Women with diabetes are less likely to get preventive care than those without the condition, a UCLA-led study suggests.

The findings are based on an analysis of more than 40 studies from several countries.

They highlight how physicians largely overlook the importance of these routine services for women who have diabetes mellitus, or DM, putting them at risk of preventable medical conditions such as pregnancy complications.

Lauren Wisk is associate professor of medicine in the division of general internal medicine and health services research at the David Geffen School of Medicine at UCLA and senior author on the study.

She said: “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.

“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 the concepts of women, diabetes and women’s health services, and settled on 44 that addressed treatment services for women aged 15 to 49 with type 1 or type 2 diabetes, excluding those with diabetes insipidus or gestational diabetes.

They looked at four preventive health service categories: contraceptive counselling and use, breast and cervical cancer screening, pre-conception counselling, and screening for sexually transmitted infections.

One study found that 48 per cent of women with diabetes received contraceptive services compared with 62 per cent of women without the disease.

Nine papers showed cervical cancer screening rates ranging from 38 to 79 per cent for women with diabetes compared with 46 to 86 per cent for those without diabetes.

Four studies found that breast cancer screening rates for women with diabetes ranged between 38 and 69 per cent compared with 54 and 82 per cent for those without diabetes.

Fourteen studies found pre-conception counselling rates of just over 1 per cent compared with 46 per cent for women with diabetes who are planning to get pregnant.

The researchers did not identify any studies on screening for sexually transmitted infections, which they said represents “a substantial gap in the literature.”

The researchers wrote: “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.

“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.

She said chronic disease management will often 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,” the researcher added:

There are some limitations to the findings.

The search yielded only 44 studies, many of which relied on patient recall, which can be unreliable, highlighting the need for further research.

In addition, most of the studies analysed had small sample sizes or were conducted at a single site, limiting how applicable the findings might be in other settings.

NICE has updated fertility guidance with a new endometriosis section for people struggling to conceive.

This follows feedback received during public consultation, recognising for the first time that the condition requires its own tailored approach to fertility care, separate from other causes of infertility.

Emma Cox, chief executive of Endometriosis UK, said: “This year’s Endometriosis Action Month theme is ‘Endometriosis Doesn’t Wait’ and our new State of Endometriosis Care report shows just how urgently change is needed.

“With average diagnosis times now standing at 9 years and 4 months, and 11 years for those from ethnically diverse communities, many have already waited far too long by the time they reach fertility services.

Today’s guidance marks a step change in the fertility support that anyone with endometriosis should receive.

“For years, those with endometriosis have told us they felt invisible within the fertility system, grouped with unexplained infertility despite having a diagnosed condition.

“We welcome NICE’s decision to listen to patient voices during consultation, to create a dedicated pathway, and to remove misleading labels like ‘mild’ and ‘severe’ endometriosis.”

“Endometriosis doesn’t wait. And now, at last, neither will the guidance.”

Endometriosis UK and others told NICE during consultation that endometriosis was being grouped with unexplained infertility, despite it being a diagnosed condition.

The committee agreed this was inappropriate and that endometriosis requires a distinct fertility pathway.

Respondents also told NICE that terms such as “mild” and “severe” endometriosis were clinically ambiguous and did not reflect the complexity of the condition or its impact on fertility.

The committee agreed and those terms have been removed from the final guideline.

Under the new recommendations, clinicians will discuss a range of options with patients with endometriosis who are trying to conceive, taking into account individual factors including how long they have been trying to conceive, the severity of their symptoms, their age, their ovarian reserve, which is a measure of remaining egg supply, and any male fertility factors.

The guideline sets out a treatment pathway. Where appropriate, expectant management, meaning time to try to conceive naturally, may be offered, or surgical treatment to address endometriosis, in line with NICE’s existing endometriosis guideline (NG73).

If neither approach is suitable or successful after 2 years, fertility treatment options including intrauterine insemination (IUI), where sperm is placed directly into the womb, or IVF will be discussed.

The new guidance supports the ambitions set out in the NHS 10 Year Health Plan, which commits to shifting care closer to home and empowering patients and professionals to make the best choices about treatment.

Setting out a clear, personalised pathway in the guideline for endometriosis helps ensure fertility services are better tailored to individual need, reducing variation in care and supporting equitable access across England.

Eric Power, interim director of the Centre for Guidelines at NICE, said: “We listened carefully to what patients, clinicians and patient groups told us during consultation.

“They described how complex endometriosis is, how they felt existing labels were misleading, and that the condition needed its own pathway. The committee agreed and acted on that feedback.”

“By creating a dedicated section for endometriosis, we are giving clinicians a clear, evidence-based framework to have better, more personalised conversations with their patients, ensuring that everyone, regardless of the cause of their fertility problems, has access to the right care at the right time.”

Public health minister Sharon Hodgson said: “Every woman with endometriosis deserves fertility care that recognises the complexity of her condition.

“This landmark guidance will ensure women can access a clear, personalised pathway to fertility care that leads to clearer conversations with clinicians and fewer barriers.

“We’re committed to giving every woman the support she deserves, and today’s guidance is a significant step towards ending the inconsistency that has let down too many, for too long.”

Women’s HealthX is convening a powerful lineup of pharmaceutical and biotech leaders, uniting global organisations including AstraZeneca, Bayer, Gilead, Chiesi, Eli Lilly, Alexion, and Daré Bioscience alongside 750+ senior clinicians, hospital leaders, insurers, and policy makers shaping the future of women’s health.

As the women’s health market continues to evolve, the event provides a unique platform for pharma leaders to share how they are leveraging clinical trial data, real world evidence, and digital innovation to reduce regulatory risk, improve representation in research, and unlock new opportunities for partnership and pipeline growth.

Across seven dedicated stages covering the full lifecycle of care, attendees will gain direct insight into how industry leaders are driving measurable change in outcomes, access, and equity.

Confirmed sessions and trailblazers include:

Maternity & Maternal Care

• Empowering Mothers, Advancing Equity, and Improving Outcomes in Premature Care

Erica Smith, Vice President, Value & Market Access, US, Chiesi

Evidence, Data & Innovation

• Addressing Design Barriers: Paving the Way for Sex Specific Data Clarity

Julieta Jimenez, Executive Director, Program Management Clinical Operations, V&I, AstraZeneca

• Design Trials That Generate Clinically Meaningful Evidence for Women

Luba Soskin, Global Clinical Lead, Women’s Health, Bayer

Chronic Disease Management

• Improving Outcomes in Obesity Through Evidence Based Person Centred Care

Tracy Sims, Executive Director, Corporate Affairs, Cardiometabolic Health, Eli Lilly

• Tackling Sex Based Health Inequities by Breaking Down Barriers and Bias

Adrian Kielhorn, Senior Director, Global Head HEOR Neurology, Alexion

Sexual Health & Wellness

• The Clinical Impact of Internal Stigma in Sexual Health

Kesha O’Reilly, Director Medical Affairs, HIV Franchise, Gilead

• Explore Innovative Product Manufacturing Pathways Beyond Conventional Regulatory Models

David Friend, Chief Science Officer, Daré Bioscience

We have also just announced Endometriosis Advocate Padma Lakshmi as a keynote speaker, bringing one of the most influential voices in women’s health advocacy to the stage.

See full list of confirmed trailblazers here

Together, these leaders represent the organisations driving innovation across research, development, and commercialisation, offering practical insight into how to bring safer, more effective solutions to women worldwide.

The program moves beyond discussion into delivery, equipping attendees with the latest clinical evidence, regulatory strategies, and innovation frameworks needed to accelerate impact across the healthcare ecosystem.

With senior decision makers from across pharma, biotech, and healthcare in attendance, women’s healthX is where partnerships are formed, strategies are shaped, and the future of women’s health is defined.

Secure your free place now