Women living with diabetes: Overlooked and under-recognised, the psychosocial impact

Abstract

Aim

Diabetes intersects with women's reproductive and sexual health across the life course; however, the psychosocial implications of key reproductive transitions remain under-recognised in research and clinical practice. This review synthesised evidence on the psychosocial impacts of diabetes during menstruation, pregnancy, the menopausal transition and sexual functioning, with the aim of identifying critical gaps in research and care.

Methods

A narrative review was conducted, informed by a semi-structured literature search.

Findings

Women living with diabetes experience substantial psychosocial burdens that extend beyond glycaemic management across all reproductive stages. During menstruation, hormonal fluctuations contribute to glycaemic variability, increased self-management demands and emotional distress, often without adequate clinical guidance. Pregnancy in women with type 1, type 2, and gestational diabetes is associated with heightened anxiety, diabetes distress, stigma and guilt, yet psychosocial needs remain largely unaddressed in routine care. The menopausal transition represents a further period of vulnerability, characterised by worsening glycaemic variability, increased psychological morbidity and elevated cardiovascular risk. Sexual dysfunction is highly prevalent across the lifespan in women with diabetes and is strongly associated with depression, anxiety and body image concerns.

Conclusion

Overall, the evidence highlights a persistent disconnect between the psychosocial needs of women and the predominantly biomedical focus of current diabetes care models. Addressing this gap requires a person-centred approach that integrates psychosocial and women-specific health considerations into diabetes research, education and clinical practice. Strengthening this evidence base is essential to improving long-term health outcomes for women living with diabetes.