U.S.
Women with diabetes less likely to receive preventive care and some screenings
University of California - Los Angeles Health Sciences
Physicians are less likely to provide preventive care such as conception counseling and some cancer screenings to women with diabetes than they do for women without the disease, a UCLA-led study suggests.
The findings, to be published April 3 in the peer-reviewed Journal of General Internal Medicine, are based on a detailed analysis of more than 40 studies from several countries. They spotlight how physicians largely overlook the importance of these routine services to women who have Diabetes Mellitus (DM), putting them at risk for preventable medical conditions such as pregnancy complications.
"These findings are important because they identify that women with diabetes are not receiving recommended well-woman care, which is essential to support both managing their diabetes and their overall health,” said senior author Lauren Wisk, an associate professor of medicine in the division of general internal medicine and health services research at the David Geffen School of Medicine at UCLA. “Providers need to be aware that they should not forget to provide these essential services for women with diabetes.”
The researchers sifted through thousands of studies, focusing on concepts of “women,” “diabetes,” and “Women’s health services” and settled on 44 that addressed treatment services for women ages 15 to 49 years with type 1 or type 2 diabetes, exclusive of those with diabetes insipidus or gestational diabetes. They specifically looked at four preventive health service categories: contraceptive counseling and use, breast/cervical cancer screening, pre-conception counseling, and screening for sexually transmitted infections.
Here are key findings from the studies the researchers reviewed:
- One study found that 48% of women with diabetes received contraceptive services vs. 62% of women without the disease
- Nine papers showed cervical cancer screening rates ranging from 38% to 79% for women with diabetes compared with a 46% to 86% rate for those without diabetes.
- Four studies concluded that breast cancer screenings rates for women with diabetes ranged between 38% and 69% compared with 54% and 82% for those without diabetes
- Fourteen studies found pre-conception counseling rates of just over 1% compared to 46% for women with diabetes who are planning to get pregnant.
The researchers did not identify any studies on screenings for sexually transmitted infections, which they said represents “a substantial gap in the literature.”
“One of the more striking findings of this review is the importance of robust coordinated care teams in ensuring access to appropriate services for women with DM,” the researchers write. “Several of the identified studies provide support that a co-management model, or the concept of involving endocrinology, primary care, and other specialty care providers in the care of individuals with DM (as recommended by the American Diabetes Association), is associated with greater receipt of services.”
Within the time constraints of an office visit, primary care physicians are expected to address preventative health needs as well as chronic disease management, said Dr. Lisa Kransdorf, an associate clinical professor of medicine at the Geffen School and a study co-author. Frequently the chronic disease management will take priority.
“In cases where the patient has other providers such as specialists and clinical pharmacists actively involved in their chronic disease management, there is opportunity for primary care physicians to attend to preventative care gaps,” she said.
There are some limitations to the findings. The search yielded only 44 studies, many of which relied on patient recall, which can be unreliable, and highlighting the need for further research. In addition, most of the studies analyzed had small sample sizes or were conducted at a single site, limiting how applicable the findings might be in other settings.
“Future research should look into how health systems should use electronic health records to increase preventive health services among women with diabetes, improve care-coordination and communication between healthcare providers, and evaluate co-management models' quality of care,” Wisk said.
Study co-authors are Dr. Madeline Treasure, Dr. Pourandokht Nourbakhsh. Kate Diaz Roldan, Antonia Osuna-Garcia and Dr. Lisa Kransdorf of UCLA, and Sara Esteves of Creighton University.
Journal
Journal of General Internal Medicine
Method of Research
Literature review
Subject of Research
People
Article Title
Preventive Health Services in Reproductive-Aged Women with Diabetes Mellitus: A Scoping Review
Article Publication Date
3-Apr-2026
Female veterans faced steeper well-being declines after COVID-19, study finds
UNIVERSITY PARK, Pa. — While the COVID-19 pandemic challenged all veterans transitioning to civilian life, female post-9/11 veterans experienced a sharper decline in overall well-being compared to their male counterparts, according to new research from the Clearinghouse for Military Family Readiness at Penn State.
Recently published in Chronic Stress, the findings paint a picture of a dual reality. While female veterans demonstrated remarkable resilience in parenting, they also navigated a widening gap of gender inequality during the pandemic, resulting in more stress and less satisfaction in their professional and social lives compared to male veterans.
“Female veterans were carrying a heavier strain than males in several areas of their lives, and that pattern persisted across the periods we studied,” said Kimberly McCarthy, lead author on the study and a research project manager at the Clearinghouse. “What stands out is not only that women reported more stress in key areas, but that in some cases, the gap widened after COVID-19. That tells us support systems need to be more responsive to the realities women veterans are facing at work, at home and in their relationships.”
The researchers drew on data from two linked longitudinal studies, the Veterans Metrics Initiative and the Veterans Engaging in Transition Studies, in which participants comprised of service members who served after 9/11 were followed for 6.5 years after separation from service. The analysis compared responses collected before the pandemic from more than 5,200 veterans with responses collected after the pandemic from more than 3,100 veterans. Using standard survey measures, the study assessed stress in four well-being domains: work, relationships, social connections, and parenting.
By analyzing stress in the four well-being domains, the researchers captured a nuanced portrait of the modern female veteran. While enduring the added pressures of the pandemic, she was often highly functioning at home and competent in her parenting, but the pre-pandemic strains of underemployment, unequal division of work-family responsibilities and a lack of emotional support were exacerbated by the pandemic.
Gender differences among the studied veterans were clearest in the employment domain. Female veterans reported lower work satisfaction than male veterans before and after COVID-19, and both groups experienced declines in work satisfaction over time. Women also reported higher underemployment than men, though both groups reported some improvement in employment status over time. The sharpest difference appeared in work strain, which increased for both groups but rose more steeply among women. Globally, during the pandemic, research shows that women were, in general, more likely than men to balance work and family while taking on increased responsibilities for children’s care and schooling.
Social outcomes were more mixed. Instrumental social support — help with daily tasks, support when ill — increased slightly for both women and men, while emotional support declined for both groups. Social satisfaction also fell over time, with the decline significantly steeper among female veterans.
Parenting findings were more nuanced. Female veterans reported higher parental functioning and parenting satisfaction than male veterans at both time points, and both groups experienced declines in functioning and satisfaction from pre- to post-pandemic. Together, these findings suggest that parenting-related pressures intensified during the pandemic, even as women continued to report stronger overall parenting outcomes.
Relationship outcomes also worsened over time. Female veterans reported lower relationship satisfaction than male veterans before and after COVID-19, and the decline in satisfaction was steeper among female veterans. Relationship functioning also declined for both groups but more steeply for females over time. The researchers linked these patterns for women to work-family imbalances, unequal household demands and less emotional support from their partner.
“This study shows that large-scale disruptions, such as the pandemic, do not affect all veterans in the same way,” said Keith Aronson, director of the Clearinghouse and research professor in the Department of Biobehavioral Health.
Although the sample size was large, the researchers said the study may not fully represent all veteran parents. Compared with 2017 Department of Defense numbers, the parent veterans in the study’s sample were somewhat older, suggesting the study may underestimate stress in the broader post-9/11 veteran population.
Ultimately, the researchers suggest that the pandemic didn’t just create new problems; it exposed and amplified existing issues for women in the veteran community. The data show well-being moving in multiple directions at once, and the researchers argue that "one-size-fits-all" veteran benefits and support services are insufficient.
"This research clearly indicates that resilience and strain often exist side-by-side," said Daniel F. Perkins, principal scientist and founder of the Clearinghouse and distinguished professor of family and youth resiliency and policy. "The steeper satisfaction and functioning declines we see in female veterans’ social and professional lives are a call-to-action. Our policies must move beyond individual clinical health and address the full complexity of their lives, from childcare and equitable employment to the strengthening of virtual support communities."
Mary M. Mitchell, research professor at the Clearinghouse, also contributed to this work.
The research was supported by the Henry M. Jackson Foundation for the Advancement of Military Medicine Inc., and the Pew Charitable Trusts.
Journal
Chronic Stress
Method of Research
Data/statistical analysis
Subject of Research
People
Article Title
Employment, Relationship, and Parenting Stress Among Post-9/11 Veterans: Life Before and After the COVID-19 Pandemic
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