 
3. 2-5 times a year 
4. Every two months 
5. Once a month 
6. Once a week or more often 
7. Every day 
pumpdata_why [if pumpdata 
= 3, 4, 5, 6 or 7] 
Why do you transfer data from your 
insulin pump to your computer? Feel free 
to choose several reasons. 
1. So that my healthcare provider can 
analyze the development of my blood 
sugar and whether the insulin pump is 
set correctly 
2. So that I can analyze the 
development of my blood sugar and 
whether the insulin pump is set 
correctly 
3. Other 
4. Do not know 
Pumpdata_why_other [if 
pumpdata_why = 3] 
For what other reasons do you transfer 
data from your insulin pump to your 
computer? 
Open-ended response 
pumpdata_why [if pumpdata 
= 1 or 2] 
Why do you never/rarely transfer data 
from your insulin pump to your computer 
at home? Feel free to choose several 
reasons. 
 
1. I do not own a computer 
2. I did not know it was a possibility 
3. I do not know how to do it 
4. Data is too hard to understand 
5. It takes too long 
6. The insulin pump program is not 
compatible with my computer 
7. I prefer to keep a diabetes diary 
8. I do not find the data useful 
9. I do not like seeing my data 
10. I do not want to share my data with 
an insulin pump company 
11. I do not feel the need to transfer 
data at home 
12. Other 
13. Do not know 
pumpdata_whynot_other [if 
pumpdata_why = 12] 
For what other reasons do you not 
transfer data from your insulin pump to 
your computer? 
Open-ended response 
pumpadjust 
Who primarily decides changes in your 
insulin pump's basic settings? E.g., 
carbohydrates, insulin sensitivity, basal 
rates. 
1. My healthcare provider 
2. Myself 
3. My next of kin 

20 
 
adjustself1 [if pumpadjust = 
1] 
Even though it is primarily your 
healthcare provider who decides the 
settings, do you do it yourself sometimes? 
1. Yes 
2. No 
adjustself2 [if pumpadjust = 2 
or adjutself1 = 1] 
When you adjust the basic settings of the 
insulin pump yourself, which ones do you 
typically adjust? Feel free to choose 
several options. 
 
1. Carbohydrate ratio 
2. Insulin sensitivity 
3. Basal rate 
4. Insulin's duration/time of action 
5. Target blood sugar 
daysset 
How many days typically pass between 
you changing insulin needle/insulin 
catheter or pod/patch? 
Drop-down menu from 1 to 10 days. 
 
 
 
 

21 
 
Page 5 of 28 
 
Scale/item [branching logic] 
[branching logic] 
Question 
Response categories 
The following questions are about your possible use of sensor or flash glucose measuring device. 
sensor 
Are you currently using a sensor or flash 
glucose meter? 
1. Yes 
2. No 
sensortype [if sensor = 1] 
What sensor system do you use? You will 
be shown a picture of the sensor system 
below when you click on the name of the 
system. 
1. Flash Libre 
2. Guardian to 640/670G 
insulin pump 
3. Minilink to 
Paradigm/VEO insulin 
pump 
4. Guardian connect 
5. Dexcom (G4, G5 or 
G6) 
6. Eversense 
7. Medtrum 
8. Other 
bgmeasure_flash [if sensor = 1 
and sensortype = 1] 
How often do you typically scan your Flash 
Libre? (press ‘menu', 'browse history' and 
press the down arrow to 'sensor use' on your 
Flash Libre to see your daily number of 
scans). 
 
1. Rarer than once a day 
2. 1-3 times daily 
3. 4-6 times daily 
4. 7-9 times daily 
5. 10 or more times a 
day 
flash_who [if sensortype = 1] 
Who pays for your Flash Libre? 
1. Municipality 
2. The hospital/region 
3. Out-of-pocket 
payment  
4. Do not know 
sensortype_other [if sensortype = 
8] 
What other sensor are you using? 
Open-ended response 
sensorstop [if sensor = 0] 
Have you previously used a sensor but 
stopped? 
1. Yes 
2. No 
sensorstop_why [if sensorstop = 
1] 
Why did you stop using a sensor? Feel free 
to choose several reasons. 
1. Skin problems 
2. Too many alarms 
3. Technical problems 
(e.g., signal failure) 
4. Not accurate enough 
5. Annoying to wear 
6. Attachment problems 
7. Information overload 
8. It was too difficult to 
understand and use the 
sensor values 
9. Other 
10. Do not know/do not 
remember 
sensorstop_why_other [if 
sensorstop_why = 9] 
What other reasons were there for you 
choosing to stop  using a sensor? 
Open-ended response 

22 
 
bgmeasure [if sensor = 0] 
How often do you measure your blood 
sugar? 
1. Less than once a day 
2. 1-3 times daily 
3. 4-6 times daily 
4. 7-9 times daily 
5. 10 or more times a 
day 
sensoryear [if sensor = 1] 
In which year did you get your first sensor? 
If you do not remember the exact year, 
please provide an approximate estimate 
Open-ended reponse 
sensorindication [if sensor = 1] 
What was the reason for you originally 
being offered a sensor? Feel free to choose 
several reasons. 
 
1. I had too high long-
term blood sugar 
(HbA1c) 
2. I had severe 
fluctuations in my blood 
sugar levels 
3. I could not feel when I 
had low blood sugar 
4. I could not make 
blood sugar reading 
work at work (e.g., due 
to hygiene requirements) 
5. I had problems with 
my fingers/hands 
6. Other 
7. Do not know/do not 
remember 
8. I was not offered a 
sensor. I bought it and 
continue to pay for it 
myself 
 
sensorindication_other [if 
sensorindication = 6] 
What other reasons were there for originally 
being offered a sensor? 
Open-ended response 
whysensor [if sensor = 1] 
What was the reason(s) you initially agreed 
to use the sensor? Feel free to choose 
several reasons. 
 
1. To improve my long-
term blood sugar 
(HbA1c) 
2. To achieve a more 
stable blood sugar level 
(fewer fluctuations) 
3. Because I could not 
feel my low blood sugar 
4. To feel more 
comfortable in general 
5. I could not make 
blood sugar reading 
work at work (e.g., due 
to hygiene requirements) 
6. I had problems with 
my fingers/hands 

23 
 
7. To achieve better 
sleep 
8. To follow sensor 
values during exercise 
9. Other 
10. Do not know/do not 
remember 
whysensor_other [if whysensor = 
9] 
What other reasons were there, for you to 
agree to use/buy the sensor? 
 
sensor_no [if sensor = 1] 
How many days are you without a sensor 
within a typical month? 
1. Only when changing 
the sensor or short sensor 
problems/updates (0 
days) 
2. 1 day 
3. 2-3 days 
4. 4-5 days 
5. 6-7 days 
6. More than 7 days 
7. Do not know 
stoplow [if pumptype = 1, 3, 7 or 
8 and sensor = 1 and pumptype ≠ 
11 or 12] 
Is 'stop at low' or 'stop before low' activated 
on your insulin pump? 
1. Yes 
2. No 
trend_intro 
The following questions are about how you 
use the sensor's trend arrows. 
 
trend1 [if sensor = 1 and 
pumptype ≠ 11 or 12] 
How often do you eat food without bolus if 
the trend arrows on your sensor show a 
decreasing tendency? 
 
1. Never/rarely 
2. Occasionally 
3. Often 
4. Always/almost always 
trend2 [if sensor = 1 and 
pumptype ≠ 2, 11 or 12] 
How often do you stop or reduce the basal 
rate if the trend arrows on your sensor show 
a decreasing tendency? 
 
1. Never/rarely 
2. Occasionally 
3. Often 
4. Always/almost always 
trend3 [if sensor = 1 and 
pumptype ≠ 2, 11 or 12] 
How often do you use the trend arrows to 
take more or less than the insulin pump's 
suggestion for bolus? 
1. Never/rarely 
2. Occasionally 
3. Often 
4. Always/almost always 
autoupload [if sensortype = 1, 3, 
4, 5 or 6 and pumptype ≠ 11 or 
12. 
Do you use auto-upload via an app on your 
phone or tablet to read your sensor data? 
1. Yes 
2. No 
 
sensordataupload [if autoupload = 
0 and sensortype = 1, 3, 4, 5 or 6] 
How often do you transfer data from your 
sensor to your computer? 
1. Never 
2. Once a year or fewer 
3. 2-5 times a year 
4. Every two months 
5. Once a month 
6. Once a week or more 
often 
7. Every day 
8. Not relevant 

24 
 
sensordataupload_whynot [if 
sensordataupload = 1 or 2] 
Why do you never/rarely transfer data from 
your sensor to your computer at home? Feel 
free to choose several reasons. 
1. I do not have a 
computer 
2. I did not know it was a 
possibility 
3. I do not know how to 
do it 
4. The data are too hard 
to understand 
5. It takes too long 
6. The sensor program is 
not compatible with my 
computer 
7. I prefer to keep a 
diabetes diary 
8. I do not find the data 
useful 
9. I do not like seeing 
my data 
10. I do not want to 
share my data with a 
sensor company 
11. I do not feel the need 
to transfer data at home 
12. Other 
13. Do not know 
sensordataupload_whynot_other 
[if sensordataupload_whynot = 
12] 
What other reasons are there for you not 
transferring data from your sensor to your 
computer at home? 
Open-ended response 
sensorshare [if sensor = 1, 3, 4, 5, 
6 or pumptype = 12. 
Do you share sensor data with your next of 
kin using the sensor's share function? 
1. Yes 
2. No 
sensorshare_who [if sensorshare 
= 1] 
Which next of kin do you share your sensor 
data with? Feel free to choose several 
options. 
1. Spouse/significant 
other 
2. Children 
3. Parents 
4. Friends 
5. Others 
 
 
 

25 
 
Page 6 of 28 
 
Scale/item [branching logic] 
Question 
Response categories 
Think back to the teaching and guidance you received when you started your insulin pump treatment. By this 
we mean a course lasting a day or more in which you received information and guidance on insulin pump 
treatment and the use of the insulin pump. 
educationtime 
Approximately  how long t did the 
start-up/education last? 
1. 1 day or less 
2. 2-3 days 
3. 3-4 days 
4. Other 
5. Do not remember 
education_other [if 
educationtime = 4] 
Did the start-up/education take place 
over a longer or shorter period? 
Please be specific. 
Open-ended response 
educationprep 
How did you prepare for the insulin 
pump start-up? Feel free to choose 
several options. 
1. I found information on the internet 
about insulin pump treatment 
 
2. I talked to other insulin pump users in 
my network 
 
3. I sought out groups on social media 
with insulin pump users 
 
4. I did not seek out special information 
other than the information given to me 
by my health care provider 
 
5. I do not remember 
 
educationhcp 
Who taught you about insulin pump 
start-up? Feel free to choose several 
options. 
1. Representative from a pump company 
2. Dietitian 
3. Diabetes doctor 
4. Diabetes nurse 
5. I do not remember 
educationt 
How did the teaching take place? 
1. I received mostly group-based lessons 
2. I received mostly individual 
instruction 
3. I do not remember 
educationfam 
Were your relatives invited to all or 
part of the education? 
1. Yes 
2. No 
3. I do not remember 
educationgroup_intro [if 
education = 1] 
To what degree do you agree with the 
following statements? 
 
educationgroup1 [if educationt 
= 1] 
Group education suited me well 
1. Strongly disagree 
2. Disagree 
3. Neither agree nor disagree 
4. Agree 
5. Strongly agree 

26 
 
educationgroup2 [if educationt 
= 1] 
I appreciated talking to the other 
participants in the group and hearing 
about their experiences 
1. Strongly disagree 
2. Disagree 
3. Neither agree nor disagree 
4. Agree 
5. Strongly agree 
educationgroup3 [if educationt 
= 1] 
I would have preferred individual 
education 
1. Strongly disagree 
2. Disagree 
3. Neither agree nor disagree 
4. Agree 
5. Strongly agree 
educationgroup4 [if educationt 
= 1 and educationfam = 1] 
I found it valuable that my next of kin 
could participate in all or part of the 
education 
1. Strongly disagree 
2. Disagree 
3. Neither agree nor disagree 
4. Agree 
5. Strongly agree 
educationind_intro [if education 
= 2] 
To what degree do you agree with the 
following statements? 
 
educationind1 [if education = 2] 
The individual education suited me 
well 
1. Strongly disagree 
2. Disagree 
3. Neither agree nor disagree 
4. Agree 
5. Strongly agree 
educationind2 [if education = 2] 
I appreciated having time with 
the teacher alone without other 
participants present 
1. Strongly disagree 
2. Disagree 
3. Neither agree nor disagree 
4. Agree 
5. Strongly agree 
educationind3 [if education = 2] 
I would have preferred 
group training with others in the 
same situation 
1. Strongly disagree 
2. Disagree 
3. Neither agree nor disagree 
4. Agree 
5. Strongly agree 
educationind4 [if education = 2 
and educationfam = 1] 
I found it valuable that my next of kin 
could participate in all or part of the 
teaching 
1. Strongly disagree 
2. Disagree 
3. Neither agree nor disagree 
4. Agree 
5. Strongly agree 
 

27 
 
Page 7 of 28 
 
Scale/item [branching 
logic] 
Question 
Response categories 
The following questions are about the teaching or exchange of experience you have participated in as an 
experienced insulin pump user. 
educationnow 
Have you participated in either of these types of 
courses in relation to your insulin pump treatment in 
the past 5 years? If you have participated in both, 
choose the course you remember best. 
1. Carbohydrate counting 
course in a group 
 
2. "Refresher course" 
experience-sharing course 
about insulin pump in a 
group 
 
3. No, I have not participated 
in such courses in the last 5 
years 
educationgroup2intro 
To what degree do you agree with the following 
statements? 
 
educationgroup21 
[educationnow = 1 or 2] 
Group education suited me well 
1. Strongly disagree 
2. Disagree 
3. Neither agree nor disagree 
4. Agree 
5. Strongly agree 
educationgroup22 
[educationnow = 1 or 2] 
I appreciated talking to the other participants in the 
group and hearing their experiences 
1. Strongly disagree 
2. Disagree 
3. Neither agree nor disagree 
4. Agree 
5. Strongly agree 
educationgroup23 
[educationnow = 1 or 2] 
I would have preferred individual education 
1. Strongly disagree 
2. Disagree 
3. Neither agree nor disagree 
4. Agree 
5. Strongly agree 
 
 
 

28 
 
Page 8 of 28 
 
Scale/item 
[branching 
logic] 
Question 
Response categories 
In the following we ask about your current needs for knowledge, education and experience-sharing 
about your insulin pump. 
knowledge1 
Do you need a refresher or more knowledge about the 
use of the different insulin pump features? 
 
1. No 
2. Yes, to some degree 
3. Yes, very much 
4. I do not know 
knowledge2 
Do you need sparring and experience-sharing in 
relation to everyday-life with your insulin pump? 
Topics could be family life, sport, working life, travel, 
or the fact that you carry an insulin pump 24/7 
1. No 
2. Yes, to some degree 
3. Yes, very much 
4. I do not know 
knowledge3 
Do you need more practical knowledge of the upload 
and interpretation of data from your insulin pump and 
possible sensor? (With upload we mean transferring 
data to computer/app, e.g., blood glucose levels, sensor 
curves and insulin doses) 
1. No 
2. Yes, to some degree 
3. Yes, very much 
4. I do not know 
knowledge4 
Do you need more knowledge and/or practical training 
in how you can adjust the insulin pump settings 
yourself? 
1. No 
2. Yes, to some degree 
3. Yes, very much 
4. I do not know 
knowledge5 
Do you seek out knowledge  about new initiatives in 
insulin pump treatment on, e.g., the internet or in 
networks with other insulin pump users outside your 
place of treatment? 
1. No 
2. Yes, to some degree 
3. Yes, very much 
4. I do not know 
 
 
 

29 
 
Page 9 of 28 
 
Scale/item [branching 
logic] 
Question 
Response 
categories 
The next questions are about carbohydrate counting. 
carbcount 
Do you count carbohydrates? 
 
1. Yes 
2. No 
carbcount_whynot [if 
carbcount = 2] 
Why do you not count carbohydrates? Feel free to choose several 
reasons. 
 
 
1. I never learned 
it 
2. It is too much 
of a hassle 
3. I lack 
training/practice 
in it 
4. I do not feel 
that I need it 
5. Other reasons 
6. I do not know 
 
carbcount_whynot_other 
[if carbcount_whynot = 
5] 
What other reasons are there for you not counting carbohydrates? 
Open-ended 
response 
carbcounthow [if 
carbcount = 1] 
What methods do you use to count carbohydrates? Feel free to 
choose several methods. 
1. I eyeball 
2. I use weight 
3. I use an app 
4. I use nutrition 
fact declarations 
5. I use 
encyclopedias 
(e.g., 
carbohydrate 
lists) 
6. I use Google 
7. None of the 
above 
carbcountlearn [if 
carbcount = 1] 
How did you learn to count carbohydrates? Feel free to choose 
several reasons. 
1. Individual 
guidance from 
dietitian 
2. Carbohydrate 
counting course 
3. Self-taught 
(e.g., from books, 
social media or 
experience-
sharing with 
others) 
4. None of the 
above 

30 
 
carbcount_intro 
You now have the opportunity to participate in a carbohydrate 
counting challenge. 
 
If you eat the following food items occasionally or often, you will 
be shown a picture of different portion sizes for the given item. You 
must then pick the portion size you typically eat and state the 
amount of carbohydrates you think it contains. The rules are simple: 
you cannot use aids such as carbohydrate lists, apps, or nutrition fact 
declarations. The idea is that you simply respond based on your 
immediate assessment of carbohydrate content in each item. 
 
On the last page of the questionnaire, you can compare your 
response with the actual amount of carbohydrates in each food. 
1. I would like to 
participate 
2. I do not want 
to take part in the 
challenge 
choco1 [if carbcount = 1 
and carbcount_intro = 1] 
How often do you eat dark chocolate? 
1. Rarely/Never 
2. Occasionally 
3. Often 
choco2 [if choco1 = 2 or 
3] 
Select the image that matches the portion size you typically eat. If 
you typically eat a larger or smaller portion than any of the shown, 
select the image that comes closest. 
1. Portion size A 
2. Portion size B 
3. Portion size C 
4. Portion size D 
5. Portion size E 
6. Portion size F 
choco3 [if choco1 = 2 or 
3] 
 
 
choco4 [if choco2 ≠ .] 
Type the amount of carbohydrates (in grams) that are on the image 
you have selected. 
Open-ended 
response 
pasta1 [if choco1 = 1 or 
choco4 ≠ .] 
How often do you eat pasta? 
 
1. Rarely/Never 
2. Occasionally 
3. Often 
pasta2 [if pasta1 = 2 or 
3] 
Select the image that matches the portion size you typically eat. If 
you typically eat a larger or smaller portion than any of the shown, 
select the image that comes closest. 
1. Portion size A 
2. Portion size B 
3. Portion size C 
4. Portion size D 
5. Portion size E 
6. Portion size F 

31 
 
pasta3 [if pasta1 = 2 or 
3] 
 
 
pasta4 [if pasta2 ≠ .] 
Type the amount of carbohydrates (in grams) that are on the image 
you have selected. 
Open-ended 
response 
grapes1 [if pasta1 = 1 or 
pasta4 ≠ .] 
How often do you eat grapes? 
 
1. Rarely/Never 
2. Occasionally 
3. Often 
grapes2 [if grapes1 = 2 
or 3] 
Select the image that matches the portion size you typically eat. If 
you typically eat a larger or smaller portion than any of the shown, 
select the image that comes closest. 
1. Portion size A 
2. Portion size B 
3. Portion size C 
4. Portion size D 
5. Portion size E 
6. Portion size F 
grapes3 [if grapes1 = 2 
or 3] 
 
 
grapes4 [if grapes2 ≠ .] 
Type the amount of carbohydrates (in grams) that are on the image 
you have selected. 
Open-ended 
response 
bun1 [if grapes1 = 1 or 
grapes4 ≠ .] 
How often do you eat wholegrain bread rolls? 
1. Rarely/Never 
2. Occasionally 
3. Often 
bun2 [if bun1 = 2 or 3] 
Select the image that matches the portion size you typically eat. If 
you typically eat a larger or smaller portion than any of the shown, 
select the image that comes closest. 
1. Portion size A 
2. Portion size B 
3. Portion size C 
4. Portion size D 
5. Portion size E 
bun3 [if bun1 = 2 or 3] 
 
 

32 
 
bun4 [if bun2 ≠ .] 
Type the amount of carbohydrates (in grams) that are on the image 
you have selected. 
Open-ended 
response 
 
 
 

33 
 
Page 10 of 28 
Scale/item [branching logic] 
Question 
Response categories 
The following statements are about your satisfaction with your current insulin pump. Think about your 
everyday life with the pump and indicate the degree to which you agree or disagree with the following 
statements. 
 
My insulin pump … 
idds1 
… helps me to feel more in control of my diabetes 
1. Strongly disagree 
2. Disagree 
3. Neutral 
4. Agree 
5. Strongly agree 
idds2 
… works well when I need it 
1. Strongly disagree 
2. Disagree 
3. Neutral 
4. Agree 
5. Strongly agree 
idds3 
… does not really benefit me much 
1. Strongly disagree 
2. Disagree 
3. Neutral 
4. Agree 
5. Strongly agree 
idds4 
… helps me feel more positive about the future 
1. Strongly disagree 
2. Disagree 
3. Neutral 
4. Agree 
5. Strongly agree 
idds5 
… helps me to have good blood glucose control 
1. Strongly disagree 
2. Disagree 
3. Neutral 
4. Agree 
5. Strongly agree 
idds6 
… is too complicated 
1. Strongly disagree 
2. Disagree 
3. Neutral 
4. Agree 
5. Strongly agree 
idds7 
… is too much of a hassle to use 
1. Strongly disagree 
2. Disagree 
3. Neutral 
4. Agree 
5. Strongly agree 
idds8 
… has too many pieces and parts to manage 
1. Strongly disagree 
2. Disagree 
3. Neutral 
4. Agree 
5. Strongly agree 
idds9 
… takes too much time to use 
1. Strongly disagree 
2. Disagree 
3. Neutral 

34 
 
4. Agree 
5. Strongly agree 
idds10 
… is often embarrassing to use when I am in public 
1. Strongly disagree 
2. Disagree 
3. Neutral 
4. Agree 
5. Strongly agree 
idds11 
… makes it difficult to be as spontaneous as I’d like to 
be 
1. Strongly disagree 
2. Disagree 
3. Neutral 
4. Agree 
5. Strongly agree 
idds12 
… is inconvenient to use when I am away from home 
1. Strongly disagree 
2. Disagree 
3. Neutral 
4. Agree 
5. Strongly agree 
idds13 
… is a hassle to carry around 
1. Strongly disagree 
2. Disagree 
3. Neutral 
4. Agree 
5. Strongly agree 
 
 
 

35 
 
Page 11 of 28 
 
Scale/item [branching 
logic] 
Question 
Response categories 
The following statements concern your satisfaction with your current glucose meter (e.g., 
blood glucose monitor or sensor). Base your answer on the meter you use the most or consider your primary 
meter and indicate the degree to which you agree or disagree with the following statements. 
devicetype 
Please specify which glucose meter you are basing your 
answers on? 
 
1. Sensor or Flash glucose 
meter 
2. Blood sugar device 
gmss_intro 
My current blood glucose monitor/sensor … 
 
gmss1 
… helps me feel more satisfied with how things are going 
with my diabetes 
1. Strongly disagree 
2. Disagree 
3. Neutral 
4. Agree 
5. Strongly agree 
gmss2 
… makes me think about diabetes more than I want to 
 
1. Strongly disagree 
2. Disagree 
3. Neutral 
4. Agree 
5. Strongly agree 
gmss3 
… takes too much time to use 
 
1. Strongly disagree 
2. Disagree 
3. Neutral 
4. Agree 
5. Strongly agree 
gmss4 
… doesn’t seem to be as accurate as I would like it to be 
 
 
1. Strongly disagree 
2. Disagree 
3. Neutral 
4. Agree 
5. Strongly agree 
gmss5 
… makes me worry a lot 
 
1. Strongly disagree 
2. Disagree 
3. Neutral 
4. Agree 
5. Strongly agree 
gmss6 
… is too much of a hassle to use 
 
 
1. Strongly disagree 
2. Disagree 
3. Neutral 
4. Agree 
5. Strongly agree 
gmss7 
… gives me numbers that I don’t entirely trust 
1. Strongly disagree 
2. Disagree 
3. Neutral 
4. Agree 
5. Strongly agree 
gmss8 
… helps me feel less restricted by diabetes 
 
 
1. Strongly disagree 
2. Disagree 
3. Neutral 
4. Agree 

36 
 
5. Strongly agree 
gmss9 
… makes me feel more frustrated with my diabetes 
 
 
1. Strongly disagree 
2. Disagree 
3. Neutral 
4. Agree 
5. Strongly agree 
gmss10 
… helps me to be more spontaneous in daily life 
 
1. Strongly disagree 
2. Disagree 
3. Neutral 
4. Agree 
5. Strongly agree 
gmss11 
… Causes too many skin irritations or bruises 
 
1. Strongly disagree 
2. Disagree 
3. Neutral 
4. Agree 
5. Strongly agree 
gmss12 
… often gives me results that don't make sense 
1. Strongly disagree 
2. Disagree 
3. Neutral 
4. Agree 
5. Strongly agree 
gmss13 
… makes me feel more down and depressed 
 
 
1. Strongly disagree 
2. Disagree 
3. Neutral 
4. Agree 
5. Strongly agree 
gmss14 
… helps me to be more open to new experiences in life 
 
 
1. Strongly disagree 
2. Disagree 
3. Neutral 
4. Agree 
5. Strongly agree 
gmss15 
… is too painful to use 
1. Strongly disagree 
2. Disagree 
3. Neutral 
4. Agree 
5. Strongly agree 
 
 
 

37 
 
Page 12 of 28 
 
Scale/item [branching 
logic] 
Question 
Response categories 
We would like to know how you experience wearing the insulin pump on your body. 
bodyimageintro1 
Please indicate the degree to which you agree or disagree 
with the following statements: 
 
bodyimage1 
The insulin pump makes me feel me different in the eyes of 
others 
1. Strongly disagree 
2. Disagree 
3. Neither disagree 
nor agree 
4. Agree 
5. Strongly agree 
bodyimage2 
It bothers me that I always have an insulin catheter in my body 
1. Strongly disagree 
2. Disagree 
3. Neither disagree 
nor agree 
4. Agree 
5. Strongly agree 
bodyimage3 
With the insulin pump, others immediately notice that I have 
diabetes 
1. Strongly disagree 
2. Disagree 
3. Neither disagree 
nor agree 
4. Agree 
5. Strongly agree 
bodyimage4 
The insulin pump makes me less attractive 
1. Strongly disagree 
2. Disagree 
3. Neither disagree 
nor agree 
4. Agree 
5. Strongly agree 
bodyimageintro2 
Please indicate the degree to which you agree or disagree 
with the following statements: 
 
bodyimage5 
The insulin pump bothers me when I sleep 
 
 
1. Strongly disagree 
2. Disagree 
3. Neither disagree 
nor agree 
4. Agree 
5. Strongly agree 
bodyimage6 
The insulin pump bothers me when I exercise 
1. Strongly disagree 
2. Disagree 
3. Neither disagree 
nor agree 
4. Agree 
5. Strongly agree 
bodyimage7 
The insulin pump bothers me when I have sex 
 
1. Strongly disagree 
2. Disagree 
3. Neither disagree 
nor agree 
4. Agree 

38 
 
5. Strongly agree 
bodyimage8 
The insulin pump prohibits me from wearing the clothes that I 
want to wear 
1. Strongly disagree 
2. Disagree 
3. Neither disagree 
nor agree 
4. Agree 
5. Strongly agree 
 
 
 

39 
 
Page 13 of 28 
 
Scale/item 
[branching 
logic] 
Question 
Response 
categories 
In the following, we ask about your general health behavior, including exercise, diet and 
alcohol habits as well as smoking status. 
exercise1 
In a normal week, how much time do you spend doing physical activities 
that cause you to be short of breath (e.g., running, gymnastics, or ball 
games)? 
1. 0 minutes / No 
time 
2. Less than 30 
minutes 
3. 30-60 minutes 
(0.5-1 hour) 
4. 60-90 minutes (1-
1.5 hours) 
5. 90-120 minutes 
(1.5-2 hours) 
6. 120-150 minutes 
(2-2.5 hours) 
7. More than 150 
minutes 
exercise2 
In a normal week, how much time do you spend doing everyday exercise 
(e.g., walking, cycling or manual labor)? 
 
1. 0 minutes / No 
time 
2. Less than 30 
minutes 
3. 30-60 minutes 
(0.5-1 hour) 
4. 60-90 minutes (1-
1.5 hours) 
5. 90-150 minutes 
(1.5-2.5 hours) 
6. 150-300 minutes 
(2.5-5 hours) 
7. More than 300 
minutes (5 hours) 
exercise3 
How much time do you spend sitting down on a regular day when sleep is 
not included? 
1. Pretty much all 
day 
2. 13-15 hours 
3. 10-12 hours 
4. 7-9 hours 
5. 4-6 hours 
6. 1-3 hours 
7. No time 
diet1 
How many vegetables do you eat (raw or prepared)? 
 
Think in servings, e.g., a carrot or 100 g fried vegetables. If you eat both 
a carrot and 100 g of fried vegetables, you have eaten two servings. 
1. 6 a day or more 
2. 5-6 a day 
3. 3-4 a day 
4. 1-2 a day 
5. 5-6 a week 
6. 3-4 a week 
7. 1-2 a week 

40 
 
8. Fewer or none 
 
diet2 
How much fruit do you eat? 
 
Think in servings, e.g., an apple or 10 grapes. 
 
1. 6 a day or more 
2. 5-6 a day 
3. 3-4 a day 
4. 1-2 a day 
5. 5-6 a week 
6. 3-4 a week 
7. 1-2 a week 
8. Fewer or none 
diet3 
How often do you eat whole grains? 
 
Whole grain foods include, e.g., oatmeal, rye bread, whole grain bread or 
whole grain pasta. 
 
1. More than 2 
times a day 
2. 1-2 times a day 
3. 4-6 times a week 
4. 1-3 times a week 
5. Rarely or never 
diet4 
How often do you eat fish (fresh, prepared, or canned)? 
1. More than once a 
day 
2. 5-7 times a week 
3. 3-4 times a week 
4. 1-2 times a week 
5. Rarely or never 
diet5 
Do you follow The Danish Health Authority’s recommendation to eat less 
saturated fat and choose plant oil instead? 
 
Recommendation: Choose lean meat and lean dairy products, and limit 
the amount of butter, 
whole-fat cheeses and cream. Use plant oil/liquid margarine in cooking. 
1. Almost always 
2. Usually 
3. Occasionally 
4. Rarely 
5. Never 
diet6 
To the best of your knowledge, how often does is your intake of fast 
carbohydrates in the form of, e.g., candy, cake, ice cream and other 
sweets  so great that it causes a prolonged blood sugar increase? 
1. Never or very 
rarely 
2. Rarely (about 
once a month) 
3. Occasionally (a 
few times a month) 
4. Often (1-2 times 
a week) 
5. Very often (daily 
or almost daily) 
alcohol 
How much beer, wine, and/or spirits do you drink on average per week? 
Please reply in units of alcohol (1 unit equals, e.g., 1 beer, 1 glass of 
wine, 1 schnapps or 1 shot). 
1. I do not drink 
2. 1-7 units 
3. 8-14 units 
4. 14-21 units 
5. More than 21 
units 
smoking 
Do you smoke? 
 
1. No 
2. Yes, daily 
3. Yes, occasionally 
4. Former smoker 
 
 
 

41 
 
Page 14 of 28 
 
Scale/item 
[branching logic] 
Question 
Response 
categories 
The next questions are about low blood sugars. We would like to stress that your responses to the following 
questions will not be shared with your health care provider. 
hypobehavior_intro 
Here are five statements about things people with diabetes sometimes do to 
avoid low blood sugar and consequences of it. Please specify what you 
have done the last month in your everyday life to AVOID low blood sugar 
and its effects. 
 
To avoid low blood sugar and the repercussions of it, I have ... 
 
hypob1 
... limited my out of town travel 
1. Never 
2. Rarely 
3. Sometimes 
4. Often 
5. Almost 
always 
hypob2 
... avoided visiting friends 
1. Never 
2. Rarely 
3. Sometimes 
4. Often 
5. Almost 
always 
hypob3 
... made sure there were other people around 
1. Never 
2. Rarely 
3. Sometimes 
4. Often 
5. Almost 
always 
hypob4 
... kept my blood sugar higher than usual in social situations 
1. Never 
2. Rarely 
3. Sometimes 
4. Often 
5. Almost 
always 
hypob5 
... kept my blood sugar higher than usual while doing important tasks 
1. Never 
2. Rarely 
3. Sometimes 
4. Often 
5. Almost 
always 
hypoworry_intro 
Here are six statements about concerns that people with diabetes sometimes 
have due to low blood sugar. 
 
Please indicate how often during the past month you have been 
CONCERNED about each statement due to low blood sugar. 
 
Because my blood sugar could drop, I was worried about ... 
 

42 
 
hypow1 
... not to recognizing I was having a low blood sugar 
1. Never 
2. Rarely 
3. Sometimes 
4. Often 
5. Almost 
always 
hypow2 
... passing out in public 
 
1. Never 
2. Rarely 
3. Sometimes 
4. Often 
5. Almost 
always 
hypow3 
... having a hypoglycemic episode while driving 
 
1. Never 
2. Rarely 
3. Sometimes 
4. Often 
5. Almost 
always 
hypow4 
... low blood glucose interfering with important things I was doing 
 
1. Never 
2. Rarely 
3. Sometimes 
4. Often 
5. Almost 
always 
hypow5 
... becoming hypoglycemic during sleep 
 
1. Never 
2. Rarely 
3. Sometimes 
4. Often 
5. Almost 
always 
hypow6 
… getting emotionally upset and difficult to deal with 
1. Never 
2. Rarely 
3. Sometimes 
4. Often 
5. Almost 
always 
 
 
 

43 
 
Page 15 of 28 
 
Scale/item 
[branching logic] 
Question 
Response categories 
Below is a list of statements about various forms of concern that many people with type 1 diabetes experience. 
 
We ask you to assess the extent to which each of the following statements has been a problem for you within 
the past month. 
dds1 
Feeling that I am not as skilled at managing diabetes as I should 
be 
1. Not a problem 
2. A slight problem 
3. A moderate problem 
4. A somewhat serious 
problem 
5. A serious problem 
6. A very serious 
problem 
dds2 
Feeling that I don’t eat as carefully as I probably should 
1. Not a problem 
2. A slight problem 
3. A moderate problem 
4. A somewhat serious 
problem 
5. A serious problem 
6. A very serious 
problem 
dds3 
Feeling that I don’t notice the warning signs of hypoglycemia as 
well as I used to 
1. Not a problem 
2. A slight problem 
3. A moderate problem 
4. A somewhat serious 
problem 
5. A serious problem 
6. A very serious 
problem 
dds4 
Feeling that people treat me differently when they find out I 
have diabetes 
1. Not a problem 
2. A slight problem 
3. A moderate problem 
4. A somewhat serious 
problem 
5. A serious problem 
6. A very serious 
problem 
dds5 
Feeling discouraged when I see high blood glucose numbers that 
I can’t explain 
1. Not a problem 
2. A slight problem 
3. A moderate problem 
4. A somewhat serious 
problem 
5. A serious problem 
6. A very serious 
problem 
dds6 
Feeling that my family and friends make a bigger deal out of 
diabetes than they should 
1. Not a problem 
2. A slight problem 

44 
 
3. A moderate problem 
4. A somewhat serious 
problem 
5. A serious problem 
6. A very serious 
problem 
dds7 
Feeling that I can’t tell my diabetes doctor what is really on my 
mind 
1. Not a problem 
2. A slight problem 
3. A moderate problem 
4. A somewhat serious 
problem 
5. A serious problem 
6. A very serious 
problem 
dds8 
Feeling that I am not taking as much insulin as I should 
1. Not a problem 
2. A slight problem 
3. A moderate problem 
4. A somewhat serious 
problem 
5. A serious problem 
6. A very serious 
problem 
dds9 
Feeling that there is too much diabetes equipment and stuff I 
must always have with me 
1. Not a problem 
2. A slight problem 
3. A moderate problem 
4. A somewhat serious 
problem 
5. A serious problem 
6. A very serious 
problem 
dds10 
Feeling like I have to hide my diabetes from other people 
1. Not a problem 
2. A slight problem 
3. A moderate problem 
4. A somewhat serious 
problem 
5. A serious problem 
6. A very serious 
problem 
dds11 
Feeling that my friends and family worry more about 
hypoglycemia than I want them to 
1. Not a problem 
2. A slight problem 
3. A moderate problem 
4. A somewhat serious 
problem 
5. A serious problem 
6. A very serious 
problem 
dds12 
Feeling that I don’t check my blood glucose level as often as I 
probably should 
1. Not a problem 
2. A slight problem 
3. A moderate problem 

45 
 
4. A somewhat serious 
problem 
5. A serious problem 
6. A very serious 
problem 
dds13 
Feeling worried that I will develop serious long-term 
complications, no matter how hard I try 
1. Not a problem 
2. A slight problem 
3. A moderate problem 
4. A somewhat serious 
problem 
5. A serious problem 
6. A very serious 
problem 
dds14 
Feeling that I don’t get help I really need from my diabetes 
doctor about managing diabetes 
1. Not a problem 
2. A slight problem 
3. A moderate problem 
4. A somewhat serious 
problem 
5. A serious problem 
6. A very serious 
problem 
dds15 
Feeling frightened that I could have a serious hypoglycemic 
event when I’m asleep 
1. Not a problem 
2. A slight problem 
3. A moderate problem 
4. A somewhat serious 
problem 
5. A serious problem 
6. A very serious 
problem 
dds16 
Feeling that thoughts about food and eating control my life 
1. Not a problem 
2. A slight problem 
3. A moderate problem 
4. A somewhat serious 
problem 
5. A serious problem 
6. A very serious 
problem 
dds17 
Feeling that my friends or family treat me as if I were more 
fragile or sicker than I really am 
1. Not a problem 
2. A slight problem 
3. A moderate problem 
4. A somewhat serious 
problem 
5. A serious problem 
6. A very serious 
problem 
dds18 
Feeling that my diabetes doctor doesn't really understand what 
it's like to have diabetes 
1. Not a problem 
2. A slight problem 
3. A moderate problem 
4. A somewhat serious 
problem 

46 
 
5. A serious problem 
6. A very serious 
problem 
dds19 
Feeling concerned that diabetes may make me less attractive to 
employers 
1. Not a problem 
2. A slight problem 
3. A moderate problem 
4. A somewhat serious 
problem 
5. A serious problem 
6. A very serious 
problem 
dds20 
Feeling that my friends or family act like “diabetes police” 
(bother me too much) 
1. Not a problem 
2. A slight problem 
3. A moderate problem 
4. A somewhat serious 
problem 
5. A serious problem 
6. A very serious 
problem 
dds21 
Feeling that I’ve got to be perfect with my diabetes management 
1. Not a problem 
2. A slight problem 
3. A moderate problem 
4. A somewhat serious 
problem 
5. A serious problem 
6. A very serious 
problem 
dds22 
Feeling frightened that I could have a serious hypoglycemic 
event while driving 
1. Not a problem 
2. A slight problem 
3. A moderate problem 
4. A somewhat serious 
problem 
5. A serious problem 
6. A very serious 
problem 
dds23 
Feeling that my eating is out of control 
 
1. Not a problem 
2. A slight problem 
3. A moderate problem 
4. A somewhat serious 
problem 
5. A serious problem 
6. A very serious 
problem 
dds24 
Feeling that people will think less of me if they knew I had 
diabetes 
1. Not a problem 
2. A slight problem 
3. A moderate problem 
4. A somewhat serious 
problem 
5. A serious problem 

47 
 
6. A very serious 
problem 
dds25 
Feeling that no matter how hard I try with my diabetes, it will 
never be good enough 
1. Not a problem 
2. A slight problem 
3. A moderate problem 
4. A somewhat serious 
problem 
5. A serious problem 
6. A very serious 
problem 
dds26 
Feeling that my diabetes doctor doesn't know enough about 
diabetes and diabetes care 
1. Not a problem 
2. A slight problem 
3. A moderate problem 
4. A somewhat serious 
problem 
5. A serious problem 
6. A very serious 
problem 
dds27 
Feeling that I can’t ever be safe from the possibility of a serious 
hypoglycemic event 
1. Not a problem 
2. A slight problem 
3. A moderate problem 
4. A somewhat serious 
problem 
5. A serious problem 
6. A very serious 
problem 
dds28 
Feeling that I don’t give my diabetes as much attention as I 
probably should 
1. Not a problem 
2. A slight problem 
3. A moderate problem 
4. A somewhat serious 
problem 
5. A serious problem 
6. A very serious 
problem 
dds29 
Feeling that I can't do my job because of my diabetes 
1. Not a problem 
2. A slight problem 
3. A moderate problem 
4. A somewhat serious 
problem 
5. A serious problem 
6. A very serious 
problem 
 
 
 

48 
 
Page 16 of 28 
 
Scale/item 
[branching logic] 
Question 
Response categories 
How supportive have the following people been in helping you to manage your diabetes in the past month? 
sos1 
Your family 
1. Not supportive 
2. Somewhat supportive 
3. Very supportive 
4. Do not have these (not relevant 
with support from here) 
sos2 
Friends or other people close to you 
1. Not supportive 
2. Somewhat supportive 
3. Very supportive 
4. Do not have these (not relevant 
with support from here) 
sos3 
People at your place of work or study 
1. Not supportive 
2. Somewhat supportive 
3. Very supportive 
4. Do not have these (not relevant 
with support from here) 
sos4 
Your diabetes healthcare provider 
1. Not supportive 
2. Somewhat supportive 
3. Very supportive 
4. Do not have these (not relevant 
with support from here) 
sos5 
Other people with type 1 diabetes 
1. Not supportive 
2. Somewhat supportive 
3. Very supportive 
4. Do not have these (not relevant 
with support from here) 
sos6 
People on social media (e.g. in Facebook groups 
for people with type 1 diabetes) 
1. Not supportive 
2. Somewhat supportive 
3. Very supportive 
4. Do not have these (not relevant 
with support from here) 
 
 
 

49 
 
Page 17 of 28 
 
Scale/item [branching 
logic] 
Question 
Response 
categories 
We want to know how you perceive your own abilities to do and achieve the things you want to 
in your life with diabetes. 
 
Please state to what degree the following statements fit you. 
selfeffi1 
I can always manage to solve difficult problems if I try hard 
enough 
1. Not at all true 
2. Hardly true 
3. Moderately true 
4. Exactly true 
selfeffi2 
If someone opposes me, I can find the means and ways to get what 
I want 
1. Not at all true 
2. Hardly true 
3. Moderately true 
4. Exactly true 
selfeffi3 
It is easy for me to stick to my aims and accomplish my goals 
1. Not at all true 
2. Hardly true 
3. Moderately true 
4. Exactly true 
selfeffi4 
I am confident that I could deal efficiently with unexpected events 
1. Not at all true 
2. Hardly true 
3. Moderately true 
4. Exactly true 
selfeffi5 
Thanks to my resourcefulness, I know how to handle unforeseen 
situations 
1. Not at all true 
2. Hardly true 
3. Moderately true 
4. Exactly true 
selfeffi6 
I can solve most problems if I invest the necessary effort 
1. Not at all true 
2. Hardly true 
3. Moderately true 
4. Exactly true 
selfeffi7 
I can remain calm when facing difficulties because I can rely on 
my coping abilities 
1. Not at all true 
2. Hardly true 
3. Moderately true 
4. Exactly true 
selfeffi8 
When I am confronted with a problem, I can usually find several 
solutions 
1. Not at all true 
2. Hardly true 
3. Moderately true 
4. Exactly true 
selfeffi9 
If I am in trouble, I can usually think of a solution 
1. Not at all true 
2. Hardly true 
3. Moderately true 
4. Exactly true 
selfeffi10 
I can usually handle whatever comes my way 
1. Not at all true 
2. Hardly true 
3. Moderately true 
4. Exactly true 
 
 
 

50 
 
Page 18 of 28 
 
Scale/item 
[branching logic] 
Question 
Response categories 
Long-term blood glucose (HbA1c) 
 
hba1c_intro 
What long-term blood sugar level (HbA1c) would 
you yourself like to be at? You can enter your 
answer in either % or mmol/mol by indicating your 
preference here. 
1. % 
2. mmol/mol 
3. I have not set myself a fixed 
goal for HbA1c 
hba1c_goal_percent 
[if hba1c_intro = 1] 
HbA1c (%) 
Open-ended response 
hba1c_goal_mmol 
[if hba1c_intro = 2] 
HbA1c (mmol/mol) 
Open-ended response 
hba1c_realistic [if 
hba1c_intro ≠ 3] 
How likely do you think it is that you will have 
achieved/stayed on that particular long-term blood 
sugar level (HbA1c) in a year? Please indicate your 
answer on a scale from 0-10. 
 
0. Completely unlikely 
10. Completely likely 
 
 
 

51 
 
 
Page 19 of 28 
 
Scale/item 
[branching logic] 
Question 
Response 
categories 
The next questions are more about your general health and overall satisfaction with life. 
healthstatus 
How good or bad do you consider your health today? Please indicate 
your answer on a scale from 0-10. 
0. Very bad 
10. Very good 
 
satisfaction 
How satisfied are you with your life today all things considered? 
Please indicate your answer on a scale from 0-10. 
0. Not at all 
satisfied 
10. Completely 
satisfied 
who5_intro 
Please indicate for each of the 5 statements which is closest to how 
you have been feeling over the past 2 weeks. 
 
Over the past 2 weeks … 
 
who51 
... I have felt cheerful and in good spirits 
1. All of the time 
2. Most of the time 
3. More than half 
the time 
4. Less than half 
the time 
5. Some of the time 
6. At no time 
who52 
... I have felt calm and relaxed 
1. All of the time 
2. Most of the time 
3. More than half 
the time 
4. Less than half 
the time 
5. Some of the time 
6. At no time 
who53 
... I have felt active and vigorous 
1. All of the time 
2. Most of the time 
3. More than half 
the time 
4. Less than half 
the time 
5. Some of the time 
6. At no time 
who54 
... I woke up feeling fresh and rested 
1. All of the time 
2. Most of the time 
3. More than half 
the time 
4. Less than half 
the time 
5. Some of the time 
6. At no time 
who55 
... my daily life has been filled with things that interest me 
1. All of the time 

52 
 
2. Most of the time 
3. More than half 
the time 
4. Less than half 
the time 
5. Some of the time 
6. At no time 
 
 
 

53 
 
Page 20 of 28 
 
Scale/item 
[branching logic] 
Question 
Response 
categories 
The COVID-19 pandemic may impact the lives and opportunities of insulin pump users in relation to 
treatment and education. 
 
covid19_intro 
How is the COVID-19 pandemic CURRENTLY impacting the following 
aspects of your life? 
 
covid1 
Your diabetes 
1. Very negative 
impact 
2. Negative 
impact 
3. Slightly 
negative impact 
4. No impact 
5. Slightly 
positive impact 
6. Very positive 
impact 
7. Not applicable 
covid2 
Your sleep 
1. Very negative 
impact 
2. Negative 
impact 
3. Slightly 
negative impact 
4. No impact 
5. Slightly 
positive impact 
6. Very positive 
impact 
7. Not applicable 
covid3 
Your physical health 
1. Very negative 
impact 
2. Negative 
impact 
3. Slightly 
negative impact 
4. No impact 
5. Slightly 
positive impact 
6. Very positive 
impact 
7. Not applicable 
covid4 
Your emotional wellbeing 
1. Very negative 
impact 
2. Negative 
impact 

54 
 
3. Slightly 
negative impact 
4. No impact 
5. Slightly 
positive impact 
6. Very positive 
impact 
7. Not applicable 
covid5 
Your financial situation 
1. Very negative 
impact 
2. Negative 
impact 
3. Slightly 
negative impact 
4. No impact 
5. Slightly 
positive impact 
6. Very positive 
impact 
7. Not applicable 
covid6 
Your relationship with your family, friends and peers 
1. Very negative 
impact 
2. Negative 
impact 
3. Slightly 
negative impact 
4. No impact 
5. Slightly 
positive impact 
6. Very positive 
impact 
7. Not applicable 
covid7 
Your leisure activities 
1. Very negative 
impact 
2. Negative 
impact 
3. Slightly 
negative impact 
4. No impact 
5. Slightly 
positive impact 
6. Very positive 
impact 
7. Not applicable 
covid8 
Your work or studies 
1. Very negative 
impact 
2. Negative 
impact 
3. Slightly 
negative impact 

55 
 
4. No impact 
5. Slightly 
positive impact 
6. Very positive 
impact 
7. Not applicable 
covid9 
Your feelings about the future 
1. Very negative 
impact 
2. Negative 
impact 
3. Slightly 
negative impact 
4. No impact 
5. Slightly 
positive impact 
6. Very positive 
impact 
7. Not applicable 
covidrisk 
How likely do you think it is for you to be become seriously ill if you get 
infected with the COVID-19 virus? Please indicate your answer on a 
scale from 0-10. 
0. Completely 
unlikely 
10. Completely 
likely 
 
 
 

56 
 
Page 21 of 28 
 
Scale/item 
[branching 
logic] 
Question 
Response 
categories 
You are now finished with the part of the questionnaire about your diabetes and your insulin pump. 
 
We hope you also want to answer the next questions, which are more about you in general terms. Your answer 
to these questions will be used to gain an understanding of how people make decisions. 
 
The questions are not a test and there are no right or wrong answers. 
lottery 
Imagine that you unexpectedly inherit 2,500 kr from a distant relative. You 
then get the opportunity to participate in a lottery with an equal chance of 
either doubling the money to 5,000 kr. or losing the money. This means that 
there is a 50% chance that you will walk away with 5,000 kr. and a 50% 
chance of losing the 2,500 kr. Which choice would you make in this 
scenario? 
1. I choose to 
participate in the 
lottery 
2. I choose not to 
participate in the 
lottery and keep the 
2,500 kr. 
 
 
 

57 
 
Page 22 of 28 
 
Scale/item 
[branching logic] 
Question 
Response 
categories 
Where do you stand with regards to taking risks? 
risk1 
Are you someone who is willing to take risks in general? Please indicate 
your answer on a scale from 0-10. 
0. Fully 
unwilling 
10. Fully 
willing 
risk2 
Are you someone who is willing to take risks with your health in 
general? Please indicate your answer on a scale from 0-10. 
0. Fully 
unwilling 
10. Fully 
willing 
risk3 
Are you someone who is willing to take risks with your financial 
situation? Please indicate your answer on a scale from 0-10. 
0. Fully 
unwilling 
10. Fully 
willing 
 
 
 

58 
 
Page 23 of 28 
 
Scale/item 
[branching logic] 
Question 
Response 
categories 
How patient and impulsive are you? 
patience 
In general, how patient are you? Please indicate your answer on a scale 
from 0-10. 
0. Very 
impatient 
10. Very patient 
impulsive 
Are you a person who generally acts impulsively, or do you think a lot 
about things before you act? Please indicate your answer on a scale from 
0-10. 
0. Not impulsive 
at all 
10. Very 
impulsive 
riskage 
Think about the future. How likely do you think it is that you will 
experience your 90th birthday? Please indicate your answer on a scale from 
0-10. 
 
0. Completely 
unlikely 
10. Completely 
likely 
 
 
 

59 
 
Page 24 of 28 
 
Scale/item [branching 
logic] 
Question 
Response categories 
liveplando_intro 
To what degree do you agree with the following 
statements? 
 
livelife 
I live life one day at a time and do not think too much 
about my future 
1. Strongly disagree 
2. Disagree 
3. Neither disagree nor 
agree 
4. Agree 
5. Strongly agree 
planlife 
I plan everything in good time 
 
1. Strongly disagree 
2. Disagree 
3. Neither disagree nor 
agree 
4. Agree 
5. Strongly agree 
dolife 
When I set a goal for myself, I always achieve it 
1. Strongly disagree 
2. Disagree 
3. Neither disagree nor 
agree 
4. Agree 
5. Strongly agree 
 
 
 

60 
 
Page 25 of 28 
 
Scale/item 
[branching logic] 
Question 
Response 
categories 
The following questions are about time and money. 
 
The questions are not a test and there are no right or wrong answers. 
 
priselist_intro1 
Imagine that you can choose between getting 5,000 kr. today or another 
amount in 1 year. What amount do you prefer in each of the following seven 
situations? The money is yours no matter what, and there is no risk of you 
losing a future amount if you choose to wait. 
 
We have filled out the first answer for you as we believe you would prefer to 
have 5,000 kr. in your hand today rather than in 1 year. 
 
pricelist1 
 
1. 5,000 kr. 
today 
2. 5,000 kr. 
in a year 
pricelist2 
 
1. 5,000 kr. 
today 
2. 5,100 kr. 
in a year 
pricelist3 
 
1. 5,000 kr. 
today 
2. 5,250 kr. 
in a year 
pricelist4 
 
1. 5,000 kr. 
today 
2. 5,500 kr. 
in a year 
pricelist5 
 
1. 5,000 kr. 
today 
2. 6,000 kr. 
in a year 
pricelist6 
 
1. 5,000 kr. 
today 
2. 7000 kr. in 
a year 
pricelist7 
 
1. 5,000 kr. 
today 
2. 9000 kr. in 
a year 
 
 
 

61 
 
Page 26 of 28 
 
Scale/item 
[branching logic] 
Question 
Response 
categories 
The next questions are like the previous, only now the time horizon varies. 
 
How much would you require in addition to the 5,000 kr. to wait for the money in each scenario? 
 
There are no right or wrong answers. 
 
When you enter an amount, the total sum is calculated in the following field, and you therefore do not have to 
write anything in this field. 
tp1 
How much money would you require in addition to the 5,000 kr. if you 
had to wait 1 month to get the money? 
Open-ended 
response 
tp1_calc [if tp1 ≠ .] 
This means that instead of 5,000 kr. today, you will get… 
X kr. in 1 month 
tp2 
Against waiting 3 months? 
 
Open-ended 
response 
tp2_calc [if tp2 ≠ .] 
This means that instead of 5,000 kr. today, you will get 
X kr. in 3 
months 
tp3 
Against waiting 6 months? 
Open-ended 
response 
tp3_calc [if tp3 ≠ .] 
This means that instead of 5,000 kr. today, you will get 
X kr. in 6 
months 
tp4 
Against waiting 12 months? 
Open-ended 
response 
tp4_calc [if tp4 ≠ .] 
This means that instead of 5,000 kr. today, you will get 
X kr. in 12 
months 
tp5 
Against waiting 24 months? 
Open-ended 
response 
tp5_calc [if tp5 ≠ .] 
This means that instead of 5,000 kr. today, you will get 
X kr. in 24 
months 
 
 
 

62 
 
Page 27 of 28 
 
Scale/item 
[branching logic] 
Question 
Response 
categories 
Now imagine a situation where you cannot get the 5,000 kr. before 12 months from now. 
tp24 
How much money would you require in addition to the 5,000 kr. in 12 
months for you to wait another 12 months to get the money? 
 
Open-ended 
response 
tp24_calc 
This means that instead of getting 5,000 kr. in 12 months you will get 
X kr. in 24 
months 
 
 
 
 

63 
 
Page 28 of 28 
 
Scale/item [branching 
logic] 
Question 
Response categories 
Thank you so much for your help! 
 
Your reply will help us to learn more about how people with type 1 diabetes use and live with their insulin 
pump. We will use this knowledge to improve treatment options for insulin pump users at Nordsjællands 
Hospital Hillerød and Steno Diabetes Center Copenhagen. 
sdccnoh 
Are you treated at Nordsjællands Hospital Hillerød or 
Steno Diabetes Center Copenhagen? 
1. Nordsjællands Hospital 
Hillerød 
2. Steno Diabetes Center 
Copenhagen 
contact 
Can we send you a similar questionnaire in a year? 
1. Yes 
2. No 
panel 
At Steno Diabetes Center Copenhagen, we carry out 
numerous research projects with different research 
subjects on an ongoing basis. In the context of this, we 
have been given permission to create a register of people 
interested in participating in new research projects. 
 
By ticking here, you agree that we may contact you with 
information about the possibility of participation in 
upcoming research projects/trials. Your consent is valid 
for 1 year. You can say no to participating in the trials at 
any time, just as you can always withdraw your consent to 
be included in the register. 
 
1. Yes, I would like to be 
included in the register and 
contacted via e-Boks when 
new research projects come 
in 
2. Yes, I would like to be 
included in the register and 
contacted via e-Boks and/or 
phone when new 
research projects come in. 
3. I do not want to be part of 
the register 
phone [if panel = 2] 
Please provide a phone number we may contact you at. 
Enter only the 8 digits. 
 
Open-ended response. 
carbcountanswer_intro 
Bonus info: fact list for the carbohydrate counting 
exercise! 
 
 
carbcountanswer1 
Chocolate: You replied that there are [choco4] grams of 
carbohydrates in the chocolate in the selected image. The 
exact amount of carbohydrates is: 
 
X 
carbcountanswer2 
Pasta: You replied that there is [pasta4] grams of 
carbohydrates in the pasta in the selected image. The exact 
amount of carbohydrates is: 
 
X 
carbcountanswer3 
Grapes: You replied that there are [grapes4] grams of 
carbohydrates in the grapes in the selected image. The 
exact amount of carbohydrates is: 
X 
carbcountanswer4 
Buns: You replied that there are [bun4] grams of 
carbohydrates in the bread roll on the selected image. The 
exact amount of carbohydrates is: 
X