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While the world has been grappling with an unprecedented pandemic and the urgent problems caused by it for the past two years, unfortunately in the meanwhile, the focus has been waning from pre-existing chronic conditions that contribute, affect or worsen one's overall health, thereby making us more vulnerable to a variety of health issues.
Diabetes tops the list of such diseases, with India being listed among the top three countries in the world with a high diabetic population . As per the International Diabetes Federation (IDF), the estimated cases of diabetes in India in the age group of 20-70 years, was almost 7 crore in 2015. And this number has continued to grow at an alarming pace. This means that diabetes is affecting a huge part of India's population in the reproductive age group.
The bad news is that diabetes can have an adverse effect on fertility and reproductive health in both men and women. Therefore, if you are in the reproductive age group, or if you have been trying unsuccessfully to have a baby, it would be a good idea to get your sugar level checked with a simple blood test.
All You Need To Know About Diabetes
A healthy body produces insulin to convert sugar, starches and other food into energy. However, sometimes not enough insulin is produced in the pancreas, which means the sugar or glucose remains in the body leading to high blood sugar levels. High blood sugar levels over a prolonged period cause diabetes, which if untreated can have life-altering and sometimes, life-threatening consequences.
There are several types of diabetes, which can occur at any age-therefore keeping an eye out for symptoms is most important.
- Type 1 diabetes is when the immune system attacks and destroys the cells in your pancreas that make insulin. It is usually diagnosed in children and young adults and requires a dose of insulin to be taken every day.
- Type 2 diabetes is when your body does not make or use insulin well. It is more commonly seen in middle-aged and older people.
Gestational diabetes develops in some women when they are pregnant, and mostly, goes away after the baby is born. However, such women have a higher risk of getting type 2 diabetes later.
It is important to note that while the first two types of diabetes can affect fertility-or the body's ability to get pregnant, gestational diabetes can have consequences on the pregnancy itself.
Should You Be Concerned?
If you are planning a baby or if you have been trying to conceive for a while and have been unsuccessful so far, a simple blood sugar test might be able to reveal the problem. Very few people are aware that diabetes can interfere with male fertility as well as female fertility, putting your baby-making plan on hold indefinitely.
Diabetes can affect the sexual health of men, as well as have a direct impact on their fertility potential. About 50 per cent of men with diabetes suffer from erectile dysfunction. Diabetes can also cause retrograde ejaculation.
Diabetes affects testosterone production and lowers sperm quality. This is particularly worrying as this means that diabetes can damage sperm DNA by producing a high rate of DNA fragmentation. An egg fertilized by a sperm with fragmented DNA is less likely to become a healthy embryo, affecting its uterine implantation potential and thus increasing the incidence of spontaneous abortions-all of this can also affect the success rates of IVF procedures.
Since many women have type 2 diabetes or gestational diabetes during their reproductive years, women need to be concerned and take active steps to keep a check on their blood sugar levels. The prevalence of diabetes has increased by 80 per cent among women in India between 1980 to 2014 (Lancet). The irregular menstrual cycle is very common in women having type 1 diabetes whereas, women suffering from type 2 diabetes often have issues such as PCOS (polycystic ovarian syndrome) and obesity. Uncontrolled diabetes puts women at risk of ovulation problems and cervical-vaginal infections. Diabetes can put expecting mothers at risk of miscarriage and stillbirth, children with birth defects and neonatal complications.
Diabetes And Pregnancy
Fortunately, diabetes though a chronic condition can be managed with a few simple steps. The biggest key to managing diabetes is following a healthy diet and getting regular exercise. Monitor your blood sugar levels, and consult your doctor for oral medications such as Metformin or insulin use via injections or pumps.
If you have been diagnosed with type 1 or 2 diabetes, and are planning on having a baby, there are some steps you can take to make sure you are able to conceive and carry the pregnancy to term. A healthy pregnancy is certainly possible with diabetes, but it will require you to be extra careful.
Talk to your doctor, who might recommend you to an infertility specialist or a pre-conception care team. Usually, simple diabetes management actions can restore fertility. If not, you can consider options such as In Vitro Fertilization coupled with Intracytoplasmic Sperm Injection (IVF + ICSI).
Keeping a check on glucose levels and bringing them to the normal range will not only increase the chances of pregnancy but also help you reduce the risk of miscarriage, birth defects, and stillbirth. Pregnancy can change how your body uses glucose, so your treatments for diabetes may need to change. Therefore, keeping a close eye on your blood sugar levels is even more important.
On A Final Note...
Lastly, but most importantly, addressing diabetes requires long-term lifestyle changes. Having a healthy diet and weight management, regular exercise, quitting tobacco, and reducing stress are all steps that will ensure you are the best version of yourself not just while preparing to conceive, but also during pregnancy and after you have the baby-good health is a gift that will serve you and your baby for the rest of your life.
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