Diabetes and Fertility – Not a sweet couple!

Dr. Durga G Rao, Co-founder and Medical Director, Oasis Fertility

November 14^th is considered World Diabetes Day. Access to Diabetes care is the theme for World Diabetes Day 2021-23. Diabetes has become a very common health issue these days and the shocking fact is India is considered the Diabetes Capital of the World as more than 70 million people in India are affected with diabetes (According to 2019 survey). According to a research paper published in the Journal DIABETOLOGIA, more than half of men (55%) and some two thirds (65%) of women currently aged 20 years in India will likely develop diabetes in their lifetime, with most of those cases (around 95%) likely to be type 2 diabetes (T2D) which could be due to various factors like rapid urbanisation, sedentary lifestyle, and unhealthy diet habits.

Diabetes causes many health complications affecting multiple organs like the eye, brain, heart, kidneys, and other organs. But many don’t realize that diabetes can also impact one’s ability to conceive. Diabetes affects the fertility potential of both men and women.

First, let us understand how Diabetes affects the body. The food we eat is broken down into sugars especially glucose. Insulin is a hormone produced by the b-cells of the pancreas that helps the cells in our body to take up glucose. Using glucose, the body gets the necessary energy. But in diabetic patients, the body either doesn’t produce enough insulin, or the insulin produced is not used effectively by the body. This results in the build-up of glucose (sugar) in the bloodstream.

Types of Diabetes:

Type 1 Diabetes:

 Type 1 Diabetes Mellitus is an autoimmune disease. In this case, the cells that produce insulin are attacked by the body’s own cells. This condition is also known as juvenile diabetes and can affect children and young adults. Type 1 diabetes might also be a cause of premature ovarian failure thereby affecting their dream of motherhood.

Type 2 Diabetes:

Type 2 Diabetes Mellitus is the most common type. Here, the body doesn’t effectively use the insulin produced. Lifestyle modifications, exercise, and healthy food habits can help one to control sugar levels.

Gestational Diabetes:

This condition is seen in pregnant women. Along with causing complications during pregnancy like the need for insulin use, increased risk of cesarean delivery, it can lead to fetal complications like macrosomia and neonatal problems like hypoglycemia. In many women, the sugar levels become normal after delivery, but there is a high likelihood of 1 in 2 of them going on to become diabetic in the future.

How does Diabetes impact women’s fertility?

Diabetes can lead to several complications right from causing obesity, irregular periods, premature menopause, and infertility too. Ovulation and egg quality are affected and uncontrolled sugar levels may result in miscarriage and structural fetal anomalies. With couples delaying their parenthood due to various reasons, and if the female partner suffers from diabetes, achieving the desired family size can become a cause of concern. Hence, a preconception check-up to look for factors like blood sugar levels, B.P. along with ovarian reserve tests and seminal parameters will go a long way in achieving a healthy pregnancy.

Preconception care:

• Women who plan for pregnancy should go in for preconception counseling and have a thorough checkup of hormone and  Sugar levels
• It is highly essential to quit smoking and alcohol
• Maintaining sugar levels within the normal range are important
• Regular exercise and consumption of healthy foods is necessary
• Keeping weight under check can help in managing diabetes

Motherhood is a very special experience and women have to be aware of their health condition and consult a fertility specialist if they have diabetes.