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Fertility, Pre-Diabetes & Diabetes: Everything You Need To Know

What's the connection between diabetes and fertility, and how can you prepare for the healthiest pregnancy possible?

September 12th, 2023 | 8 min. read

By Lisa Rosenthal

Trying to conceive and want to make sure that you and your future baby-to-be are as healthy as possible? We've got some good news! There are some simple lifestyle and nutrition changes you can make that will have a big impact.

In this article:

Planning for a Healthy Pregnancy

Preconception planning is important because it sets you and your baby-to-be up for the best outcome. Download our 90-Day Preconception Checklist to get a head start! Preconception planning includes learning about the key conditions to be aware of in order to prepare for the healthiest pregnancy possible.

While there are many facets to preconception planning, let's focus in on prediabetes and diabetes. And we have some good news: you don’t even have to do anything drastic to reduce your risk factors.

Trying to overhaul your entire life and eat "perfectly" can feel overwhelming - but the good news is, you don't have to. All the small changes will add up (and better yet, they're more sustainable in the long run). And we're here to walk you through how to implement them - while staying sane in the process. 

Note: If you have PCOS or know that there’s a family history of any level of diabetes, it’s a good idea to ask questions and be as proactive as possible, especially if you’re trying to conceive.

Trust the Experts

There is a lot of confusing information (and misinformation) out there.

Isn’t it a relief to know that there are programs in place, led by qualified, knowledgeable, and passionate professionals that can take a scary-sounding condition like diabetes, then explain and manage it so that your efforts to have a healthy pregnancy are successful?

At Illume Fertility, we have two Registered Dietitian Nutritionists, Jill Hickey and Jennifer Walsh, who are part of our larger PCOS program. Our PCOS team includes professionals like Reproductive Endocrinologist Dr. Ilana Ressler, Physician Associate Diana D’Amelio, fertility nurse Kerry Tomson, and other PCOS experts.

All of our clinicians are knowledgeable about the interactions between prediabetes, diabetes, PCOS, and establishing safe pregnancies and healthy families. 

We put their expertise to the test and asked them to debunk some of the biggest myths about prediabetes, diabetes and fertility - and what YOU can do now to mitigate your risk factors for any future problems.

Diabetes & Fertility: Myth vs Fact

Wondering why this is such an important subject? Or how it could affect you? Well, let's start by recognizing that there is a big difference between an actual fact and frequently repeated information (which often turns out to actually be a myth).

Below are some examples of myths about diabetes and fertility that have been disproved -  and some solid facts you can trust instead!

MYTH: A diagnosis of prediabetes will delay fertility treatment 

While making healthy changes before trying to conceive can add to your timeline, it does not need to majorly delay the process! Being proactive and adopting some simple lifestyle changes can lower your risk of diabetes - meaning healthier parents-to-be and a healthier baby.

Lifestyle changes your doctor or nutritionist may recommend:

  • Moderate exercise five days a week
  • Making some changes to your diet (decreasing simple sugars and increasing complex carbs, fiber, veggies, and lean protein)
  • Working on reducing body weight (if appropriate or necessary) by as little as 5-10%
Pro tip: If you have a partner on this journey with you, it is often helpful if both partners work together to improve their health! By committing to these goals together, it's possible to lower your glucose levels within 2-3 months and move ahead with your goal of becoming parents.

MYTH: Only women need to be concerned about diabetes

Well, yes and no. Let's explain.

In women, elevated blood sugar levels and insulin resistance can complicate ovulation and make menstrual cycles less predictable. The American Diabetes Association reports that high glucose levels increase a woman’s chance of early pregnancy miscarriage by 30-60%.

This means that high glucose levels can prevent the embryo from implanting in the uterus before a woman realizes that she is even pregnant. Elevated glucose can also negatively affect estrogen, progesterone and testosterone levels - all of which are important for pregnancy to occur and be sustained until delivery. 

However, men are NOT off the hook! In men with prediabetes or diabetes, high glucose levels may contribute to erectile dysfunction and even damage sperm DNA. Damage to the DNA can result in miscarriage and birth defects.

FACT: Diabetes is a common and serious disease

The rate of diabetes in the United States has reached epidemic proportions and is a real health threat, including as a comorbidity for other diseases and infections. Data from the 2022 National Diabetes Statistics Report estimate that 37.3 million people have diabetes (that's 11.3% of the U.S. population).

Perhaps even more alarming is that 8.5 million people are undiagnosed. Prediabetes data indicate that 96 million people over the age of 18 have pre-diabetes. That's 38% of the adult population of the U.S.

Note: Diabetes and prediabetes are increasingly diagnosed in both women and men in their childbearing years. Similarly, there has also been a considerable rise in diabetes that is first diagnosed in pregnancy (known as gestational diabetes).

With the use of the most current diagnostic criteria for gestational diabetes, it is estimated that 2-10% of pregnancies in the U.S. are affected by gestational diabetes and 50% of those women go on to develop type 2 diabetes. Additionally, children affected by elevated glucose levels in utero are at increased risk for diabetes themselves.

Can Ozempic help me?

GLP-1 medications like Ozempic can be used to treat insulin resistance and type 2 diabetes. Learn more from Dr. Ilana Ressler.

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FACT: Illume Fertility screens all patients for diabetes

We do, and we have for many years now. Hemoglobin A1c (HgbA1c) levels are checked in every new patient. This simple blood test indicates how well blood glucose has been controlled over the past 2-3 months.

The higher the glucose concentration is in the blood, the higher the level of HgbA1c. Ideal HgbA1c range is 4.8-5.5. All Illume Fertility patients with a HgbA1c of > 5.7 will go for further testing and are referred to one of our in-house nutritionists for nutrition and lifestyle counseling. 

Good to know: A Hgb A1c <6.0 is desirable prior to starting fertility treatment and higher levels may result in delayed treatment in order to improve maternal health and pregnancy outcomes.

FACT: Abnormal glucose levels can cause issues for mom & baby

Diabetes (type 1, type 2 or gestational) can affect the health of both the mother and her unborn child. Poor blood sugar control during pregnancy increases the risk for miscarriage, birth defects, and other serious problems.

Uncontrolled gestational diabetes increases your risk for an extra-large baby, C-section, preeclampsia, and hypoglycemia in newborns.

The truth is that many years ago, those with uncontrolled blood sugar or diabetes were told that it would not be safe to become pregnant, but now with medical support and monitoring to keep blood glucose levels within a safe range, having a healthy child (even with diabetes) is possible.

FACT: Just because I'm at risk doesn’t mean I'll get diabetes

Absolutely true!

However, knowing relevant and appropriate information is necessary to lower glucose levels. This can improve fertility outcomes and reduce risks to both mom and baby.

Controlling glucose levels and getting them closer to a normal level is possible, especially with the help of trained professionals. Doing so will accomplish several goals - it will reduce risks, in turn increasing the odds of a healthy pregnancy and child. 

How can I reduce my risk of diabetes?

In addition to seeking medical guidance, you can make small but impactful lifestyle modifications. Here are some common recommendations given to those who may be at risk for pre-diabetes or diabetes:

Recommendations for those at risk for diabetes
Healthy nutrition guidelines
  • Choose foods low in saturated fats
  • Pick clean meats or fish and low-fat dairy
  • Include high-fiber foods like fresh vegetables and fruits
  • Choose heart-healthy fats, while limiting high-fat foods
  • Avoid processed carbohydrates and added sugars; limit sweets
  • Choose complex carbohydrates and whole grains 

One final, important fact: Knowing and addressing your pre-diabetes and/or diabetes risks gives you powerful information that you can use to change your life. 

Remember: You're in Control

Preconception is the perfect time to examine your lifestyle and make changes so you can achieve your optimal health. The modifications you make now are building a healthy and strong environment for fertilization, implantation and fetal growth.

We know that having a healthy pregnancy, healthy parents and a healthy baby is everyone’s goal, and we are here to help you achieve it!

Lisa Rosenthal

With 35+ years experience in the fertility field, as well as navigating her own infertility, Lisa has dedicated her life to advocating for and supporting those struggling to grow their families. Her work includes serving as Illume Fertility's Patient Advocate, Strategic Content Lead, and founder of Fertile Yoga, as well as advocating for those with infertility at RESOLVE, Resolve New England, and other organizations.

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