What Most Women With Diabetes Never Get Told
Pregnancy Planning Support Is Nearly Absent
The data on prepregnancy and fertility counseling was particularly striking. Women with diabetes received this type of care at low and inconsistent rates across the studies — in some studies, the rate was as low as 1 percent. Prepregnancy counseling for women with diabetes is medically significant because blood sugar control before and during pregnancy directly affects fetal development and pregnancy outcomes. Marilyn Tan, MD, an endocrinologist at Stanford Health Care, noted that taking proactive steps before conception is important for both prenatal and postpartum outcomes in women with diabetes. Despite this, the data suggest most women are not receiving that guidance in any systematic way.
STI Screening: A Research Gap on Top of a Care Gap
Researchers also found that no studies in their review compared sexually transmitted infection screening rates between women with and without diabetes. This absence is notable for two reasons. First, it suggests a potential area of unexamined care disparity. Second, it highlights a gap in the research itself — the field simply hasn’t gathered enough data to understand whether women with diabetes are also missing out on this category of care. The study authors specifically flagged this as an area needing future investigation. It’s a reminder that the gaps identified in this analysis may represent only part of the full picture of preventive care disparities for this population.
Why More Doctor Visits Don’t Close the Gap
One of the more counterintuitive aspects of the findings is that women with diabetes tend to have more contact with the healthcare system than the average person — yet they’re still missing preventive services. Neha Narula, MD, a clinical assistant professor and primary care doctor at the Stanford University School of Medicine, noted that what stood out most was precisely this paradox: more frequent healthcare interactions, but still falling short across multiple areas of preventive care. This suggests the issue isn’t simply about access to doctors in a general sense. Something structural within those healthcare encounters is causing these services to be overlooked, even when a patient is already engaged with the medical system.
How the Fragmented System Plays a Role
Experts point to the structure of the U.S. healthcare system as a contributing factor. Care coordination between specialists and primary care providers is inconsistent, and there’s often no designated person responsible for making sure all recommended preventive services are being tracked. When a patient’s medical care is primarily focused on managing a chronic condition like diabetes, other health maintenance tasks can fall through the cracks — not because anyone intends to neglect them, but because no one is explicitly tracking them. Wisk described it directly: if one provider is focused on diabetes, someone else needs to be ensuring preventive care is happening, and that coordination doesn’t always occur in practice.