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PCOS | Diabetes | Women's Health | preconception

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

September 24th, 2021 | 7 min. read

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

Lisa Rosenthal

Lisa has over thirty years of experience in the fertility field. After her personal infertility journey, she felt dissatisfied with the lack of comprehensive services available to support her and was determined to help others undergoing fertility treatment. Lisa has served as Illume Fertility's dedicated Patient Advocate and Strategic Content Lead for many years and is the founder of Fertile Yoga, a program designed to support patients through gentle movement and meditation. Her experience also includes working with RESOLVE: The National Infertility Association and The American Fertility Association (now Path2Parenthood), where she was Educational Coordinator, Conference Director and Assistant Executive Director.

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Trying to conceive and want to make sure that you, your pregnancy, and your baby-to-be are as healthy as possible? I've got some good news! 

The good news is that there are some simple lifestyle and food choices you can explore that can make a big difference. The other piece of good news? You don’t 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. 

Preconception Planning

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.

In this blog, let's focus on pre-diabetes and diabetes.

Note: If you have Polycystic Ovary Syndrome (PCOS) or know that there’s a family history of any level of diabetes, it’s a good idea to ask some more questions and be as proactive as possible, especially if you’re trying to become pregnant. 

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 become and stay pregnant are safe and successful?

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

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

Download the ultimate guide to life with PCOS:Get My Free PCOS Handbook

Diabetes & Fertility: Myths and Facts

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 a 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 pre-diabetes or diabetes will delay fertility treatment and pregnancy for an extended time.

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 5 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.

FACT: Diabetes is a frequently occurring and serious disease.

Diabetes is occurring in the United States in epidemic proportions and is a real health threat, including as a co-morbidity for other diseases and infections. Data from the 2020 National Diabetes Statistics Report estimate 34.2 million U.S. children and adults have diabetes, which accounts for 10.5% of the population.

Perhaps more alarming is that 7.3 million people are undiagnosed. Pre-diabetes data indicate that 88 million people over the age of 18 have pre-diabetes. That's 34.5% of the adult population of the U.S.

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

With the use of new 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. Children affected by elevated glucose levels in utero are at increased risk for diabetes themselves.

FACT: Illume Fertility screens all women for diabetes or pre-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. 

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.

Let's explore why getting glucose under control is vital:

Insulin Resistance & Preconception

MYTH: Only women need to be concerned about pre-diabetes and 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. 

But men are NOT off the hook! In men with pre-diabetes or diabetes, high glucose levels may contribute to erectile dysfunction and damage to sperm DNA. Damage to the DNA could result in miscarriage and birth defects.

FACT: Abnormal glucose levels can cause health concerns for both mother and 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 leads to increased risk for an extra-large baby, c-section, pre-eclampsia and hypoglycemia in the newborn.

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

FACT: Just because I’m at high risk for diabetes doesn’t mean I will get it.

Absolutely true! However, knowing relevant and appropriate information is necessary to lower glucose levels. This can improve fertility and reduce risks to the mother and her unborn child.

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 and create a safer pregnancy, in turn increasing the odds of a healthy pregnancy and child. 

We can all reduce our risks for diabetes by seeking medical guidance, when necessary, and by making important lifestyle modifications. 

Some common recommendations for those at risk for diabetes:

  • Lose 5-10% of body weight (when necessary or appropriate; under medical guidance)
  • Participate in 30-60 minutes of physical activity each day
  • Eliminate smoking and recreational drugs
  • Eat regular (and balanced) meals
  • Find tools or methods to manage your stress
  • Engage in good sleep hygiene to improve your quality of sleep

Healthy dietary guidelines:

  • Choose foods low in saturated fats
  • Pick clean meats or fish and low-fat dairy
  • Include high fiber foods by eating fresh vegetables and fresh fruits
  • Choose heart-healthy fats, while limiting high-fat foods
  • Avoid processed carbohydrates, low added sugars, limit sweets
  • Choose complex carbohydrates/whole grains 

Read more about fertility-boosting nutrition from our Registered Dietician Nutritionist, Jill Hickey.

One final, important fact: Knowing and addressing 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 any adaptations necessary for your optimal health. The changes you make now are building a healthy and strong environment for fertilization, implantation and fetal growth.

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

Ready to take the next step or get expert guidance?

Request A Consultation

More Resources

To learn more about preventing or managing pre-diabetes or diabetes, visit the following agencies and organizations: