Diabetes is the most common and well-studied disorder. The impact of diabetes on the body and long-term complications are well documented. We will review the effects of uncontrolled diabetes and fertility. Diabetes in men and women can affect their fertility and lowers the chance of having a baby. The silver lining is, the risk of fertility difficulties is considerably reduced when diabetes is well managed. It is a well-known fact that Diabetes can cause hormonal disruptions which lead to delayed implantation and conception. Also, uncontrolled diabetes often generates poor-quality sperm and embryo and DNA damage at the same time. We all know an easily available carbohydrate called Glucose is an essential source of energy for the body. Usually, glucose requirements by the body and blood glucose levels are well controlled by insulin, a hormone produced by the pancreas. When glucose metabolism is successfully managed, the body is sufficiently active and the body’s glucose levels are within the safe range. If sugar metabolism is not managed properly, the body shows the symptoms of impaired glucose tolerance or diabetes. Diabetes is a metabolic disorder and is of 3 types. Type 1 diabetes: Insulin is the hormone that controls blood sugar levels, In type 1 diabetes, the pancreas is unable to make insulin. This may be due to inactive cells that produce hormones or inactive glands, so sugar is not metabolized, which we refer to as, is the dietary source of energy. In such circumstances, the blood sugar levels in the body are managed by injectable insulin. Daily medication like (insulin) is, therefore, necessary to control blood sugar levels. That is the reason, type 1 diabetes is also called insulin-dependent diabetes. Type 1 diabetes can happen at any age and 5-10% of diabetes falls into this category. Type 2 diabetes: Type 2 diabetes is, where the body produce insufficient insulin. As we know, insulin is produced by beta cells of the pancreas. Insulin acts as key which allows sugar to enter the cells of the body. In type 2 diabetes, blood sugar levels are high and body cells don’t get energy as sugar cannot enter the cells. It occurs over time eventually the body becomes resistant to the effects of insulin. This results in high blood sugar levels. Depending on the severity, type 2 diabetes can be managed with diet and exercise or may need the combination of diet, exercise, and safe & well-studied medication. Type 2 diabetes is most commonly seen and manageable form. Gestational diabetes: Gestational diabetes is developing during pregnancy and usually disappears after giving birth. It can be well managed holistically with a healthy diet and exercise and medications. A well-known, myth is, Diabetes only affects people who are overweight, whereas, the fact is Diabetes can affect anyone, regardless of weight. Maintaining a healthy weight with a well-planned diet and regular exercise is important for controlling blood sugar levels. Avoiding simple sugar like glucose is very important. How diabetes affects the reproductive process in a couple? In women, uncontrolled diabetes can result in irregular menstrual cycles. In men, it can cause issues of sexual erections and lower levels of testosterone. Increase the risk of miscarriage and stillbirth, cesarean section and the babies may need intensive care after birth. Type 1 diabetes, and female fertility Women with type 1 diabetes often have menarche & menstrual cycle disturbances. Longer menstrual cycle length (>31 days), longer and heavy menstruation (≥6 days) Juvenile diabetes (type 1) causes delayed menarche. Anovulation: Anovulation is the absence of ovulation. Anovulation can result from a variety of factors such as chronic mental illness, hormonal imbalances, ovarian failure, diabetes, and Low BMI. Anti-sperm antibodies: The antibodies which are produced in diabetes can directly attack the sperm and eggs and induce infertility. How does type 2 diabetes affect female fertility? Diabetes, obesity, and PCOS: With modern dietary and lifestyle patterns, obesity is rising, which burdens the journey of conception. Diabetes causes oxidative stress & fatigue. Obesity often causes irregular menstrual cycles and is also linked to PCOS. It is mostly found that 50-70% of women who have PCOS also have insulin resistance. There is a hormone Adiponectin which improves insulin sensitivity and prevents obesity. In women with PCOS, there is low Adiponectin leads to poor sensitivity to insulin and fat breakdown. So patients having PCOS often are diabetic and obese. There exist three-way threats to fertility and reproductive health. Losing weight means body fat with a healthy diet and exercise can easily correct hormonal imbalance and insulin resistance. This can increase fertility and prevent Type 2 diabetes and the resulting complications. How does diabetes affect male fertility? Diabetes affects the ability of erection and sex drive in men, which may cause infertility. Lack of glucose (the only source of energy for the brain) may cause fatigue, weakness, and less sexual drive in men. How does type 1 diabetes affect male fertility? Sperm DNA damage: Diabetes is associated with increased mitochondrial and DNA damage that may impair the reproductive capability of men How does type 2 diabetes affect male fertility? Type 2 diabetes is associated with poor sperm concentration in semen, and motility along with structural damage to the sperm and DNA integrity. Treatment of diabetes which can control infertility The best part is diabetes can be controlled with diet, exercise, medications What are the different treatment options for infertility? Diabetes is a morbid condition for infertility and control of diabetes will ensure the burden of infertility is reduced. Do remember, well-controlled blood sugar levels: Helps in regularizing menstrual cycles. Reduce the risk of erection problems Improves testosterone levels Increase sex drive Reduce the risk of miscarriage Reduced risk of neonatal ICU admission Every cloud has a silver lining and the good news is, diabetes is the best-studied and well-researched disorder. The blood sugar levels can be tested with easily available tests & kits. Self-control over an unhealthy diet and a properly planned exercise schedule can help. The result of such lifestyle modifications can be seen and tested. Stress is often regarded as a powerful factor in diabetes as well as infertility, that’s why reducing stress and anxiety, and quitting smoking is vital. Medication may also be needed. Your doctor can help you with the right information and access the support you need.
