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. 2025 Aug 31.
doi: 10.1007/s12020-025-04345-1. Online ahead of print.

Sexual knowledge and contraceptive use in adolescents with type 1 diabetes in comparison with their healthy peers

K Karavanaki  1 , K Kakleas  2 , B Kandyla  3 , A Soldatou  3 , G Paltoglou  3 , S E Karanasios  3 , C Tzavara  4 , A Tsitsika  4 , L Kossiva  3
Affiliations

Sexual knowledge and contraceptive use in adolescents with type 1 diabetes in comparison with their healthy peers

K Karavanaki et al. Endocrine. .

Abstract

Purpose: Adolescents with type 1 diabetes mellitus (T1D) may differ from their healthy peers in respect to sexually transmitted diseases (STDs) knowledge and contraceptive use. We aimed to explore sexual knowledge and contraceptive use and associated factors in T1D adolescents compared to healthy peers.

Methods: Fifty- eight T1D adolescents (mean ± SD age 16.3 ± 2.0 years, disease duration 6.7 ± 3.5 years) were compared to 116 healthy controls (matching 1:2 for school, age and gender). Anonymous questionnaires were used to evaluate sexual knowledge and contraceptive methods.

Results: The commonest contraceptive method at the last sexual contact was the condom. The use of birth pill was reported by 11.8% patients and by 8.3% controls, withdrawal was reported by 33.3% of T1D and 24% of controls, no protection by 23.5% patients and by 10.2% controls, while double protection (≥2 methods) was reported by 35% patients and 27.7% controls. No study participant used long-acting reversible contraception (LARC). The high protection (dual protection) group was characterized by younger age and older age at sexual debut (16.4 vs 15.8 years, p = 0.010). The low protection group (no contraception/withdrawal) was characterized by older patients' age (p = 0.023) and younger paternal age (p = 0.046). Among controls, the use of dual protection was more common in the group whose parents were married versus those with divorced parents (34.3 vs. 10%, p = 0.042).

Conclusions: Among the study population, the condom was the commonest contraceptive method for both groups, while 23.5% of patients and 10.2% controls used no protection. The degree of contraception use among patients was associated with patients' age and parental age and with the family structure in controls. The above underline the necessity for health care professionals to provide sexual education and contraception counseling to young adolescents with T1D and their healthy peers.

Keywords: Adolescents; Contraception; STDs; Sexual education; Type 1 diabetes.

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Conflict of interest statement

Compliance with ethical standards. Institutional review board statement: The study was approved by the Ethics Review Board of both the “P. &A. Kyriakou” Children’s Hospital in Athens, Greece, and the Hellenic Ministry of Education and Religious Affairs. Informed consent statement: Informed consent for study was obtained from all parents/legal guardians of eligible participants prior to participation in the study. Conflict of interest: The authors declare no competing interests.

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