Contraceptive Pearl: Diabetes and Contraception Use
Diabetes and Contraception Use
Unplanned pregnancy among women with diabetes mellitus poses serious risks to both the mother and the fetus. Contraception is a critical and often over looked component of diabetes management.
Recent research dispels the notion that contraceptive hormones interfere with glucose metabolism. Hormonal contraceptives have no effect on HgA1C levels nor do they affect insulin requirements. Women who have had uncomplicated diabetes for less than 20 years can safely use any contraceptive method.
Estrogen-containing contraceptives and the progestin injection (“depo”) pose risks to a small subset of diabetic women of reproductive age. Those with advanced vascular disease, end-organ involvement (neuropathy, retinopathy, nephropathy) or uncomplicated diabetes with duration over 20 years should generally not use estrogen-containing methods or the progestin injection. These methods’ cardiovascular risks are too high for women with advanced or complicated diabetes. However, most of these women can safely use the progestin-only pill, the progestin implant, and either type of IUD. Barrier methods are also safe for this group, as is emergency contraception.
Women with diabetes should prepare carefully for a healthy pregnancy, delaying conception until blood glucose is well-controlled. Clinicians should inform these women about all contraceptive options, and should periodically assure that these women remain satisfied with their current contraceptive method.
We appreciate your feedback! Please write us at pearls@reproductiveaccess.org with any questions, comments or additional resources to add to our list.
Helpful Resources
Medical Eligibility for Initiating Contraception
Birth Control Choices Fact Sheet
Sources
WHO Medical Eligibility Criteria for Contraceptive Use
Pharma-free
The Reproductive Health Access Project does not accept funding from pharmaceutical companies. We do not promote specific brands of medication or contraception. The information in the Contraceptive Pearls is unbiased, based on science alone.
