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August 15, 2012

Family Planning, Other Medications

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Question from Millington, Micihigan, USA:

My 19-year-old daughter, who has brittle type 1 diabetes, has told me she would be going on birth control to help stabilize her sugar. I have not been able to verify that this is medically supported.

Answer:

From: DTeam Staff

Birth control pills are not used to stabilize blood sugars. In fact, estrogen/progesterone birth control pills cause insulin resistance and can cause some worsening of blood sugars. That being said, it may be important to prevent pregnancy, even if it means an adjustment in insulin therapy. This is especially true for women with diabetes and poor blood sugar control.

JTL
Additional comments from Dr. Bill Jones:
Based on several reviews, it appears that oral contraceptives do not have a major impact on glucose control in women with well-regulated diabetes. Some of the triphasic compounds may cause a slight increase in fasting glucose and insulin resistance in women without diabetes. I could not find any information suggesting that oral contraceptives improve glucose control.

Oral contraceptives are, in general, safe. However, there is an increased risk of blood clot formation. Diabetes is also a risk factor for thrombosis, particularly arterial thrombosis. Therefore, if your daughter is going to start birth control pills, I would recommend that she be screened for any underlying clotting abnormalities: Factor V mutation, Factor II mutation, protein S deficiency, protein C deficiency, antithrombin III deficiency. This is a common screening panel and her doctor will know about it. I would also say that the risks of pregnancy with diabetes probably outweighs the risk of oral contraceptive use.

OWJ