Aim of the study:
Type 1 diabetes requires continuous self-management and may be associated with anxiety, diabetes-related distress, and reduced quality of life. Although advanced diabetes technologies improve treatment safety and metabolic outcomes, their relationship with psychological functioning remains uncertain. This pilot study examined associations between anxiety and quality of life and compared adults treated with and without closed-loop technology.

Subject or material and methods:
This cross-sectional pilot study included 50 adults with type 1 diabetes treated at a diabetology outpatient clinic. Twenty participants used a closed-loop system, whereas 30 were treated with multiple daily injections or continuous subcutaneous insulin infusion without closed-loop technology. Anxiety, life satisfaction, psychological well-being, and diabetes-related emotional burden were assessed using the STAI, SWLS, WHO-5 Well-Being Index, PAID, and DDS-17. Groups were compared using the Mann–Whitney U test, and associations were examined using Spearman’s rho.

Results:
Higher state and trait anxiety were associated with lower life satisfaction and psychological well-being and with greater diabetes-related emotional burden and diabetes distress. No statistically significant differences were observed between participants using and not using closed-loop technology in anxiety, quality of life, psychological well-being, or diabetes-related emotional burden.

Discussion:
The findings indicate that anxiety and subjective diabetes burden are clinically relevant correlates of poorer psychological functioning. However, the results should be interpreted cautiously because of the pilot, cross-sectional design and limited sample size.

Conclusions:
Assessment of anxiety and diabetes-related distress should remain an important component of comprehensive diabetes care, regardless of the technology used.