Year of Publication

2022

College

Public Health

Date Available

4-23-2024

Degree Name

Master of Public Health (M.P.H.)

Committee Chair

Mary E. Lacy

Committee Member

Richard Crosby

Committee Member

W. Jay Christian

Abstract

Introduction: Polycystic ovarian syndrome (PCOS) is a hormonal disorder that affects 6-12% of United States women of reproductive age. Women with PCOS are at an increased risk of developing type 2 diabetes and fall into high-risk groups for screening guidelines put out by the American College of Obstetricians and Gynecologists (ACOG). Guidelines further suggest that an oral glucose tolerance test (OGTT) be used for diabetes screening in women with PCOS as opposed to an A1C or fasting plasma glucose test. The purpose of this study is to examine rates and type of diabetes screening used among a sample of women across the country with PCOS.

Methods: This project used the Truven Marketscan Commercial Claims database from 2011-2019 to identify a sample of women aged 18-64 with PCOS with at least 5 years of continuous enrollment. PCOS was ascertained using diagnosis codes (ICD-9: 256.4; ICD-10: E28.2). Diabetes screening was ascertained using CPT codes (A1C: 83036, 83037; Fasting blood sugar: 82947; OGTT: 82950). Diabetes screening rates were calculated across the entire study period for the following subgroups- age, overweight/obese, hypertension, hypercholesterolemia, and vascular disease.

Results: In our sample of 173,144 women with PCOS from the Truven Marketscan database, we found that 77.98% of women were screened at least once for diabetes. Out of these women who were screened, only 20.5% were screened using the AES recommended OGTT, with the A1C (66.84%) and the fasting blood sugar (28.08%) tests used at higher frequencies.

Conclusion: Almost 80% of women with PCOS are complying with the ACOG screening guidelines for diabetes. Further, while the OGTT is recommended for women with PCOS, it was the least utilized screening test when compared with the A1C and fasting blood sugar tests.

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