Ladies with diabetes much less probably to make use of contraception after prognosis, research finds

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Uncontrolled diabetes increases the risk for both mother and child during pregnancy. As a result, the American Diabetes Association (ADA) recommends discussing family planning and providing effective contraception to more than three percent (more than one million) women of childbearing potential in the United States with diabetes. However, a new study found that women with diabetes are less likely to use contraception after being diagnosed with diabetes.

Efforts are needed to ensure that women with diabetes receive the counseling and clinical services necessary to carefully plan their pregnancy. “

Mara Murray Horwitz, MD, Corresponding Author, Assistant Professor, Boston University School of Medicine

The researchers used claims data from a major national insurer to identify women of childbearing age and divided them into two groups: those who were newly diagnosed with diabetes and those who were not diagnosed with diabetes. They then matched individuals in each group against other important variables to make the groups more similar. Using the medical diagnosis, pharmacy filling, and procedure codes, contraceptive use was measured in both groups in the year before diagnosis and in the year after diagnosis. Finally, they compared the change in contraceptive use from the year before diagnosis to the year after diagnosis in the diagnosed group with that in the undiagnosed group.

They found that being diagnosed with diabetes did not make a person more likely to use contraception, and it can actually lead to a decrease in the use of certain types of effective contraception, namely short-acting hormonal methods such as pills and injections.

The ADA notes that “women with diabetes have the same birth control options and recommendations as women without diabetes” and that “the risk of an unplanned pregnancy outweighs the risk of using a particular birth control option”. “Nonetheless, many patients and physicians report concerns about the necessity and safety of contraceptives in diabetes. It is conceivable that – as our study suggests – a diagnosis of diabetes leads to less rather than more contraceptive advice and prescription,” added Murray Horwitz, a doctor at Boston Medical Center.

The researchers hope this study will result in more comprehensive care for people with diabetes who may become pregnant, including family planning with all safe and effective contraceptive options. “Ultimately, we want everyone to be able to decide when and if they get pregnant and have the information, tools and support they need to optimize their pregnancy outcomes,” she said.

Source:

Boston University School of Medicine

Journal reference:

Horwitz, MEM et al. (2021) Contraception Use Before and After a Diagnosis of Diabetes: An Observational Cohort Study. Primary Care Diabetes. doi.org/10.1016/j.pcd.2021.02.012.