[Which contraceptive methods are recommended for young women with type 1 diabetes mellitus? A survey among practitioners in Germany]

Abstract

Aim: The aim of this study was to find out which recommendations German gynecologists gave to young patients with type 1 diabetes mellitus in respect to contraception. In addition, it was asked to what extent German gynecologists/obstetricians had experience regarding counselling of young women with type 1 diabetes.

Subjects and methods: A structured questionnaire containing questions about attitudes, health care beliefs and contraception in young women with type 1 diabetes was developed. 804 attendees of the Giessen Gynecological Seminar which was held in January 1997 were asked to participate in the study.

Results: Only 142 (17.7%) of the questionnaires were returned. There was no consensus in respect to contraception in young women with diabetes. 61% of the respondents referred to the micropill (< 0.3 mg estrogen) as the preferred contraceptive method for young women with diabetes. Condoms were regarded as second line contraceptive devices in this age and patient group. There was only very limited experience in regard to counselling and treating adolescents/young women with type 1 diabetes.

Conclusion: Among the German gynecologists questioned there was no consensus in respect to contraception in young women with diabetes. Most importantly, there was only very limited individual experience in regard to counselling and treating adolescents/young women with type 1 diabetes among the doctors who participated in the study.

PIP: A structured questionnaire containing questions about attitudes, health care beliefs and contraception in young women with Type 1 diabetes was offered to 804 gynecologists attending the Giessen Gynecological Seminar held in January 1997. Only 142 (17.7%) of the questionnaires were returned. 64.8% of the respondents were general practitioners, 42% were in private practice, 28.9% were employed at non-university clinics, and 2.1% at university clinics. 33% of the respondents did not provide any information about the number of women under their care and 19% did not treat any young patients aged 14-18 with Type I diabetes. 40% of the rest of the respondents treated 5 patients at the most with Type I diabetes. 61% of the respondents cited the micropill (0.3 mg estrogen) as the preferred and recommended contraceptive method for young patients with Type I diabetes. 25% referred to the condom as the recommended method. For young patients with type I diabetes who smoked, the most recommended method was the condom (31%) followed by the IUD (15.2%) and the very-low-dose pill. 4.2% of the physicians who decided against the very-low-dose pill for young patients with Type I diabetes cited the danger of blood vessel-related side effects and 14.6% cited inadequate safety. 35.2% of the respondents cited the danger of blood vessel related side effects and 7% inadequate safety for not recommending the low-dose pill for young patients with Type I diabetes. There was very limited individual experience in regard to counseling and treating young women with Type I diabetes among the doctors who participated in the study.