Clinical guidelines on contraception and diabetes.
Diabetic women present an interesting challenge to the reproductive health-care physician and gynecologist. Good preconceptual counselling reduces the risk of adverse consequences of the pregnancy to the mother and the fetus and should be encouraged. Poor metabolic control has been linked with an increased risk of congenital malformations. The low-dose combined pill (COC) does not appear to increase the risk of diabetes in women with a history of gestational diabetes. Young healthy diabetic women under 25 years old may be prescribed the low-dose COC with careful metabolic monitoring. The copper intrauterine contraceptive device is a useful choice in diabetic women with vascular disease, proliferative retinopathy and nephropathy. The progestogen-only pill and barrier methods may sometimes have unacceptable failure rates in diabetic women who may require to avoid a pregnancy at any cost. When a couple's family is complete, sterilization and vasectomy should be encouraged.
Obstetric Department, Guy's and St. Thomas' Hospital, London, UK.
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Gupta
D003267:Contraception / Q000379:methods*; D003376:Counseling / Q000379:methods*; D003920:Diabetes Mellitus / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008487:Medical History Taking; D018579:Patient Selection; D010808:Physical Examination; D016742:Preconception Care / Q000379:methods*; D011247:Pregnancy