Women with diabetes can face several reproductive health challenges that need careful consideration of contraceptive options. When reflecting on a choice of contraception, sufficient thought must be given around the particular efficacy and safety of the chosen method, whilst balancing the need for effective pregnancy prevention with the potential impact on glucose metabolism and vascular, mental and sexual health.
Guidelines consistently remind us about need to tailor diabetes care to the person based on their needs and desires. This approach to individualized care is equally important when considering the reproductive health needs of your client. Extending this theme, the American Diabetes Association (ADA) 2024 Standards of Care allude to incorporating preconception care from the start of puberty. Additionally, the ADA Guidelines state that “Family planning should be discussed, and effective contraception (with consideration of long-acting, reversible contraception) should be prescribed and used until an individual’s treatment plan and A1C are optimized for pregnancy.”
By attending to these needs early enough in the life course of the person with diabetes, ample opportunities will arise for sufficient discussion around the risks of unplanned pregnancies, and about improved maternal and foetal outcomes with adequate pregnancy planning at any health care visit.
