Contraception in adolescents with diabetes

Abstract

The prevalence of diabetes mellitus is increasing dramatically worldwide, resulting in more and more women of reproductive age being affected by type 1 or type 2 diabetes. Contraceptive management is a critical issue due to the risks specific effects associated with pregnancy and those potentially induced by hormonal contraceptives in diabetic women. It is well known that unplanned pregnancy can have serious outcomes in women with diabetes, from the fetal to neonatal period. Diabetes with poor metabolic control promotes congenital anomalies, spontaneous abortions, stillbirth, excessive fetal growth leading to macrosomia, neonatal hypoglycemia and hyperbilirubinemia, as well as many other harmful effects on the fetus or newborn.

Furthermore, unplanned pregnancy can also lead to dramatic complications for pregnant diabetic women, including an increased risk of hypertension and preeclampsia, as well as worsening of pre-existing degenerative complications such as retinopathy or nephropathy.

For all this, contraception is of vital importance in diabetic women and those methods that have high contraceptive effectiveness and minimal metabolic impact should be encouraged. In this way, these women will be able to plan their pregnancy with excellent metabolic control at the time of conception and during the first months of pregnancy, which reduces the risk of congenital anomalies and complications of the disease.