I am a 24 year old female who has had diabetes since the age of four. I am considering going on a birth control pills. What are the short and long term effects of birth control pills on blood sugars? What secondary complications from diabetes may one be at increased risk for?

This is a good question. I think it is very important to raise the concern that unplanned pregnancies in women with type�1 diabetes are very dangerous. First, the baby is at risk of birth defects unless the glucose levels are controlled well from the time of conception. Second, the sharp decline in glucose levels from preconception levels to pregnancy levels (bad to good control) is associated with worsening eyes and kidneys. These risks have to be contrasted to the problem of minor increases in blood sugars which may be related to the estrogen and the progesterone in the pill. The minor increases in blood sugar which may occur can be managed. There can even be changes made for the cyclical levels of hormonal changes with birth control pills. In general, the problems are minor compared to an unplanned pregnancy.

JTL