Diabetes And Fertility: How Diabetes Can Affect Your Fertility
You’ve have been trying with no luck to get pregnant and have not been able to a find a reason for your infertility. You may have tried a fertility cleanse, begun eating a fertility diet, and are taking all the right supplements and herbs, but are still having trouble conceiving. It may be time to have a simple blood test to determine if your glucose levels are too high. With the rates of Type II diabetes rising every year in the U.S., more and more infertility specialists are looking toward this health issue as a main cause of some otherwise unexplained infertility cases they see. According to the American Diabetes Association, there are more than 200,000 new cases of Type II diabetes diagnosed every year, with another 2.4% of the general childbearing population suffering from the disease but not knowing it. When it comes to diabetes and infertility the answer is clear: there is a connection. No, in many cases (especially among women), diabetes alone does not keep them from getting pregnant, but it oftentimes keeps them from staying pregnant. In many cases, say fertility doctors, “a woman with higher than normal glucose levels does get pregnant month after month. Unfortunately her diabetes status prevents that embryo from implanting in the uterus, causing a miscarriage before she ever realizes she is pregnant.” In this case, the diabetes isn’t preventing conception, but is preventing an ongoing pregnancy. High glucose levels are reported to increase a woman’s chances of miscarriage by 30-60% according to statistics released by the American Diabetes Association. Even when implantation does occur, there are other risks to consider, including: An increased risk of birth defects due to damage caused to embryonic cells form the high levels of glucose in the blood Continue reading >>
Does Diabetes Affect Fertility?
There was a time when women who had diabetes were strongly advised to avoid getting pregnant. Attempting to produce a biologically-related family was just too dangerous [source: Brucker]. Fortunately, diabetic women are no longer given that heartbreaking direction from caregivers. Diabetics can, and routinely do, get pregnant and give birth to healthy children. Type 1 or Type 2 diabetes, however, can still be a major factor in fertility for men or women. There are challenges diabetics face in getting a partner pregnant, becoming pregnant, maintaining a pregnancy and ensuring they give birth to a healthy, full-term baby. Diabetes (Type 1 or Type 2) can harm sperm [source: Paddock]. Type 2 diabetes can make it far more difficult to become pregnant. There's an increased rate of miscarriage among diabetics in general, and women with Type 1 diabetes are somewhat more likely to have a baby with a birth defect or a child born prematurely [source: MyDr]. However, all of these challenges can largely be managed by being attentive to and responding to signals from the body. In order to understand why diabetes affects reproduction, it helps to have a general understanding of the disease in both of its forms. A healthy human body digests food and -- with the help of a hormone called insulin -- transports a form of sugar known as glucose through the bloodstream to cells for energy. Diabetics have flaws in their metabolism. A Type 1 diabetic's body doesn't make insulin. The body of a Type 2 diabetic either fails to create enough insulin, the person's cells don't react properly to the insulin or both malfunctions occur [source: Nordqvist]. Click ahead to learn the specifics of how Type 1 diabetes influences reproduction and how it can be managed. You've undoubtedly heard a pregnant wom Continue reading >>
Have A Safe Pregnancy With Type 2 Diabetes
It used to be that women with type 2 diabetes were discouraged from becoming pregnant. These days, with careful pregnancy planning and monitoring of blood glucose levels, you can have a safe pregnancy and a healthy baby. Diabetes and Pregnancy: Your Prenatal Care Team If you have type 2 diabetes and you want to become pregnant, the first step would ideally be to speak with both your endocrinologist and your obstetrician. They can help you be at your healthiest to conceive. Both before you become pregnant and during your pregnancy (and beyond), it will be important for you to keep your blood sugar levels under control and to follow all the other guidelines to minimize all health risks to you and your baby. Fortunately, different diabetes practitioners can work with you on all the aspects of pregnancy, including exercise and nutrition. Your medical team might include: Your obstetrician. The ob-gyn you choose should care for patients with type 2 diabetes or have experience with high-risk pregnancies. Your dietitian. This professional can outline a pre-pregnancy and pregnancy diet that will keep blood glucose under control. Your diabetes educator. This specialist can help you learn about your body’s changing needs throughout your pregnancy. Your future pediatrician. Your baby’s doctor should have experience treating infants of mothers with diabetes. Diabetes and Pregnancy: Control Blood Glucose First While every woman is urged to get her body into baby-ready shape before conceiving, this is especially important if you have diabetes. According to the American Diabetes Association, your blood glucose levels should be in the suggested range for three to six months before you try to conceive and, of course, during your entire pregnancy. This may involve more doctor visits, Continue reading >>
Women’s Top Diabetes Concerns
Managing type 2 diabetes means being good to yourself. “Diabetes requires self-care to do it well,” says Robin Goland, MD, diabetes research director at New York-Presbyterian Hospital. “While many women are comfortable at taking care of others, it can be hard for them to take care of themselves.” Your first line of defense is a healthy diet and exercise plan, so talk to your doctor about creating one that will likely include: Getting at least 30 minutes of physical activity on most days. Anything that gets your heart rate up and causes you to sweat a little is beneficial, even if it’s gardening, walking, or cleaning your house. Eating foods that will keep your blood sugar levels in check. That means choosing high-fiber foods, swapping out white starchy foods for whole grains, putting lots of vegetables on your plate, and steering clear of sweetened beverages, including fruit juice. Ask your doctor who else can help you, like a nutritionist or a diabetes specialist. Having diabetes makes heart disease more likely. That's all the more reason to follow your doctor's guidelines about diet and exercise. Also, track your blood pressure, says OB/GYN and diabetes educator Cassandra Henderson, MD, of New York’s Lincoln Hospital and Albert Einstein College of Medicine. Keeping your cholesterol levels in check will also help protect your heart. Continue reading >>
Pregnancy If You Have Diabetes
If you have diabetes and plan to have a baby, you should try to get your blood glucose levels close to your target range before you get pregnant. Staying in your target range during pregnancy, which may be different than when you aren’t pregnant, is also important. High blood glucose, also called blood sugar, can harm your baby during the first weeks of pregnancy, even before you know you are pregnant. If you have diabetes and are already pregnant, see your doctor as soon as possible to make a plan to manage your diabetes. Working with your health care team and following your diabetes management plan can help you have a healthy pregnancy and a healthy baby. If you develop diabetes for the first time while you are pregnant, you have gestational diabetes. How can diabetes affect my baby? A baby’s organs, such as the brain, heart, kidneys, and lungs, start forming during the first 8 weeks of pregnancy. High blood glucose levels can be harmful during this early stage and can increase the chance that your baby will have birth defects, such as heart defects or defects of the brain or spine. High blood glucose levels during pregnancy can also increase the chance that your baby will be born too early, weigh too much, or have breathing problems or low blood glucose right after birth. High blood glucose also can increase the chance that you will have a miscarriage or a stillborn baby.1 Stillborn means the baby dies in the womb during the second half of pregnancy. How can my diabetes affect me during pregnancy? Hormonal and other changes in your body during pregnancy affect your blood glucose levels, so you might need to change how you manage your diabetes. Even if you’ve had diabetes for years, you may need to change your meal plan, physical activity routine, and medicines. Continue reading >>
Type 2 Diabetes During Pregnancy
There’s lots of good news these days for pregnant women with type 2 diabetes (a condition in which the body doesn’t respond as it should to insulin). In fact, with the right medical help and diligent self-care, you have about the same excellent chances of having a successful pregnancy and a healthy baby as any other expectant mom. The key to managing type 2 diabetes during pregnancy? Achieving normal blood glucose levels six months before conception and maintaining those levels throughout the nine months following it. So if you’ve been on top of keeping your diabetes under control, it’s more important than ever to continue your routine now that there are two of you on board. Here's what to think about if you're heading into pregnancy with type 2 diabetes: Your care team How does diabetes affect babies during pregnancy? If you have type 2 diabetes, you already have higher levels of glucose circulating in your blood; issues can come up if your blood sugar levels aren’t well monitored and managed. That’s because extra sugar can be transferred to baby while you're expecting — and a fetus that’s served too much glucose reacts by producing an increased supply of insulin (which can result in a too-large baby and other complications). READ MORE: Gestational Diabetes Finding your pregnancy and diabetes care team Be prepared: You’ll have a lot more prenatal visits than other expectant moms and will probably be given more doctors’ orders to follow (all for a good cause). So it’s a good idea to get your medical team in place as soon as you think you might want to get pregnant. The OB or midwife who supervises your pregnancy should have plenty of experience caring for diabetic moms-to-be, and he or she should work together with the doctor who has been in charge Continue reading >>
Diabetes And Getting Pregnant
Having a chronic condition such as diabetes (diabetes mellitus) takes careful monitoring of your health at the best of times, and this becomes even more crucial during pregnancy, a time when your body changes dramatically. Most women who have pre-existing diabetes who become pregnant have type 1 diabetes (once called insulin-dependent or juvenile diabetes), although some may have type 2 (once called non-insulin dependent or maturity-onset) diabetes. Another type of diabetes called gestational diabetes is a temporary type of diabetes that occurs in pregnant women who have never had diabetes before and it usually goes away after the baby is born. This article deals only with pre-existing diabetes — also known as 'pre-gestational diabetes'. If you have diabetes, there’s no reason that you can’t have a healthy and successful pregnancy and deliver a healthy baby. What it does mean is that you will probably have to work closely with your doctor and other healthcare professionals to ensure you manage your diabetes well during your pregnancy. I have diabetes and want to become pregnant: what should I do? Seeing your doctor for pre-pregnancy planning is an important step in ensuring the best outcome for you and your baby. You have a pre-existing condition, so you can plan ahead and discuss with your doctor what you need to do before you become pregnant, and what you can do to manage your diabetes during pregnancy. For example, if you have diabetes, you have a slightly higher risk than other women of your baby: having a birth defect; being born prematurely; weighing too much or too little; having jaundice; or having dangerously low blood sugar levels after birth. You yourself have an increased risk of having a miscarriage or of developing high blood pressure during the preg Continue reading >>
Infertility In Women
Tweet Diabetes is associated with lower rates of fertility. There are a number of reasons which can play a part including, obesity, being underweight, having diabetic complications, having PCOS and having an autoimmune disease. With this said, many women with diabetes are able to conceive, particularly if diabetes is well controlled and a healthy body weight is maintained. Conditions The following conditions are associated with reduced fertility rates: Polycystic ovary syndrome (PCOS) Oligomenorrhea (irregular periods) Secondary amenorrhea (absent periods) Premature menopause (premature ovarian failure) Endometrial cancer (uterine cancer) Microvascular and cardiovascular complications Polycystic ovary syndrome (PCOS) PCOS is a common condition in which a large number of cysts develop on the ovaries. Whilst this feature does not in itself pose a health risk, it can reduce fertility. Women with PCOS have higher than normal levels of testosterone (hyperandrogenism). PCOS can affect fertility by leading to irregular periods (oligomenorrhea) or absent periods (secondary amenorrhea). The condition can be treated through making lifestyle changes, while medications such as clomifene and metformin can help with improving the chances of conception. PCOS is particularly associated with obesity and type 2 diabetes. People with type 1 diabetes that are taking high amounts of insulin daily may also be at risk of or suffer from PCOS. Oligomenorrhea and secondary amenorrhea Oligomenorrhea is the term for irregular periods that arrive at intervals of 35 days or more between each period. Secondary amenorrhea is said to occur if you have previously had a normal menstrual cycle but have stopped getting a periods for 6 months or longer. Both type 1 diabetes and type 2 diabetes are associate Continue reading >>
Patient Education: Care During Pregnancy For Women With Type 1 Or 2 Diabetes Mellitus (beyond The Basics)
INTRODUCTION Before insulin became available in 1922, women with diabetes mellitus were at very high risk of complications of pregnancy. Today, most women with diabetes can have a safe pregnancy and delivery, similar to that of women without diabetes. This improvement is largely due to good blood glucose (sugar) control, which requires adherence to diet, frequent daily blood glucose monitoring, and frequent insulin adjustment. This topic review discusses care of women with type 1 or 2 diabetes during pregnancy, as well as fetal and newborn issues. It does not address gestational diabetes, which is diabetes that is first diagnosed during pregnancy. (See "Patient education: Gestational diabetes mellitus (Beyond the Basics)".) IMPORTANCE OF BLOOD GLUCOSE CONTROL Glucose in the mother's blood crosses the placenta to provide energy for the baby; thus, high blood glucose levels in the mother lead to high blood glucose levels in the developing baby as well. High blood glucose levels can cause several problems: Early in pregnancy, high glucose levels increase the risk of miscarriage and birth defects. These risks are highest when glycated hemoglobin (hemoglobin A1C or A1C) is >8 percent or the average blood glucose is >180 mg/dL (10 mmol/L). In the last half of pregnancy and near delivery, high blood glucose levels can cause the baby's size and weight to be larger than average and increase the risk of complications during and after delivery (see 'Newborn issues' below). In particular, women with large babies are more likely to have difficulty with a vaginal birth and have a higher chance of needing a cesarean delivery. In the last half of pregnancy, women with diabetes are more prone to developing pregnancy-induced hypertension (preeclampsia) and an excessive amount of amniotic Continue reading >>
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- Improved pregnancy outcomes in women with type 1 and type 2 diabetes but substantial clinic-to-clinic variations: a prospective nationwide study
- Relative effectiveness of insulin pump treatment over multiple daily injections and structured education during flexible intensive insulin treatment for type 1 diabetes: cluster randomised trial (REPOSE)
I Have Diabetes. What Should I Know Before I Get Pregnant?
If you have type 1 or type 2 diabetes there are steps you can take to prepare yourself for pregnancy. Rest assured that these steps can make a big difference to how healthy you and your baby are throughout the pregnancy you're hoping for. You will need to be very careful to monitor your blood sugar (glucose) levels, though. That's because, once you're pregnant, you and your unborn baby will have a higher risk of complications. Rarely, these complications caused by diabetes can result in a baby being born with a life-long condition. Sadly, mums-to-be with diabetes are more likely to have a miscarriage, or even experience the loss of a baby at birth. Babies born to mums with diabetes are also more likely to develop diabetes in later life. Most heart defects, kidney problems and nerve and brain defects happen in the first eight weeks of pregnancy. These potential risks are probably due, in part, to the way blood glucose levels can rapidly go up and down beyond the normal range. So controlling your diabetes starting now is key to preventing complications or, in the worst of cases, the loss of a longed-for pregnancy. The good news is that with careful planning and the support of your GP and diabetes specialist, this is very achievable. There may be a preconception diabetes clinic in your area where you can get help too. Taking the following steps will help you to be in the best of health, ready for conception: Aim to control your blood sugar. Your diabetes counsellor will recommend a glycosolated haemoglobin level (HbA1c) for you to maintain. If you don't already have one, you should be offered a kit for testing your own blood sugar levels often. Manage your diet carefully and take regular exercise. Don't drink alcohol, as it can make your blood sugar levels rise and fall ra Continue reading >>
Pregnancy
Pregnancy in women with type 1 or type 2 diabetes usually results in a normal delivery with no effects on the mother’s or the child’s long-term health. However, poorly controlled blood glucose levels during pregnancy can have long term effects for mum and baby, as well as complications during delivery. You can have a healthy pregnancy and a good outcome with planning, multidisciplinary care and excellent control of blood glucose levels. If you develop diabetes during pregnancy, it is called gestational diabetes. Learn more about gestational diabetes. Pre-pregnancy care for people with diabetes First talk to your doctor, credentialled diabetes educator and obstetrician for pre-pregnancy planning and care. You can receive advice and guidance on blood glucose management, a review of all self care skills and knowledge, an assessment of diabetes equipment and management of hypoglycaemia and hyperglycaemia. High blood glucose levels can increase the risk of having a baby with a birth defect. However this can be minimised by ensuring excellent blood glucose control at the time of conception and during the first eight weeks of pregnancy. Careful attention to nutrition is essential, not only for good diabetes control, but to meet the body’s increased nutritional requirements during pregnancy. Exercise is also helpful in maintaining general fitness and good blood glucose control. Breast-feeding There is no reason why women with diabetes should not breast-feed. Insulin requirements are generally slightly lower during this time. Insulin does not pass into the breast milk and is not harmful to the baby. Hypoglycaemia can be an issue. You should discuss with your doctor or credentialled diabetes educator about strategies to minimise hypoglycaemia. Resources Type 1 Diabetes and Continue reading >>
Labour And Birth With Type 1 Or 2 Diabetes
Your birth experience may be different to the one that you had expected, and this can be hard to come to terms with. Finding out what might happen could help you feel mentally prepared for what may lie ahead. It can help to remember that although the birth itself is important, it is just one step in the journey towards having your baby. Where to give birth with type 1 or 2 diabetes If you have diabetes, it is recommended that you give birth in a hospital with the support of a consultant-led maternity team. It is not unusual for babies of mothers with diabetes to be larger than normal, which could lead to birth difficulties such as shoulder dystocia (in which the baby’s shoulder gets stuck during the birth). This means that options such as home birth are unlikely to be recommended. When to give birth with type 1 or 2 diabetes You will be advised to give birth early if you have diabetes. This is to reduce the risk of stillbirth. It is recommended by NICE that women with type 1 or type 2 diabetes and no other complications should give birth between 37 weeks and 38 weeks +6 days – either by being induced or having a planned caesarean. If you have any complications that pose a risk to you or the baby, you might be offered an even earlier delivery. 'I had always been aware that I would be on the ward for high-risk cases. I am so grateful to be pregnant, I’m not going to complain about stuff like that. If there is an issue, I would rather be ready for it.' Svenja, mum-to-be How to give birth with type 1 or 2 diabetes As the recommendation is to give birth by 38+6 weeks, you are likely to be offered an induction or a caesarean section. Diabetes is not in itself a reason that you cannot have vaginal birth. Unless there are other complications there is no reason this should Continue reading >>
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Diabetes And Pregnancy
If you have diabetes or prediabetes and you want a child, can you do it? What will you be getting yourself into? If you’re considering children, here are some things you should know. Pregnancy in diabetes carries serious risks to mother and child. The American Diabetes Association (ADA) says that women with poor diabetes control are at greater risk for birth defects and also miscarriage. Your baby’s organs are completely formed by seven weeks after your last period. That time may be up before you realize you are pregnant. High glucose levels can damage those developing organs. So it’s important, says ADA, to get glucose levels under control before getting pregnant. Doctors recommend three to six months of very good control before trying to conceive. If you have high glucose levels, you may not get pregnant at all. You may conceive normally, but the fertilized egg won’t attach to the uterine lining. Not getting pregnant may be better than pregnancy with out of control diabetes. The ADA lists some common complications for babies of mothers with diabetes. • Three to four times greater risk of birth defects such as heart, brain, and spinal defects, oral clefts, kidney defects, and gastrointestinal problems. • Premature delivery • Miscarriage • Prolonged jaundice (yellowing of the skin) • Respiratory distress (difficulty breathing) The mother faces her own risks. Diabetic eye and kidney problems could get worse. She is at higher-than-normal risk of preeclampsia (high blood pressure, often with protein in the urine), which can be life-threatening. Delivery may be difficult or may require a C-section. Prediabetes pregnancy also risky If you have prediabetes, pregnancy could push you over the line into diabetes. This is called “gestational diabetes.” It ca Continue reading >>
Pregnancy In Women With Type 1 Or Type 2 Diabetes
Being well-prepared for pregnancy can help reduce the risk of complications, keep you healthy throughout your pregnancy, and give your baby a good start in life. Blood glucose (sugar) control is a daily challenge for people with diabetes. Hormonal changes during pregnancy make diabetes even more challenging. The majority of women who properly control their diabetes before and during pregnancy have successful pregnancies, and give birth to beautiful, healthy babies. Risks and potential complications Women with diabetes have a higher risk of miscarriage and of having a baby with birth defects (heart and kidney defects, for example). This risk significantly increases if blood glucose (sugar) control is not optimal, especially at conception and during the first 3 months of pregnancy, when the baby's organs are forming. If your blood glucose (sugar) levels are poorly controlled, you should avoid becoming pregnant until your healthcare team has helped you improve your blood sugar control. Risks for the mother: Miscarriage Rapidly worsening retinopathy (damage to the retina caused by diabetes) Rapidly worsening nephropathy (kidney damage caused by diabetes) and kidney failure A more difficult vaginal delivery (because of the baby’s weight) requiring special maneuvers by the obstetrician or the use of forceps or suction Caesarean delivery Gestational hypertension and pre-eclampsia (a pregnancy complication characterized by high blood pressure and significant swelling) Excess amniotic fluid, which can cause premature labour Risks for the baby: Defects (especially if the diabetes is poorly controlled in the first 3 months of pregnancy) of the heart, kidneys, urogenital tract, brain, spinal cord and backbone Higher-than-average birth weight (more than 4 kg or 9 lbs.) or, convers Continue reading >>
- Improved pregnancy outcomes in women with type 1 and type 2 diabetes but substantial clinic-to-clinic variations: a prospective nationwide study
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- Postprandial Blood Glucose Is a Stronger Predictor of Cardiovascular Events Than Fasting Blood Glucose in Type 2 Diabetes Mellitus, Particularly in Women: Lessons from the San Luigi Gonzaga Diabetes Study
Pre-existing Diabetes And Pregnancy
If you have type 1 or type 2 diabetes and are planning a family, you should plan your pregnancy as much as possible. Controlling your blood sugars before conception and throughout pregnancy gives you the best chance of having a trouble-free pregnancy and birth and a healthy baby. If you have diabetes and your pregnancy is unplanned, there’s still plenty you can do to give your baby the best start in life. The information on this page is for women who have diabetes before becoming pregnant. If you develop diabetes during pregnancy, it is called gestational diabetes. Planned pregnancy Visit your doctor or diabetes educator at least 6 months before you start trying to fall pregnant, if you can. You will be given advice and guidance on controlling your blood sugars as tightly as possible, and taking necessary supplements like folate. You may also be advised to change medications. If you are healthy and your diabetes is well controlled when you become pregnant, you have a good a chance of having a normal pregnancy and birth. Diabetes that is not well controlled during pregnancy can affect your health long-term and can also be risky for your baby. Unplanned pregnancy Not everybody can plan their pregnancy. If you have diabetes and think you might be pregnant, see your doctor as soon as you can. Your healthcare team You may be cared for by a team of health professionals including: an obstetrician who can handle high risk pregnancies a specialist experienced in diabetes care during pregnancy, who may be an endocrinologist or who may be a general physician a diabetes educator to help you manage your diabetes a dietician who can provide dietary advice at all the different stages - before conception, while pregnant and after the birth a midwife who is experienced in all aspects Continue reading >>
