Hormonal Birth Control Safe for Women With Diabetes
What to Know
Keeping blood glucose under tight control is essential for women with diabetes, both before and during pregnancy, because elevated glucose levels increase the possibility of birth defects. For that reason, women who have diabetes need to carefully plan their pregnancies. Birth control plays a big role in such planning, preventing up to 99 percent of pregnancies, according to data from the Centers for Disease Control and Prevention. Condoms, by comparison, prevent 82 percent of pregnancies.
The problem: Physicians do not often prescribe effective hormonal contraceptives, such as the pill, skin patches, and intrauterine devices, because of concerns that they raise the risk of heart disease and stroke. But are such birth control methods truly a danger? Researchers conducted a study to answer that question.
The researchers looked at the health records, collected between 2002 and 2011, of 146,080 women ages 14 to 44. All of the women had either type 1 or type 2 diabetes. First, the researchers identified 3,012 women who had had blood clots, also known as a thromboembolism, as well as those who had had related complications, such as a stroke or a heart attack. Then they combed the data for information on the types of birth control, if any, that those women had used in order to see if it increased their risk of such complications.
Overall, the authors conclude, the risk of blood clots, stroke, or heart attack was low among women who had used hormonal birth control. They estimate that, in a given year, only 1 in 100 women will have such a complication. However, some types of contraceptives appear safer than others. The researchers found that intrauterine devices and under-the-skin implants offer the least risk, compared with vaginal rings and contraceptive patches, which had the highest risk.
This study suggests that hormonal contraceptives offer a low-risk means of planning a pregnancy, which could help reduce the chances of birth defects for infants born to women with diabetes. Yet the authors found that 72 percent of the women they studied had not been prescribed any birth control, perhaps due to fears that it could cause stroke, heart attack, or blood clots. The researchers don’t know whether factors like smoking, obesity, or family health history contributed to the women’s risk of clots and related issues. Also, few women in the study used under-the-skin implants, which makes their findings about that birth control method inconclusive.
“Hormonal Contraception and Risk of Thromboembolism in Women with Diabetes.” Sarah H. O’Brien, Terah Koch, Sara K. Vesely, and Eleanor Bimla Schwarz. Diabetes Care, 2016 Nov. dc161534; DOI: 10.2337/dc16-1534