Wil Dubois

Got questions about life with diabetes? So do we! That's why we offer our weekly diabetes advice column, Ask D'Mine, hosted by veteran type 1, diabetes author and community educator Wil Dubois.

This week, Wil is going back to the bedroom with a new line of questioning. Intimate moments are a part of our lives with diabetes, and sometimes they get tricky -- especially when we are trying to start a family. Here's what Wil has to say about this, for one woman overseas.


{Got your own questions? Email us at AskDMine@diabetesmine.com}



Marapatla, type 2 from India, writes: I am suffering with diabetes and thyroid problems and I am trying to get pregnant. Please help. 

Wil@Ask D’Mine answers: I’m always happy to help a woman get pregnant, even at this hour of the morning ;)

Oops! That may not have come out sounding quite the way I intended it to...

But anyway -- moving on -- for 64 ideas on the mechanics of getting pregnant, I’ll refer you to the Kama Sutra, while here today at the 'Mine we’ll focus on the specific medical challenges you’re dealing with. Even though we are a diabetes publication, we’ll start with the thyroid, which is not as crazy as it sounds because thyroid disease and diabetes are bosom buddies. Relevant to you, Marapatla, one study found that nearly 32% of female type 2s have a thyroid disorder.

Oh, but backing up for a moment to put the horse before the cart, the thyroid is a butterfly-shaped gland that wraps itself around the front of your windpipe, just below your Adam’s apple. In adults, the thyroid’s job is to regulate metabolism and body temperature. In kiddos, it plays a critical role in body growth and brain development.

Thyroid problems come in two flavors: Hypo and hyper, simply meaning the thyroid either under- or over-performs. And either can lead to a wide range of bizarre symptoms and dysfunctions. But luckily for all of us that have a thyroid disorder, they are easily treated, in most cases with a single daily generic pill.

As to the thyroid and getting pregnant, both flavors of thyroid disorders can affect fertility negatively. In fact, even mildly out-of-whack thyroids can cause trouble in the baby-making department as even “subclinical hypothyroidism” has been shown to cause both infertility and miscarriages.   :-(   Subclinical means that under normal circumstances the thyroid is close enough to normal to not even be worth treating, but due to the miscarriage risk, many docs will go ahead and fine tune the thyroid in women of childbearing age.

On the bright side, once thyroid function is normal, fertility rebounds rapidly. So much so that endos treating young ladies for thyroid disorders often start birth control at the same time they start thyroid meds.Thyriod Pregnancy

Beyond the plumbing, untreated thyroid disorders are apparently big libido killers, but I couldn’t find any data on whether or not libido bounces back as quickly as fertility. My advice on the thyroid and pregnancy front is to take your thyroid meds and read your Kama Sutra. Or just peruse the illustrated version. Or, kid you not, the Pop-Up version.

Getting back to diabetes, but still speaking of fertility, the diabetes starter drug metformin increases fertility in women. So much so that it’s used off-label by fertility clinics. So if metformin isn’t part of your therapy plan, ask your doctor if metformin is right for you. And be sure to take pre-natal vitamins.

Now, just as uncontrolled thyroid disease lowers fertility, so too does uncontrolled diabetes. If your blood sugar isn’t what it should be, getting your glucose numbers knocked down can help you get knocked up. And as an added bonus, this will save you time and effort downstream, because once you are pregnant you’ll need to have the best blood sugar control of your life. There’s a ton of evidence that even slightly elevated blood sugars in the mother can cause birth defects in her baby.

And speaking of while you are pregnant, I was interested to discover that thyroid disorders tend to temporarily suspend themselves while women are pregnant. Apparently, the immune system is the driver behind many thyroid issues and changes in the immune system during pregnancy shut off the thyroid problems. So your medical team will need to carefully monitor your thyroid and adjust your meds while you’re “with child,” possibly even stopping the meds for a time. That said, within a week of giving birth, your thyroid problems will rebound to their previous levels.

So both diabetes and the thyroid have a role to play. The diabetes needs to be controlled to have a healthy pregnancy and healthy baby. The thyroid needs to be controlled to get pregnant in the first place. But neither are barriers that cannot be surmounted. Control both and you can start building your family.

But one last thing: I was troubled to read your statement that you were “suffering with diabetes.” I don’t mind people being challenged by diabetes. Or even being frustrated by it. But I think if you are suffering from it, the problem has more to do with your brain than your blood. Suffering is a negative mindset that’s a dead end. It’s a waste of mental energy that sets you up for self-fulfilling defeat. I worry that you will never get your diabetes contained and controlled without an adjustment in attitude first.

So before the thyroid, and the metformin, and the prenatal vitamins, and the Pop-Up Kama Sutra, look inside and find a way to abandon suffering and embrace the challenges… and rewards… that lie ahead.

This is not a medical advice column. We are PWDs freely and openly sharing the wisdom of our collected experiences — our been-there-done-that knowledge from the trenches. But we are not MDs, RNs, NPs, PAs, CDEs, or partridges in pear trees. Bottom line: we are only a small part of your total prescription. You still need the professional advice, treatment, and care of a licensed medical professional.
Disclaimer: Content created by the Diabetes Mine team. For more details click here.


This content is created for Diabetes Mine, a consumer health blog focused on the diabetes community. The content is not medically reviewed and doesn't adhere to Healthline's editorial guidelines. For more information about Healthline's partnership with Diabetes Mine, please click here.