552-P: Disparities in Preventive Reproductive Health Services in Women with Type 1 and Type 2 Diabetes

Abstract

About 50% of (~13 million) reproductive aged women with Type I or II diabetes receive any preconception care. Even fewer receive contraceptive counseling, or other vital reproductive health services. This scoping review aimed to explore if reproductive aged women with diabetes receive adequate preventative reproductive health services compared to women without diabetes. A systematic search strategy of the published literature was built and applied in multiple databases (PubMed, Web of Science, Cochrane). Interventional and observational studies describing access to reproductive health services among reproductive-aged women with compared to those without diabetes were included. The Preferred Reporting Items for Scoping Reviews and Meta-Analyses (PRISMA) guidelines were followed. The search strategy identified 6785 unique records. A two reviewer method was used to screen abstracts, with 41 studies identified to be relevant. These studies were separated into the domains of contraception counseling (N=20), cervical cancer screening (N=12), counseling/screening for sexually transmitted infections (N=3), and preconception counseling (N=12). We did not include studies focusing on prenatal care, pregnancy, menstrual irregularities, sexual dysfunction, or breast cancer screening. While a vast amount of literature exists related to diabetes and pregnancy, this scoping review draws attention to the lack of research focused on the reproductive health of women with diabetes prior to pregnancy. The majority of available literature focuses on contraception and preconception management, consistently demonstrating that women with diabetes lack adequate preventative reproductive healthcare compared to their nondiabetic counterparts. Far less evidence exists for sexually transmitted infection risk assessment and screening. It is imperative that future research focus on ways to mitigate disparities in access to reproductive health services for women with diabetes. Disclosure M.Treasure: None. P.S.Nourbakhsh: None. A.Osuna-garcia: None. S.C.Esteves: None. L.N.Kransdorf: None. L.E.Wisk: None.