TY - JOUR
T1 - Use of contraception before and after a diabetes diagnosis
T2 - An observational matched cohort study
AU - Murray Horwitz, Mara E.
AU - Pace, Lydia E.
AU - Schwarz, Eleanor Bimla
AU - Ross-Degnan, Dennis
N1 - Funding Information:
M.E.M.H. was supported by an Institutional National Research Service Award from the National Institutes of Health (Grant No. 2-T32-HP10251 ) and the Harvard Pilgrim Health Care Institute . D.R.D. received support from Harvard Pilgrim Health Care Institute to provide mentorship for the study, and was supported in part by the National Institute Of Diabetes And Digestive And Kidney Diseases of the National Institutes of Health (Award No. P30DK092924 ). Dr. Ross-Degnan reports support from grant 1U58DP002719 from the Centers for Disease Control and Prevention/National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and 1P30-DK092924 from the NIDDK Health Delivery Systems Center for Diabetes Translational Research .
Publisher Copyright:
© 2021 Primary Care Diabetes Europe
PY - 2021
Y1 - 2021
N2 - Aims: To determine how a diabetes diagnosis affects contraception use. Methods: This retrospective cohort study used private insurance data from non-pregnant women aged 15–49 years, 2000−2014. We identified women with a new diabetes diagnosis and a control group without diabetes, matched on important potential confounders. We compared rates of prescription or procedural contraception use in the two groups before and after an index date (diabetes diagnosis and outpatient visit, respectively), yielding difference-in-differences estimates of the effect of a diabetes diagnosis on contraception use. Results: We identified 75,355 women with a new diabetes diagnosis and 7.5 million women without a diabetes diagnosis. Overall rates of contraception use did not increase in the year after diagnosis (absolute difference-in-difference: 0.4% [99.9% CI, −2.1% to 2.9%]; p < 0.001). In method-specific analyses, there was a decline in estrogen-containing and injectable contraceptives in the year after diagnosis (absolute difference-in-difference: −2.2% [−4.0% to −0.4%] and −0.8% [−1.5% to −0.1%], respectively; p < 0.001); no corresponding increase was noted for intrauterine contraception or subdermal implants. Conclusions: Women with diabetes are less likely to use contraception after their diabetes diagnosis. Efforts are needed to ensure that women with diabetes receive the counseling and clinical services needed to carefully plan their pregnancies.
AB - Aims: To determine how a diabetes diagnosis affects contraception use. Methods: This retrospective cohort study used private insurance data from non-pregnant women aged 15–49 years, 2000−2014. We identified women with a new diabetes diagnosis and a control group without diabetes, matched on important potential confounders. We compared rates of prescription or procedural contraception use in the two groups before and after an index date (diabetes diagnosis and outpatient visit, respectively), yielding difference-in-differences estimates of the effect of a diabetes diagnosis on contraception use. Results: We identified 75,355 women with a new diabetes diagnosis and 7.5 million women without a diabetes diagnosis. Overall rates of contraception use did not increase in the year after diagnosis (absolute difference-in-difference: 0.4% [99.9% CI, −2.1% to 2.9%]; p < 0.001). In method-specific analyses, there was a decline in estrogen-containing and injectable contraceptives in the year after diagnosis (absolute difference-in-difference: −2.2% [−4.0% to −0.4%] and −0.8% [−1.5% to −0.1%], respectively; p < 0.001); no corresponding increase was noted for intrauterine contraception or subdermal implants. Conclusions: Women with diabetes are less likely to use contraception after their diabetes diagnosis. Efforts are needed to ensure that women with diabetes receive the counseling and clinical services needed to carefully plan their pregnancies.
KW - Contraception
KW - Diabetes
KW - Family planning
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U2 - 10.1016/j.pcd.2021.02.012
DO - 10.1016/j.pcd.2021.02.012
M3 - Article
C2 - 33744164
AN - SCOPUS:85102843831
JO - Primary Care Diabetes
JF - Primary Care Diabetes
SN - 1751-9918
ER -