Endocrine Abstracts

Introduction: Contraception in women with diabetes is difficult. It is the subject of an individualised prescription, which takes into account the metabolic and vascular state as well as the gynaecological tolerance of the patient.

Materials and Methods: This is a prospective survey having concerned 100 diabetic women surveyed in the Maternity ward of the CHU Ibn Rochd of Casablanca, during a five-month period, between April and September 2021.

Results: The average age of the women was 35.2 years. Obesity was noted in 26%, hypertension in 51%, dyslipidaemia in 35% and in 35% and 5% of the women were smokers. Type 1 diabetes accounted for 35% and type 2 for 65%. Diabetes was unbalanced in 91% and complicated in 68%. Hormonal contraception was used in 42%, the intrauterine device in 28%, local methods in 20%, tubal ligation was performed in 9%. The maternal-foetal risks linked to unbalanced diabetes were known in 66%, the need for obstetrical and diabetic pregnancy monitoring in 63%, and the obligation to start insulin in pregnant diabetic women in 47%. Women who used hormonal contraception despite having a contraindication to the pill represented 30%.

Discussion: The problem of contraception must be systematically addressed in a diabetic woman of childbearing age, during each consultation, Oestrogen-progestin treatments should not be excluded from the contraceptive Oestrogen-progestin treatments should not be excluded from the contraceptive regimen in women with diabetes, type 1 or type 2, and under 35 years of age. Potential adverse impacts on blood glucose, lipid profile and micro angiopathy are apparently modest. The effects on macroangiopathy need to be integrated with other cardiovascular risk factors. The evaluation of knowledge concerning contraception will have to be the subject of several more in-depth studies in order to properly define the issue and to propose practical solutions to generalise the information with the aim of reducing the risk of unforeseen consequences on pregnancy in these women who most often have complicated diabetes.

Conclusion: The prescribing practitioner should be the subject of several studies in order to propose practical solutions to improve knowledge and contraceptive practices with the aim of reducing the unforeseen risks of pregnancy in these women.