Fertility In Diabetic Women: Risks, Challenges, And Management

Diabetes is a chronic disease that occurs when the body either does not produce enough insulin or can not use it effectively. Diabetes is widely known as a major cause of severe health problems such as blindness, kidney failure, heart attacks, stroke, and lower limb amputation. But what generally takes the back seat is how significantly it affects the reproductive health, particularly fertility in women.

To understand the Diabetes risk to fertility, its associated challenges, and how they can be managed, we spoke to Dr Pooja Choudhary, Senior Consultant (Obstetrician and Gynecologist), Apollo Cradle & Children's Hospital, Chirag Enclave, New Delhi.

How Does Diabetes Affect A Woman’s Fertility And Ability To Conceive?

According to the reproductive science centre of New Jersey, Hormones that are involved in regulating blood sugar levels severely disrupt the normal physiological processes of producing and carrying eggs in women, which directly impact fertility, eventually affecting conception and embryo implantation.

Dr Pooja Choudhary shared that diabetes affects fertility in many ways, one of the reasons being insulin resistance. “Insulin resistance is generally seen in Type 2 diabetes, which can lead to Polycystic Ovary Syndrome (PCOS) and affects reproductive outcomes,” she continued.

Dr Choudhary highlighted that High oxidative stress, obesity, or being underweight, and chronic inflammation also hinder the natural process of fertility.

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Risks Of Pregnancy For Women With Diabetes

Planning a pregnancy with diabetes comes with severe health risks, known as gestational diabetes, which worsens the pre-existing health conditions, including liver and heart problems. Dr Choudhary explained, “Women with diabetes have high Risks of Preeclampsia, that is, high blood pressure during pregnancy, protein in urine, and cesarean delivery. This impacts the newborn in critical ways, as the baby can have hypoglycemia or polycythemia and breathing difficulties.”

“Pregnant women with diabetes have high chances of miscarriage, pre-term delivery, and Stillbirth, which refers to fetal death of the baby after the 20th week of pregnancy, and Congenital malformations,” she stated.

Another major risk that comes with a diabetic pregnancy is that the baby can be macrosomia, which means a larger body size than usual for a newborn child. Along with this, a neonate can have an imbalanced sugar level from birth, resulting in a number of health problems that add up with the growing age due to weak immunity.

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Can Diabetes Be Managed To Support a Healthy Pregnancy?

With proper management and medical guidance, diabetes patients can conceive naturally and have a healthy outcome. Dr Choudhary shared that a couple with diabetic issues can have a healthy pregnancy if they take care of certain factors. “Before patients conceive, they should have tight sugar level control, and sugar levels should be within limits,” she stated.

Even during and after pregnancy, couples should regularly monitor and maintain their blood sugar level for the healthy growth of their child.

Lifestyle Changes That Improve Fertility Outcomes For Diabetic Women

Here are a few lifestyle changes that improve fertility outcomes for diabetic women, recommended by Dr Choudhary:

• A pregnant lady with diabetes should take a balanced diet with a balanced portion of nutrients, protein, and minerals, and limit refined carbs and sugar intake.
• Pregnant women should follow a consistent sleep schedule and maintain good sleep hygiene.
• Pregnant women should significantly reduce their blue light exposure and screen time.
• With the hectic lifestyle, depression and anxiety have become a constant part of our daily life, but for a pregnant lady, it has a severely negative impact. During pregnancy, Diabetic women should live in a peaceful and joyful environment, avoiding any kind of pressure and stress disorder.
• Any kind of intoxicant, including alcohol and tobacco, should not be consumed before, during, or just after pregnancy for the healthy growth of the baby.

Preconception Counselling For Diabetic Women

During the discussion, Dr Choudhary mentioned that diabetic women must take pre-conception counselling to get aware of the possible risks and complications that come with increased blood sugar levels during pregnancy. “Women with diabetes should be put on a high dose of folic acid, and antenatal care should continue starting during the first trimester of pregnancy to the birth of the baby.” Antenatal care basically includes regular check-ups, screenings, guidance on nutrition and lifestyle, ultrasound when necessary, and blood and urine analysis.

Taking preconception counselling helps pregnant women understand the ways to deal with all the possible complications due to high blood sugar levels and the chances of cesarean delivery. This gives them a chance to prepare for all the possible situations and work on their health.

Also Read: World Diabetes Day 2025: Is Cheese A Bane Or Boon For Diabetic Patients? Expert Decodes

Bottom Line

Several factors related to diabetes make the chances of a successful pregnancy difficult, but with medical advancement, there are various methods to achieve healthy results. However, along with medical support, a healthy lifestyle plays a major role in diabetic pregnancies.