Diabetic and Overweight Women Often Choose the Route of No Condom

According to a new study published in Diabetes Care, upwards of 40% of women who are diabetic and almost 33% of women who are overweight choose not to use contraceptives like condoms. This, however, is not directly due to the fact that these women are diabetic or medically obese but rather sociodemographic variables and other pregnancy-related factors.

Dr. Anjel Vahratian from the University of Michigan states, “Diabetes and obesity increasingly affect women of reproductive age in the U.S. Women with diabetes and those who are obese are at increased risk for pregnancy complications, including those from surgical delivery, and their offspring are at risk for congenital anomalies.” Data was used from the National Survey for Family Growth done in 2002 that had close to 6,000 female participants between 20 years old and 44 years old. The survey was used to understand the use of contraceptives like condoms amongst women in this age range.

The term “lack of contraception” included women who did not use any type of barrier (condom), hormonal (like birth control) or sterilization method. Of the participants, 135 women had been diagnosed with diabetes and 2,927 of the women were considered medically obese as defined by their BMI (body mass index). BMI is a scientific formula that uses a person’s reported height and weight to determine if that individual is normal weight, overweight or underweight. The report states, “We found that (approximately) 40 percent of women with diabetes and up to a third of women with elevated BMIs did not use contraception.”

Of the female participants who considered themselves sexually active, those women who had been diagnosed with diabetes were less likely to use any type of contraceptive compared to their non-diabetic counterparts. In addition, those women who were considered very obese (women who had a BMI of 35 or above) were also less likely to use any type of contraceptive compared to those female participants who had lower BMIs. Other data reported that women who were older, black and had a medical history of attempts to get pregnant were also less likely to utilize any type of contraception. On the other hand, those women who had achieved a higher level of education and who lived with their partners were more likely to utilize contraceptives.

Vahratian said about the results, “Clinicians caring for women with diabetes and/or elevated body mass index may wish to target women who desire pregnancy or who feel ambivalent about pregnancy for more intensive preconception management, even if these women do not intend to get pregnant. Efforts to improve family planning practices among these women should include factors associated with contraceptive use — particularly their beliefs about fecundity and potential ambivalence about their desires for pregnancy. Preconceptional management may be more successful in this subgroup if equal attention is given to daily folic acid use, weight management, and achieving optimal glycemic control and not solely initiation of family planning — regardless of whether pregnancy is immediately intended or not. This will become an increasingly important issue as the number of reproductive-aged women with diabetes increases. Most of these women do not receive any sort of preconception care, and many are diagnosed when they are older, past the reach of current preconception programs targeted primarily at young teenagers.”