On the Health Concerns of Women with Diabetes: A Combined Study 2018

Nowadays, the high prevalence of diabetes among reproductive-aged women is one of the serious problems policymakers face. The current study was designed to explain the reproductive health concerns of women with type I diabetes and make effective interventions based on their reproductive health concerns.

The present study was a multistage mixed methods study which was conducted in three stages. In the first stage, through a qualitative study, semi-structured in-depth interviews were conducted on 17 women with Type I diabetes and 4 husbands. The data gathered in this stage were analyzed by the content analysis approach using Graneheim and Lundman method.  Thereafter, in the second stage of the study, a meeting was held with six interested and experienced health professionals in various health care settings, Women’s concerns were prioritized in a nominal way according to the themes found in the qualitative part of the study. Thereafter, in relation to the proposed priority, an overview of the literature was made and an appropriate intervention was designed. In the third stage, a randomized clinical trial was conducted on 32 women with Type 1 diabetes (16 women in the intervention group and 16 in the control group) to determine the impact of couple counseling.

In the first stage, the content analysis of the qualitative data aiming at explaining the reproductive health concerns of women with Type I diabetes led to the formation of six main themes. They included physical, psychological, social, fertility, marital life and supportive and informational dimension. In the second stage, based on consensus, sexual concerns were identified as the most important concern for designing an intervention. By reviewing the related interventions and programs in Iran and other countries, a couples counseling intervention was proposed which was based on BETTER Model. It was designed in at least four sessions, including three stages of pre-test, post-test, and 2-month follow-up, to improve sexual function and satisfaction in women with diabetes. In the third stage, the results of a randomized clinical trial indicated a statistically significant difference between the intervention and control groups regarding the means of female sexual function index (P<0.001). However, no significant difference was observed between the mean of female sexual satisfaction scale among the women in the intervention group, as compared to the control group (P=0.09).

As evidenced by the obtained results, the reproductive health concerns in women with Type 1 diabetes fall into five domains. In the sexual domain, couples counseling, which was based on BETTER model, significantly increased the sexual function of women with Type I diabetes.