A new UCLA-led review published this week says women with diabetes are falling behind their peers on basic preventive care, including contraceptive counseling, breast and cervical cancer screenings, and preconception counseling. Those gaps, the researchers warn, can raise pregnancy risks and undermine overall health, with clear implications for patients and clinicians in Los Angeles, where diabetes remains a common chronic condition among adults.
The scoping review, published in the Journal of General Internal Medicine, pulled together 44 studies from several countries and zeroed in on four areas of preventive care for reproductive-aged women with type 1 or type 2 diabetes. Across that research, the authors found consistent shortfalls in contraceptive counseling and cancer screenings, along with a striking lack of data on sexually transmitted infection screening in this group.
According to the review, contraceptive service rates were lower for women with diabetes, roughly 48% compared with 62% for women without the condition, and breast and cervical screening rates also lagged. Preconception counseling showed the starkest gap, with just over 1% of women with diabetes receiving it in the studies that measured it, versus 46% of women without diabetes who were planning pregnancy. Those kinds of numbers, the researchers argue, leave people with diabetes more vulnerable to pregnancy complications and missed chances to improve their overall health. UCLA Health notes that the paper synthesizes more than 40 studies in all.
"These findings are important because they identify that women with diabetes are not receiving recommended well-woman care, which is essential to support both managing their diabetes and their overall health," said Lauren Wisk, the study's senior author and an associate professor at UCLA, in a statement to UCLA Health. The authors say better coordination among endocrinology, primary care, and reproductive-health providers would make it far easier for patients balancing chronic disease management to actually get these routine services.
Care coordination could narrow gaps
The review found that co-management models, where endocrinologists, primary-care doctors, and OB/GYNs share responsibility and keep in close contact, were linked to higher use of preventive services in several of the analyzed studies. The researchers recommend putting electronic health records and team-based care to work by flagging overdue well-woman services for patients with diabetes. The Journal of General Internal Medicine article outlines these examples and also notes the limits of the current evidence base.
Guidelines back up the call
Current clinical guidance is already pushing in the same direction. A joint guideline from the Endocrine Society and the European Society of Endocrinology recommends asking women with diabetes about pregnancy intentions at every relevant visit so that preconception care can be offered when needed. As explained by the Endocrine Society, routine check-ins like that can help clinicians time medication changes and referrals before conception, instead of scrambling after a pregnancy is already underway.
What patients and clinicians can do
Patients with diabetes who are of reproductive age can bring these topics up directly, asking their primary-care or diabetes teams about contraception options, cervical and breast screening schedules, and preconception planning. Resources from the American Diabetes Association offer checklists and guidance for planning a pregnancy with diabetes. The ADA’s guide encourages patients to raise their reproductive goals at routine visits and to work with a multidisciplinary team when pregnancy is on the horizon.
Research gaps to watch
The review also uncovered an almost complete lack of research on sexually transmitted infection screening among women with diabetes, a blind spot the authors say deserves urgent attention. As reported by MyNewsLA, many of the included papers relied on small samples or patient recall, which limits how confidently the results can be applied to broader populations.
For Los Angeles patients and clinicians, the paper serves as a reminder that chronic disease management and routine sexual and reproductive health care do not have to compete for attention. The UCLA authors argue that health systems that prioritize coordinated, team-based care and use clinical records to flag overdue preventive services could start closing these gaps, a fix they say is well within reach if local hospitals and clinics choose to push it up the priority list.
