Dear SuzyKnew!

I’m 29 years old and was recently been told by my doctor that I’m pre-Diabetic. I’m learning about my condition and read that women with Diabetes need special care during pregnancy.  I am not ready to have a baby just yet. Do I need to make any changes with my birth control?  Help a Sista out!

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Dear Reader, You are correct. Whether you have a “touch of sugar” or are a type 2 or type 1 Diabetic, routine monitoring of your blood sugar level and regular visits to your doctor are key to maintaining good health. If you don’t want to start or add to your family, preventing pregnancy is a MUST.  However, an unplanned pregnancy is nothing you want to mess with, and can result in some serious health consequences.

Managing Diabetes is tricky business, especially for newly diagnosed patients.  You have your hands full now with diet, exercise, and glycemic control.  For most women in your position, they want a reliable birth control method and want to avoid pregnancy.

There are some methods that are better than others for a woman newly diagnosed with Diabeties:

Not so great: I wouldn’t advocate a natural family planning method, in which women predict ovulation and avoid intercourse during fertile times.  This is generally not a reliable method and carries a high risk of unplanned pregnancy.  I also would caution against using a barrier method alone (meaning just a condom and not in combination with a more reliable method).

Better: Methods that do not require frequent administration are great for Diabetics.  You need to focus on diet, exercise, glycemic control, and let’s not forget about dental care, right?  Adding another daily routine just opens the door to human error.   Many hormonal products have been developed with convenience in mind, such as the ring, patch, intrauterine devices, and contraceptive injections.  These tend to work well for busy women whether they are Diabetic or not.

Here is a word of caution about the use of hormonal contraceptives from the American Diabetes Association.- many birth control methods work by altering hormone concentrations. Hormonal birth control methods (patch, ring, IUD, pills, injections, implants) can affect your blood glucose levels.  So what should you do?  Here’s some advice:

 Have your A1C, blood pressure, and cholesterol checked 3 months after you start any hormonal birth control method (pill, patch, IUD, injection, ring)

 – Check your blood glucose levels frequently when you start any new method.

 –Keep accurate daily records of your blood glucose levels and insulin usage. Bring these to your doctor’s appointment.

 Best:  The most reliable method is a tubal ligation.  This is an option if you know for sure that childbearing is not in your future.  Since most 29-year-old women are not prepared to make such a permanent change, your best option may be barrier methods used in combination with a method with higher reliability, such as a intrauterine device, injection or patch.  Then you get the best of both worlds- protection from both STDs and pregnancy!

And don’t forget Emergency Contraception (EC).   Let’s face it, mistakes happen.  Diabetics should have a prescription or better yet, a supply of EC in the bathroom cabinet.

What About That Future Baby You May Have In Mind? Most women who have Diabetes can have healthy pregnancies under the close care of their doctor.   Women with Diabetes should their doctor before they become pregnant for preconception counseling.  And during your pregnancy, it is very important to have a doctor that will closely monitor your condition. Pregnancy can but a high level of stress on multiple organ systems including your kidneys, eyes and vascular system.  These are systems that are already stressed in a Diabetic.  High levels of glucose can cause serious health effects such as a miscarriage or birth defects in a developing fetus.

Millions of Diabetic women give birth to healthy babies each year.  Just make sure you are one of them, when your time is right.

Take care.