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Diabetic Contraception

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Contraception and the risk of type 2 diabetes:JAMA:"The increased risk of diabetes associated with use of norethindrone alone was somewhat surprising considering the lack of excess risk associated with combination OCs containing similar amounts of norethindrone or another progestational agent, levonorgestrel. Although our study does not provide a definitive explanation for these findings, examination of the different circumstances under which combination and progestin-only OCs were used may provide some clues."
http://www.ama-assn.org/special/contra/library/readroom/joc72148.htm

Mini-Pill Increases Risk Of Chronic Diabetes In Women With History Of Diabetes During Pregnancy:Science Daily:"USC Researchers Urge Caution In Prescribing Progestin-Only Oral Contraceptives For High-Risk Women Women who develop diabetes during pregnancy face an increased risk of later developing type-2 diabetes. Now, USC researchers say that using the mini-pill -- progestin-only birth control pills -- may put these women at an even higher risk of developing the chronic form of the disease. "It appears that progestin-only oral contraceptives increase risk by nearly three-fold and should not be widely prescribed in this group of women," says Siri Kjos, M.D., associate professor of obstetrics and gynecology at the University of Southern California School of Medicine."
http://www.sciencedaily.com/releases/1998/08/980818070717.htm

A desktop guide to type 2 diabetes:Inernational diabetes federation:"Women of child-bearing age with Type 2 diabetes are almost invariably overweight and have a high relative risk of arterial damage / thrombotic problems Advise : on barrier methods, or low-dose oral contraceptives if low arterial risk not to discontinue contraception until adequate metabolic control achieved repeatedly the need for pregnancy planning on the intensity of diabetic pregnancy management, and the risks to the fetus"
http://www.staff.ncl.ac.uk/philip.home/t2dgch6a.htm

Preconception care for women with diabetes:diabetes.org:"Diabetes and contraception Information on pregnancy and contraception should be given to all women with diabetes of childbearing age. There are no contraceptive methods that are specifically contraindicated in women with diabetes. Methods with proven high degrees of effectiveness are to be preferred."
http://www.diabetes.org.uk/infocentre/carerec/preconcept.htm

Preconception planning for woman with diabetes:Life Clinic:"Planning to get pregnant? Read this first Women with diabetes who are considering pregnancy are strongly urged to achieve excellent blood glucose control before conception. That's because hyperglycemia can increase the risk of a miscarriage or of birth defects in the baby. When women have maintained strict blood glucose control prior to conceiving and during the first trimester, the incidence of malformations is much lower than in women with diabetes who did not. If you are planning to start your family, it is critically important that you discuss your decision with your healthcare provider and members of your diabetes care team right away. You will also want to choose an obstetrician who is familiar with the special challenges of a diabetic pregnancy."
http://www.lifeclinic.com/focus/diabetes/preconception.asp

Progestin-only pill linked to diabetes risk:Personal MD:"Women who have had gestational diabetes -- the type of diabetes that develops during pregnancy -- triple their risk of developing type 2 diabetes (adult onset diabetes) if they take progestin-only oral contraceptives while breast feeding, according to a report in the August 12th issue of The Journal of the American Medical Association. In contrast, the use of low-dose combined (estrogen + progestin) oral contraceptives, does not increase the risk of type 2 diabetes in these women, write Dr. Ruth K. Peters and colleagues, of the University of Southern California in Los Angeles. Progestin-only contraceptives are usually recommended for women who are breastfeeding because, unlike other hormones, progestin does not affect milk production."
http://www.personalmd.com/news/a1998081110.shtml

Irregular cycle may increase diabetic risk:The Hawaii Channel:"Women who have long or very irregular menstrual cycles have an increased risk for developing type 2 diabetes, according to a new study. Dr. Caren G. Solomon and colleagues from Brigham and Women's Hospital in Boston used data from the Nurses' Health Study II to assess the risk of type 2 diabetes in women with a history of long or highly irregular menstrual cycles. The study, published in Wednesday's Journal of the American Medical Association, found that women whose cycles were long -- 40 days or longer -- or very irregular had about twice the risk of developing diabetes compared with women with a usual cycle length of 26 to 31 days"
http://www.thehawaiichannel.com/sh/health/stories/health-108711420011120-141106.html

Pre-pregnancy diabetes care reduces risk of birth defects:newsandevents:"In an analysis of 16 studies involving more than 2,600 offspring of women with established diabetes prior to pregnancy, the researchers found the risk for major birth malformations was 6.5 per cent in women who did not receive pre-conception care compared to 2.1 per cent for women who did. Pre-conception diabetes care includes strict monitoring of blood glucose levels, dietary education and the use of contraception, among other interventions."
http://www.newsandevents.utoronto.ca/bin2/010815a.asp

Diabetes, Family Planning and Pregnancy:diabetes-healthnet:"If you have diabetes and are planning a pregnancy, it is important that you talk to your Diabetes Nurse or Hospital Doctor beforehand. This is because sugar control is very important at the time of conception, which will be before you know you are pregnant. Good sugar control will help reduce the risks of health problems to yourself and the baby. To achieve this, you may need some help to adjust your diet or diabetes treatment or in performing extra blood tests. If your diabetes is treated with insulin, you may need to change your insulin doses or even change the number of injections you take, to improve your overall control. If your diabetes is treated with tablets , then it is advisable that these are replaced with insulin injections before any pregnancy happens. If you are on diet alone for your diabetes, then you may need to be started on insulin at some stage before or during pregnancy."
http://www.diabetes-healthnet.ac.uk/leaflets/family.htm

Barrier Methods of Contraception:healthsquare:"Among the many ways of preventing pregnancy are the products known as barrier contraceptives---diaphragms, condoms, cervical caps, and spermicides. All do their work by blocking a man's sperm from reaching a woman's egg. All are safe and usually prevent pregnancy if you use them correctly every time you have sex. Remember, though, that all have "failure rates" ranging from 12 percent to over 20 percent. For greater protection, you'll need to talk to your doctor about hormonal contraceptives such as "the Pill." For total certainty, only abstinence will do."
http://www.healthsquare.com/mc/fgmc0216.htm



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Last updated by Andrew Lopez, RN on Wednesday, September 29, 2010


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