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OBJECTIVES: To gain a more detailed understanding, from a biopsychosocial perspective, of the sexuality of women living with diabetes. DESIGN: Anonymous questionnaire study. METHOD: Thirty-six women with type 1 diabetes, 27 women with type 2 diabetes and 67 women without diabetes completed anonymous, detailed surveys about their sexual desire, sexual satisfaction, sexual self-view and sexual function. Various features of diabetes that have potential sexual relevance were also addressed. RESULTS: Women with diabetes recognized that the following factors are associated with their disease and affect their sexuality: diabetes-associated fatigue, fear of becoming dependent on a sexual partner and an impairment of body image that is associated with diabetes. Other potential diabetes-associated concerns, including issues of fertility, birth control, difficulty finding an accepting partner and the perception of being an ëillí woman, were not found to be relevant to sexual desire or sexual function. Women with diabetes were found to be similar to women without diabetes in terms of sexual desire, sexual responses and sexual function. Dyspareunia, which was disconcertingly common in all groups, is discussed. CONCLUSIONS: Despite the likelihood of diabetesassociated impairment of genital sexual physiology in women, any effect on womenís sexual function appears to be limited. Sexual satisfaction, however, may be affected by factors to do with living with diabetes.