Contraceptive Use Among Women with Prediabetes and Diabetes in a US National Sample.
Laura E Britton, Jon M Hussey, Diane C Berry and 3 others
PMID 30548397WHAT IT FOUND
US women with diabetes were more likely than women without high blood sugar to use no contraception.
Among women with diabetes, undiagnosed diabetes was associated with less effective methods. Prediabetes showed no difference.
Key findings
01Women with diabetes used no contraception more often than women without diabetes (28.8% vs 16.4%). After adjustment, they had greater odds of using no contraception rather than a more effective method (adjusted odds ratio 1.90).
02Among women with diabetes, undiagnosed diabetes was associated with greater adjusted odds of using less effective contraception rather than more effective contraception compared with diagnosed diabetes (adjusted odds ratio 3.39).
03Contraceptive use did not differ between women with prediabetes and women without diabetes.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The analysis was cross-sectional, so it describes patterns and cannot show that diabetes caused changes in contraceptive use. It did not distinguish type 1 from type 2 diabetes. The data were collected in 2007 to 2009. Guidelines for long-acting reversible contraception have changed, new implant options are available, and the Affordable Care Act reduced out-of-pocket contraceptive costs. The survey did not record how long each method was used, whether methods were used together or in sequence, or satisfaction with the method. Pregnancy intentions were not collected at the time, so the study could not tell whether women not using contraception were trying to conceive. Some contraceptive methods listed are no longer on the U.S. market. This limits how well the results apply to current practice. The paper excluded women with missing A1C (n = 457), so the analytic sample was not all eligible women.
Declared interests
The authors declared no conflicts of interest. The supplied text does not state a funding source.
The easy way to misread this
Do not conclude that women with diabetes who used no contraception had an unmet need for contraception. The study did not collect pregnancy intentions at the time, and it was cross-sectional.