Background: Sexually active adolescents with type 1 diabetes mellitus (T1DM) are at high risk for unplanned pregnancies, reproductive and perinatal complications. Routine prepregnancy counselling is recommended for all adolescent girls with T1DM according to the National Health and Medical Research (NHMRC - 2011) guidelines. Consequently, reproductive health information, including prepregnancy counselling to these young people is an important aspect of their diabetes education.
Objective: The objective of this study was to assess issues related to existing reproductive health knowledge, contraception, attitudes and beliefs of young women with T1DM in our Young Adult Diabetes Service (YADS) which is a transition clinic at Monash Medical Centre, and to identify barriers to these women achieving optimal diabetes control, and obtaining appropriate prepregnancy counselling.
Patients and Methods: This is a descriptive study of young women on our YADS clinic database between June 2011 and June 2013. Data was collected on a cross-sectional basis from a web-based questionnaire on a sample of 100 (58%) of the 173 eligible female adolescents with T1DM, who had consented to complete a modified reproductive health attitudes and behaviour (RHAB) questionnaire. 1
Results: Diabetic Nurse Educators were considered to be the most useful source of health information. Sexually active girls perceived themselves to be at much lower risk of unplanned pregnancies and STDs compared to their risks of weight gain and blindness in their responses. Adolescent girls with T1DM are becoming sexually active at an early age, with a high risk for an unplanned pregnancy. Despite the high perceived benefits of prepregnancy counselling (PC), low PC delivery rates were reported by study participants.
Conclusion: We support recommendations of NHMRC guidelines that young adolescents, starting at puberty need developmentally appropriate information with a sensitive and proactive approach before these young women become sexually active, enabling informed choices regarding reproductive health.