Fragmented Care and Role Confusion: Barriers to Preventive Services Among Women With Diabetes

Care fragmentation across multiple providers may contribute significantly to missed preventive services in women with diabetes. Patients in this population often engage with a range of clinicians—including primary care physicians, endocrinologists, and obstetrician-gynecologists—creating ambiguity around responsibility for routine preventive care. This lack of clarity can result in critical services being deferred or omitted entirely.

In clinical practice, competing priorities frequently drive visit agendas. Diabetes management, particularly in patients with suboptimal glycemic control, often dominates limited visit time. As a result, preventive services such as cancer screening or contraceptive counseling may be deprioritized despite their long-term importance. This dynamic underscores the need for structured approaches to ensure comprehensive care delivery within time-constrained encounters.

According to Lauren Wisk, PhD, one of the key findings from the review was the potential for role confusion among providers. She emphasized that clinicians may assume another member of the care team is addressing preventive services, while patients may view a single provider as responsible for all aspects of care. Wisk highlighted that improving communication and clarifying care responsibilities—particularly across specialties—could reduce these gaps.

References:

1. Treasure ML, Nourbakhsh PS, Diaz Roldan K, et al. Preventive Health Services in Reproductive-Aged Women with Diabetes Mellitus: A Scoping Review. J Gen Intern Med. Published online April 2, 2026. doi:10.1007/s11606-026-10253-5
2. University of California, Los Angeles Health Sciences. Women with Diabetes Less Likely to Receive Preventive Care and Some Screenings. News release. April 3, 2026. Accessed Ap