Preconception care in managed care: the translating research into action for diabetes study

OBJECTIVES: This study was undertaken to examine the rates of preconception counseling in managed care for women with diabetes and associated patient and physician characteristics. STUDY DESIGN: Participants included women aged 18 to 45 years enrolled in a study of diabetes care in managed care. Women were asked if they recalled discussions regarding glucose control before conception (n = 236) and use of family planning until glucose control was achieved (n = 227). Hierarchical logistic regression models accounted for patient and physician characteristics. RESULTS: Fifty-two percent of women recalled being counseled about glucose control and 37% recalled family planning advice. In adjusted models, patient age (years) (odds ratio [OR] 0.91, 95% CI 0.86-0.96) and body mass index (BMI) (kg/m2) (OR 0.96, 95% CI 0.93-0.99) remained significant predictors of glucose control counseling. Similarly, patient age (years) (OR 0.94, 95% CI 0.89-0.99) and BMI (kg/m2) (0.96, 95% CI 0.93-0.99) remained significant predictors of family planning counseling. CONCLUSIONS: Preconception counseling rates for diabetic women are low and associated with younger age and lower BMI.

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