Physicians are less likely to provide preventive care such as conception counseling and certain cancer screenings to women with diabetes than to those without the disease, according to a UCLA-led study published on Apr. 3.
The study, which will appear in the Journal of General Internal Medicine, analyzed more than 40 studies from several countries. The researchers found that women with Diabetes Mellitus often do not receive important routine services, which can increase their risk for preventable medical conditions like pregnancy complications.
Researchers reviewed thousands of studies focusing on "women," "diabetes," and "women's health services," narrowing their analysis to 44 studies involving women aged 15 to 49 years with type 1 or type 2 diabetes. They examined four main categories: contraceptive counseling and use, breast and cervical cancer screening, pre-conception counseling, and screening for sexually transmitted infections. Notably, no studies were found addressing screenings for sexually transmitted infections among this population—a gap highlighted by the authors.
"One of the more striking findings of this review is the importance of robust coordinated care teams in ensuring access to appropriate services for women with DM," wrote the researchers. They added that involving endocrinology, primary care, and other specialists—an approach recommended by the American Diabetes Association—can lead to better delivery of these services.
Dr. Lisa Kransdorf, an associate clinical professor at UCLA's Geffen School and a co-author of the study, said that during office visits primary care physicians often must prioritize chronic disease management over preventive health needs. "In cases where the patient has other providers such as specialists and clinical pharmacists actively involved in their chronic disease management, there is opportunity for primary care physicians to attend to preventative care gaps," she said.
The authors acknowledged limitations in their findings due to small sample sizes or single-site studies within their review set. Many relied on patient recall data rather than objective measures.
"Future research should look into how health systems should use electronic health records to increase preventive health services among women with diabetes, improve care-coordination and communication between healthcare providers, and evaluate co-management models' quality of care," Wisk said.
