Preconception counseling and contraception after gestational diabetes

L Mølsted-Pedersen, S O Skouby, P Damm

16 Citations (Scopus)

Abstract

Women with gestational diabetes mellitus (GDM) diagnosed in the period 1978-1984 were followed for on average 6 yr after the index pregnancy. Thirty percent had diabetes mellitus at the follow-up examination, and preliminary results indicate that at least another third will develop diabetes during a subsequent pregnancy. Therefore, family planning and contraceptive guidance should follow the lines for women with pregestational diabetes. When low-dose hormonal contraceptives containing ethinyl estradiol and levonorgestrel were given to women with previous GDM, glucose tolerance and lipoprotein levels remained unchanged during a 6-mo treatment. However, insulin response to oral glucose increased significantly after hormonal intake for 6 mo. A triphasic preparation resulted in a significantly lower insulin response than a low-dose monophasic preparation. However, the results indicate that low-dose oral-contraceptive compounds appear to be safe for women with previous GDM when administered for limited periods. At the follow-up examination, we found no increased risk of developing diabetes in women with previous GDM who used oral contraception. We consider the intrauterine contraceptives (IUD) a safe and effective alternative for women with previous GDM. Of 154 women with GDM, 33% chose IUD, 22% a combination-type oral contraceptive, and 16% barrier methods as their first choice of contraception 2 mo postpartum. We conclude that family planning and qualified contraceptive advice are important in women with previous GDM.

Original languageEnglish
JournalDiabetes
Volume40 Suppl 2
Pages (from-to)147-50
Number of pages4
ISSN0012-1797
Publication statusPublished - Dec 1991

Keywords

  • Contraception
  • Contraceptive Devices
  • Contraceptives, Oral
  • Diabetes, Gestational
  • Family Planning Services
  • Female
  • Follow-Up Studies
  • Humans
  • Intrauterine Devices
  • Male
  • Pregnancy
  • Retrospective Studies
  • Sterilization, Reproductive
  • Journal Article

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