Women With Diabetes Receive Less Preventive Care Than Peers Without Diabetes, Review Finds

Women with diabetes are less likely to receive recommended preventive health services—including contraception counseling, cancer screening, and preconception care—compared with women without diabetes, according to a systematic review of more than 40 studies.

The findings, based on 44 studies of women aged 15 to 49 years with type 1 or type 2 diabetes, were published in the Journal of General Internal Medicine and highlight persistent gaps in routine care that may increase risk for preventable complications, including adverse pregnancy outcomes.

Lower Rates Across Key Preventive Services

Across the included studies, women with diabetes consistently received fewer preventive services than those without diabetes.

One study reported that 48% of women with diabetes received contraceptive services, compared with 62% of women without diabetes. Cervical cancer screening rates ranged from 38% to 79% in women with diabetes vs 46% to 86% in those without the condition.

Similarly, breast cancer screening rates were lower among women with diabetes, ranging from 38% to 69%, compared with 54% to 82% in women without diabetes.

Preconception counseling rates were particularly low. Fourteen studies found rates of just over 1% among women with diabetes, compared with 46% among women planning pregnancy.

The study abstract similarly reported that women with diabetes “consistently received less contraception management or contraception counseling” and had lower rates of cancer screening and preconception counseling compared with those without diabetes.

Gaps in STI Screening Data

Investigators identified no studies evaluating sexually transmitted infection screening in women with diabetes, describing this as “a substantial gap in the literature.”

The absence of data suggests that preventive care disparities in this population may be broader than currently documented.

Clinical Context and Missed Opportunities

Diabetes mellitus complicates approximately 1% of pregnancies in the United States, and preconception health is a key determinant of pregnancy outcomes.

Despite this, most research has focused on outcomes during pregnancy rather than preventive care before conception, the authors noted.

"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,” senior author Lauren Wisk, PhD, an associate professor of medicine in the division of general internal medicine and health services research at the David Geffen School of Medicine at UCLA, said in a press release.² “Providers need to be aware that they should not forget to provide these essential services for women with diabetes.”

Role of Care Coordination

The review highlights the importance of coordinated care models in improving preventive service delivery.

Studies included in the analysis suggest that comanagement involving primary care, endocrinology, and other specialists, consistent with recommendations from the American Diabetes Association, is associated with higher rates of preventive service use.

“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,” the researchers wrote.

Time constraints during primary care visits may contribute to gaps in preventive care, particularly when chronic disease management takes priority.

“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,” coauthor Lisa Kransdorf, MD, an associate clinical professor of medicine at the Geffen School, said in a press release.²

Limitations and Research Needs

The authors noted several limitations, including reliance on a relatively small number of studies, many of which were single-site or based on patient recall.

The review also identified a lack of evidence-based interventions aimed at improving preventive care delivery for women with diabetes.

“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 health care providers, and evaluate co-management models' quality of care,” Wisk said.

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 April 10, 2026. https://www.uclahealth.org/news/release/women-with-diabetes-less-likely-receive-preventive-care-and