Youth With Type 2 Diabetes Have Low Rates of Contraception and Preconception Counseling Documentation Compared With Adults With Diabetes

Youth with type 2 diabetes are at a higher risk of adverse pregnancy outcomes than their adult counterparts, and addressing contraception in this population at puberty onset is strongly recommended. This retrospective study at an academic pediatric type 2 diabetes clinic found that 30% of youth achieved the primary composite outcome of documented preconception and contraceptive counseling, contraception prescription, and gynecology referral. Only 1.4% of youth aged 12–21 years had documented preconception counseling, and 27% had documented contraception counseling. By comparison, 18% of adults with preexisting diabetes at the same academic campus met the primary outcome. Adults had a higher rate of preconception counseling (14%), but a lower rate of contraception counseling (4%). This study identifies major gaps in preconception counseling and contraception education for youth with type 2 diabetes.