Family planning and the diabetic mother.

The safety and effectiveness of various contraceptive methods for use by diabetic women was assessed by examining the results of recent studies. IUDs and condoms and diaphragms in combination with spermicides were recommended as the most appropriate contraceptive methods for these women. Sterilization was advised for diabetic women with completed families. The rhythm method was not recommended due to the frequency of menstrual cycle irregularity among diabetic women. The conclusion was reached that oral contraceptives should not be prescribed for women with diabetes mellitus. Recent studies have found an association between oral contraceptive use and the acceleration of atherogenesis. Since diabetic women are known to be at greater risk of atherogenesis the use of oral contraceptives by these women might further enhance the risk of atherogenesis. Metabolic studies have revealed that all women who use oral contraceptives experience increases in blood pressure and in blood lipid and glucose levels; these findings may have special relevancy for diabetic women. Based on these studies the recommendation was made that oral contraceptives not be used by women with subclinical diabetes. The sudden and severe rise in blood glucose levels associated with oral contraceptive use may accelerate the disease and lead to insulin dependency. Empirical studies have failed to support the theoretical contention that diabetic women who use IUDs are at greater risk of pelvic infection than non-diabetic women who use IUDs. Copper IUDs however may not be as effective for diabetic women as for women without diabetes. Plastic IUDs were recommended for diabetic women.