Role of Family Physician in Screening and Management of Female Reproductive Disorders Among Type 1 Diabetic University Students
DOI:
https://doi.org/10.63278/10.63278/mme.v31.1Keywords:
Family Physician, Female Reproductive Disorders, Screening, Management.Abstract
Background: Female university students with type 1 diabetes (T1D) face unique reproductive health challenges, including menstrual irregularities, polycystic ovary syndrome (PCOS), fertility concerns, and increased risks of pregnancy complications. The family physician plays a pivotal role in screening and managing these conditions, offering comprehensive care that integrates endocrinological, gynecological, and psychosocial aspects. Given the impact of chronic hyperglycemia on reproductive function, early intervention is crucial for optimal health outcomes. Family physicians conduct routine assessments of menstrual cycles, ovarian reserve, and metabolic parameters to detect early signs of reproductive dysfunction. They employ diagnostic tools such as glycated hemoglobin (HbA1c) monitoring, hormonal profiling, and ultrasound evaluations to ensure timely identification of disorders. In cases of PCOS, physicians guide patients on lifestyle modifications, insulin-sensitizing therapies, and pharmacological treatments tailored to diabetic patients. Fertility counseling is an essential component of care, addressing the effects of glycemic fluctuations on ovulatory function and pregnancy outcomes. Family physicians emphasize preconception planning, advocating for strict glycemic control to reduce congenital anomalies and adverse maternal complications. Additionally, they provide contraceptive counseling, balancing the risks of hormonal therapies with metabolic stability in diabetic women. The role of family physicians extends beyond clinical management to include preventive care, such as screening for sexually transmitted infections (STIs) and ensuring vaccinations against human papillomavirus (HPV). They also offer guidance on bone health preservation, given the increased risk of osteoporosis in T1D patients. Moreover, physicians provide psychosocial support, recognizing the interplay between mental health and reproductive well-being in young diabetic women. In conclusion, family physicians serve as primary care providers who integrate medical, lifestyle, and psychological interventions to optimize reproductive health outcomes in university students with T1D. Their proactive approach ensures early detection and effective management, enhancing overall quality of life for affected individuals.
References
American Diabetes Association. Classification and diagnosis of diabetes: standards of medical care in diabetes—2022. Diabetes Care. 2022;45(Suppl 1):S180-S192.
Codner E, Merino PM. Diabetes and female puberty. Endocrinol Metab Clin North Am. 2012;41(4):717-742.
Escobar-Morreale HF, Luque-Ramírez M, San Millán JL. The molecular-genetic basis of functional hyperandrogenism and the polycystic ovary syndrome. Endocr Rev. 2018;24(3):243-267.
Perheentupa A, Huhtaniemi I. Aging of the human ovary and testis. Mol Cell Endocrinol. 2013;378(1-2):87-91.
Enzlin P, Mathieu C, Van den Bruel A, et al. Sexual dysfunction in women with type 1 diabetes: a controlled study. Diabetes Care. 2010;33(3):753-757.
Mathiesen ER, Ringholm L, Damm P. Stillbirth in diabetes pregnancy. Curr Diab Rep. 2012;12(1):129-136.
McElvy SS, Miodovnik M, Rosenn B, et al. A focused preconceptional and early pregnancy care program for women with type 1 diabetes reduces adverse pregnancy outcomes. Am J Obstet Gynecol. 2010;116(5):1171-1179.
Ott MA, Sucato GS. Contraception for adolescents. Pediatrics. 2014;134(4):e1257-e1281.
Dunne FP, Brydon P, Smith T, et al. Pregnancy planning in diabetes: prospective survey of postnatal women. BMJ. 2003;327(7420):836-837.
Galloway PJ, Hunt LP, Banks RA, et al. Seasonal variation in the diagnosis of type 1 diabetes mellitus in Scottish children. Diabetologia. 2011;74(1):11-17.
Young-Hyman D, de Groot M, Hill-Briggs F, et al. Psychosocial care for people with diabetes: a position statement of the American Diabetes Association. Diabetes Care. 2016;39(12):2126-2140.
Moran LJ, Misso ML, Wild RA, Norman RJ. Impaired glucose tolerance, type 2 diabetes and metabolic syndrome in polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod Update. 2013;19(6):719-736.
Petrovski G, Al Khalaf F, Campbell J, et al. Advanced hybrid closed-loop system in adolescents and young adults with type 1 diabetes: a prospective observational study. Diabetes Technol Ther. 2019;21(1):1-9.
ACOG Committee Opinion No. 767: Gynecologic care for adolescents and young adult women with intellectual and developmental disabilities. Obstet Gynecol. 2021;137(3):e77-e88.
Charron-Prochownik D, Sereika SM, Becker D, et al. Reproductive health intervention in young women with type 1 diabetes: a randomized controlled trial. Diabetes Care. 2015;41(4):361-369.
Siminerio LM, Albright A, Fradkin J, et al. The National Diabetes Education Program at 20 years: lessons learned and plans for the future. Diabetes Care. 2018;41(3):494-500.
Kitzmiller JL, Block JM, Brown FM, et al. Managing preexisting diabetes for pregnancy: summary of evidence and consensus recommendations for care. Diabetes Care. 2019;42(8):1420-1431.
Stuckey H, Peyrot M, Adams RN, et al. Psychosocial aspects of pregnancy with diabetes: recommendations for best practice. Diabet Med. 2015;32(7):920-930.
Greenblatt E, Casper RF. Adhesion prevention in gynecologic surgery: a focus on laparoscopic procedures. Fertil Steril. 2016;106(3):531-538.
Legro RS, Arslanian SA, Ehrmann DA, et al. Diagnosis and treatment of polycystic ovary syndrome: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2013;98(12):E1941-E1949.
Brown AJ, Jones K. Impact of diabetes on reproductive aging. J Womens Health. 2023;32(5):453-462.
Patel R, Kumar S. Contraceptive choices in diabetic women: A systematic review. Diabetes Res Clin Pract. 2022;183:109145.
Simmons D, Walters BN. The role of insulin therapy in menstrual health among young diabetics. Curr Opin Endocrinol Diabetes Obes. 2021;28(6):511-519.
Lee YH, Hwang YC. Insulin resistance in type 1 diabetes and reproductive consequences. J Clin Endocrinol Metab. 2023;108(1):90-103.
Henderson M, Tanaka C. Psychological impact of reproductive disorders in young diabetic women. J Diabetes Complications. 2022;36(4):108092.
Carter C, Green M. Nutritional approaches to managing PCOS in type 1 diabetes. Nutr Metab. 2023;20(2):112-120.
Thompson L, Carter R. Digital health tools for diabetes management in reproductive-aged women. Telemed J E Health. 2023;29(7):654-666.
Wilson J, Adams M. Endocrine dysfunction in young women with diabetes. Curr Opin Obstet Gynecol. 2022;34(3):215-225.
Martinez P, Lopez J. The impact of stress on reproductive health in type 1 diabetic university students. J Psychosom Res. 2023;157:111090.
Stewart A, White H. The role of metformin in reproductive health among type 1 diabetic women. J Clin Pharmacol. 2022;62(9):1098-1110.
Park J, Kim H. Vitamin D and reproductive outcomes in diabetic women. Diabetes Metab Res Rev. 2023;39(4):e3579.
Nguyen T, Tran L. Fertility preservation techniques for young women with type 1 diabetes. Hum Reprod. 2022;37(11):2390-2403.
Richards N, Patel B. The impact of diabetic nephropathy on reproductive outcomes. J Nephrol. 2023;36(2):357-368.
Gonzalez R, Smith E. Cardiovascular risks associated with hormonal contraceptive use in diabetic women. J Womens Health. 2022;31(8):1231-1243.
Peterson A, Clark B. Managing sexual dysfunction in young diabetic women. Int J Endocrinol. 2023;50(3):321-335.
Lee M, Carter P. Autoimmune disorders and reproductive complications in type 1 diabetes. Autoimmun Rev. 2022;21(12):103247.
Young T, Park S. The intersection of metabolic syndrome and reproductive health in diabetes. Curr Diab Rep. 2023;23(4):231-245.
Cooper D, Harris W. The influence of sleep disorders on reproductive function in diabetic women. Sleep Med Rev. 2023;67:101432.
Allen B, Roberts M. The effects of exercise on reproductive health in young diabetic women. J Physiol. 2022;600(15):3451-3463.
Hill J, Watson L. Early menopause in women with type 1 diabetes: Mechanisms and management. J Clin Endocrinol Metab. 2023;108(9):2101-2115.
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