Since November is National Diabetes Month, it’s the perfect time to review birth control options for women with diabetes.  The CDC estimates there are 29 million Americans living with diabetes, including 8 million who have it and don’t know it.  While prevention, screening, and managing diabetes are extremely important for one’s health, it is also important to consider how this impacts other health goals and medications, such as family planning and birth control.

So which birth control methods can be used safely by women who have diabetes?  I hate to say this, but it depends.  Luckily, it only depends on whether you’ve diabetes for over 20 years or have complications of diabetes, such as damage to the kidneys, eyes, nerves, or other vascular diseases.  If you’ve had diabetes for over 20 years or have complications of diabetes, you should not use the birth control injection (“depo”) or the combination hormonal methods such as the combination pill, patch, or ring.  It is still safe to use the progestin-only pill, hormonal implant, or IUDs.

The good news is the prevalence of diabetes among reproductive-aged women is low (3% diagnosed, 0.5% undiagnosed).  Most women who have longstanding or complicated diabetes with changes to kidneys, eyes, nerves, or other vascular changes have already been diagnosed and are well aware of it.  For this reason, your provider does not need to check your blood sugar (called glucose) when screening for birth control use.  Your provider may ask you whether you have diabetes.  If you have diabetes, help answer your provider’s questions about it to help your provider determine which methods of birth control are safe for you.

Hormonal birth control can have an effect on blood sugar in women with or without diabetes, but the effect is minimal.  So there’s no need to screen for diabetes or monitor your blood sugar when using birth control.  To be clear, you should get screened and monitor as recommended for general health and wellness, but there are no additional screenings because you are on birth control.

Since a woman with diabetes can have complications if she gets pregnant, it is important to plan the pregnancy and get prenatal care.  See the American Diabetes Association’s advice for pregnancy.  Even women who do not have diabetes are at risk of developing diabetes during their pregnancy, known as gestational diabetes.

Discussing family planning goals with your health care providers is very important, especially for women who have diabetes.