Sexual health and pregnancy doesn't always go hand in hand with diabetes. It's an important matter. How can you be sexually healthy while having diabetes and is it safe to have children?
In this Diabetic & Me article, you will learn about:
- What is diabetes?
- Different types of diabetes
- What are the signs of diabetes?
- Current treatments for diabetes
- Diabetes and sexual health for men and women
- A safe pregnancy with diabetes
What is diabetes?
Diabetes is a common name of Diabetes Mellitus. It's a disease in which not enough insulin is produced in the human body or sometimes even no insulin is produced by the pancreas. In some cases, the body doesn't consume the insulin properly and effectively. This way sugar levels in the body are being disturbed and cause high blood sugar levels.
Diabetes is a very critical and chronic condition. According to the American Diabetes Association, alone in the US, almost every seventh death is diabetes related. There is no known cure besides taking precautions, medication and management of lifestyle with a diet.
The basic and rapid source of energy in the human body is glucose. The lack of insulin in the human body can create many other complications, such as heart diseases, eyes issues, nerve damage, kidney failures and more.
More on diabetes and managing it
Have you not yet fully mastered the basics? When it comes to diabetes management, it is best to pick up 'think like a pancreas' from Gary Scheiner. The book is about how to manage type 1 diabetes yourself and how to see patterns in your blood sugars. You will learn how you can better use a pump or pens, how to deal with sports and your blood sugars and more. Gary also addresses developments such as the best CGMs. Gary himself has type 1 diabetes, is a certified diabetes expert and with the book provides strong advice for your first years with type 1 diabetes.
Different types of diabetes
Prediabetes a stage before possibly being diagnosed with type 1 or 2 diabetes. Your blood sugar levels are higher/lower than normal but not enough yet to be diagnosed. In most cases people with prediabetes will be diagnosed with type 2 diabetes.
Type 1 diabetes
When having type 1 diabetes, the body's immune system starts attacking beta cells in your pancreas. The reason behind this attack of the autoimmune system is still vague. There are different assumptions why this is happening. Like genetic or environmental reasons could be behind such attacks. Type one diabetics have only one solution to manage their illness. Injecting insulin via a syringe, an insulin pen or an insulin pump and checking their blood sugar on daily basis.
Type 2 diabetes
With type 2 diabetes the body starts behaving as an anti-insulin agent. Which means that your body is not fully responding to the insulin your body is making. The immune system produces more insulin than the demand of the body, which decreases the levels of insulin. These low insulin levels result in high blood sugar. It's also the most common type of diabetes, around 90% of all diabetes cases in the world.
Type 2 diabetes is also a major reason behind sexual complications including pregnancy. It also affects the sexual health of both men and women equally.
Latent autoimmune diabetes in adults (LADA) is an attack on autoimmune tissue. It is not that sudden and harmful as compared to type 1 diabetes. LADA can be cured or managed with different exercises and appropriate diet plans. It can also be cured using medication like Glucobay or Glucophage.
Insulin therapy will not be considered as a priority in most of the cases. Sometimes, type 2 diabetes is misdiagnosed with LADA.
If you don't have overweight, if you are eating a healthy diet and staying away from processed meals it might result in lesser chances of developing type 2 diabetes. If you are still facing high blood sugar levels, then you may have LADA.
Defined as “maturity-onset diabetes of the young.”
The reason behind MODY is the change in one of the eleven genes found in the human body. Being a type of diabetes, it disturbs the blood sugar levels. It affects 5% of all diabetic patients. Meaning that 1 out of every 20 diabetic patients has MODY.
It is quite similar to type 1 diabetes and can be confusing. As we know, in type 1 diabetes, insulin is not produced as per requirement in the pancreas. Contrary to this, insulin releases abundantly in type 2 diabetes. It is not a thumb rule that MODY occurs only in adults; it can hit any age group. It’s a genetic disorder in which children can inherit this from their parents. The inherit ratio is around 50%.
In some cases, during pregnancy there are insulin blocking hormones produced. These cause complications during pregnancy as well as in conceiving another baby. Gestational diabetes occurs mostly in women up to the age of 25.
Children and diabetes
According to the National Center for Chronic Disease Prevention and Health Promotion, doctors discovered that there are 5300 children diagnosed with diabetes between the age group of 10 and 19 years in 2011 and 2012 only in the USA.
Type 2 diabetes is becoming increasingly common in children. Children with type 2 diabetes have many severe complications, like developing an insulin resistance.
What are the signs of diabetes?
Your blood test and/or a urine test is the fundamental way to find out which type of diabetes you have. If your health care provider takes an in-depth look at your family medical history, he can possibly tell you that you have a bigger chance of developing diabetes.
Diabetes has a few risk factors that are associated with type 1 diabetes:
- Family history
- Age (usually develops in younger adults and children)
Type 2 diabetes has less risk in genetics but leans more towards your lifestyle:
- Family history
- Overweight (BMI higher than 25)
- Unhealthy eating
- Lack of physical activity
- Increasing age
- High blood pressure
- Poor nutrition during pregnancy
- Indecent hunger
- Excessive thirst / Dry mouth
- Slow healing of wounds
- Blurry vision
- Weight loss
- Muscle cramps
- Excessive urination
- Mood swings
As a diabetic I can tell out of experience, before and after my diagnosis, that muscle cramps can be very annoying and cause pains. Especially in the legs. Taking homeopathic Leg Cramps medication against leg, calf and foot cramps helped me to relief the pain.
Specific sexual health symptoms
Besides these above-mentioned symptoms, men with diabetes can also have symptoms like extreme fatigue, decreased sexual drive and erectile dysfunction.
Women with diabetes have more chance on developing a yeast infection, having itchy and dry skin, urinary tract infections and have a low sexual or intimacy drive.
Symptoms specific to children
The main symptoms is excessive urination and muscle cramps. Thirst and hunger without any proper timing are also one of the first signs. The immediate result is dehydration and other medical conditions.
If it is not treated on time it can cause lifelong disability of any human organ and affects the body.
Current treatments for diabetes
Different approaches of doctors have been made for the treatment of diabetes and the effects on sexual health and pregnancy.
Some of them are edible in the form of pills and some are in the form of insulin injections.
Juvenile Diabetes Research Foundation says that diabetes is some kind of virus similar to poliovirus, but another family of viruses called the Coxsackie virus. As a diabetic myself. I am still hoping that there will be some kind of cure in the near future.
Type 1 diabetes treatment
The only solution to type 1 diabetes is insulin therapy and specific diet plans. There are different ways of injecting insulin. You can inject insulin with traditional disposable syringes or regular insulin pens. A newer way of using insulin is with a wired insulin pump like a Medtronic MiniMed or wireless insulin pump like Omnipod.
There are four kinds of insulin widely used:
- Rapid-acting starts working within 15 minutes and has a duration of 2 to 4 hours
- Short-acting (regular) starts working within 30 minutes and has a duration of 3 to 6 hours
- Intermediate-acting starts working within 1 to 4 hours and has a duration of 12 to 18 hours
- Long-acting starts working within a few hours and has a duration of 24 hours or even more
Combined with an insulin therapy you should always take care of your physical health with enough exercise and healthy diet. Studies show that eating plant based, vegan, vegetarian or even low carb can affect type 1 diabetes in a positive way.
Type 2 diabetes treatment
It is a mild stage as compared to type 1 diabetes but it can affect your sexual health even more.
For this purpose, doctors recommend diet plans and different types of physical activities. If the sugar level doesn't come to normal then proper medication is given to a person with type 2 diabetes. Some people having type 2 diabetes also take insulin.
Generally Metaformine (Glucophage, Glumetza, etc.) or Sulfonylureas are the first medications prescribed by doctors to manage type 2 diabetes.
These medicines help the human body to secrete more insulin and lower the production of glucose in the body by enhancing the sensitivity of the body towards insulin.
Diabetes and sexual health for men and women
When it comes to the quality of a healthy lifestyle, sexual expression is one of the top priorities. It’s important to discuss the possible sexual issues related to diabetics. It has adverse effects on both male and female.
In both sexes, diabetes affects sexual issues like lack of stamina, decrease in libido, and lighter sexual drive.
Low libido changes
Low libido results in various complex problems like:
- Hormonal disturbance
- Side effect of medications
- Lack of focus
Sexual desires in any couple are primary concerns. A little bit of lack of communication eventually results possibly in ending a beautiful relationship. Sometimes we feel that it's more convenient not to talk than finding a solution. Therefore it’s important to discuss your sexual health with your partner.
Erectile dysfunction (ED)
Erectile dysfunction (ED) is one of the most serious and common issue with men suffering from diabetes. It’s important to have a routine checkup whether you’re facing any problem or not.
If you ejaculate before maintaining an erection it can be because of serious nerve damage and ED. Diabetic medications disturb your testosterone levels which lower your sexual intimacy and develop sexual and physical health issues.
A term commonly used by doctors curing diabetic patients is diabetic neuropathy. It’s a very serious nerve-damaging situation that can destroy your sex life. Because the sexual issues related to this are numbness, genitals defectiveness, and erectile failure.
Diabetic neuropathy can kill your sexual pleasures and orgasms while having sex with your partner. Men with diabetes have 3 times more chance in developing an erectile dysfunction compared to men with no diabetes.
Another serious sexual issue that occurs with men that have type 1 or type 2 diabetes is retrograde ejaculation. In this situation, the semen are ejaculated in the bladder instead of emerging through the penis during orgasm. You do reach a sexual orgasm but with little or no semen.
Internal sphincter muscles do not work properly when having diabetes, which is the main reason behind this issue. These muscles are responsible for opening and closing passages in the human body.
Sexual health of diabetic women
Vaginal dryness is quite often in women suffering from type 1 and type 2 diabetes. It also causes a lack of blood flow in the genitals and other hormonal changes affecting the menstruation period. Vaginal infection and inflammation can occur which makes sex possibly painful instead of creating pleasure. This situation directly hits you and your partner's sexual desires.
Urinary tract infections (UTIs) can also occur quite often in women with diabetes.
Different kinds of pills, patches, creams and injectables are available nowadays to improve your libido levels.
Staying overall healthy can be more than enough to improve your sexual health.
Top 5 sexual health tips for diabetics
- It's always good, as a woman, to know your menstrual cycle. Tracking your hormonal changes before and after periods will help you to schedule your diet, exercise plan and insulin therapy.
- Men with type 2 diabetes can have low testosterone levels, which slowly affects the sexual life. Good exercise and a balanced diet improve testosterone levels.
- Don’t be shy. Consulting your doctor without any hesitation will prevent further damage to yourself and your relation.
- Don’t panic, feel depressed and relax when working on daily life issues. Depression can have a very big impact on your sexual life.
- Prepare and educate yourself as a diabetic before thinking about conceiving a baby with your partner. Consulting a doctor on this matter is always the first and best approach.
A safe pregnancy with diabetes
According to the American Diabetes Association, type 2 diabetes is one of the most viral types of diabetes that occur during a pregnancy. During pregnancy, the glucose levels in the blood can rise. Not enough insulin is produced by the body to decrease these levels, resulting in type 2 diabetes. By improving your lifestyle and diet with minimal medication you can decrease the chance of getting diabetes. Previous cases of other women show that if you have diabetes you can still be pregnant and conceive a baby without any problems.
If you are not sure and want to test if you are pregnant you can use the ClearBlue pregnancy test. Clearblue Connected Ovulation Test System is the first and only test system to track two unique hormones and connect to your phone via Bluetooth technology with smart reminders based on your personal cycles.
There are some main stages that you have to follow:
Getting yourself ready
You have to keep in mind that pregnancy will affect your blood sugar levels.
If you’re thinking to have a baby make sure you take all precautions. Make an appointment with your doctor and honestly discuss everything.
- Your current diet plans
- Your current level of activity
- Your current diseases (diabetes and/or others)
- Your latest blood sugar levels
- Your current medication (are they safe for a pregnancy)
HbA1c test before pregnancy
A blood test (HbA1c or A1c) can give you a comprehensive result of how well controlled your blood sugars has been over a period of 12 weeks. Your doctor might need to arrange a healthy diet plan before your pregnancy to manage blood sugar levels. The results of the last six months play an important role during a pregnancy. If you have high blood sugar levels within six months before getting pregnant then there is a lot more chance to have abnormalities during and after the pregnancy.
According to the American diabetes association, the safe zone of the A1c level is below 7% for a pregnant woman.
Different medical tests prevent many complications in pregnancy like:
- Blood sugar test
- Cholesterol test
- Triglyceride test
- Foot exam
In early pregnancy (before 13 weeks), higher blood sugar levels result in miscarriages or other. The ideal range for blood sugar levels during pregnancy is.
- Before meal: 70-100 mg/dL
- After meal: Less than 142 mg/Dl
- Before bedtime snacks: 100-140 mg/dL
Sometimes diabetes affects pregnancy in such a way that newly born babies are bigger in size. A situation called Macrosomia. High blood sugar is the main reason for this. The baby converts the excessive sugars into fat.
Meeting a high-risk OBGYN team
Women with type 1 or type 2 diabetes that are planning of having a baby must consult with a high-risk OBGYN (obstetrician and gynecologist) team rather than having a standardized OBGYN team. The reason behind this is that handling a pregnant woman with diabetes is a completely different thing. You have to change all the diet plans and the little change in blood sugar levels can put the mother and child in danger.
So, if you are planning your pregnancy then fix a schedule with a high-risk OBGYN team whom you can consult easily.
Treatment, medication and insulin
Insulin itself plays a vital role in the control of diabetes but when it comes to pregnant women there are some limitations. Most of the insulins are safe to use, keeping in mind the place of injection.
If you’re a diabetic mother but don’t take insulin then you must start your course after the 2nd trimester depending upon your gynecologist’s advice.
But if you already have been taking insulin the doses changes after intervals depending upon your blood sugar levels. Especially from the 16th week till the birth of the baby.
With the advancement in medical fields, there are a lot of new medicines in the market and recommended by doctors also. Always contact your OBGYN team to assist you with taking new medications that suit your body type.
Blood sufar levels during pregnancy
Below are the maximum limits of blood sugar levels for a mother conceiving a baby as recommended by the American College of Obstetricians and Gynecologists (ACOG)
- After waking up (morning): < 90 mg/dL
- Before a meal: < 105 mg/dL
- 1 hour after a meal: < 130-140 mg/dL
- 2 hours after a meal: < 120 mg/dL
The best way to constantly checking your and the baby's health during these 9 months is testing your blood sugar levels after short intervals. This allows you to guess how your medication, diet plans and lifestyle is going.
Diabetes base nutrition during pregnancy
First of all, we have to keep in mind that a pregnant woman requires vegetables, grains, meat, raw fruits and milk.
Avoid all kinds of highly processed foods, fast foods and canned stuff. Alcoholic drinks are best banned from your diet plan during pregnancy.
The basic needs of a baby in the womb of the mother include protein, high-quality fats, carbohydrates, fiber, vitamins and minerals.
The basic formula of these foods is 10% unhealthy and 90% healthy food. The unhealthy foods include a bit of craving like a little bit of pizza, cakes or ice-cream but it doesn’t include alcohol or any recreational drug use.
Being pregnant or not. Physical activities and exercise help you in combating diabetes. It will be more helpful if you healthy activities, specifically in the last trimester.
A normal walk of around 30 minutes is quite enough which helps you out in various ways, like overcoming your routine stress, natural aid to maintain sugar levels, balanced blood flow and helps in resisting insulin.