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首页> 外文期刊>Open access Journal of Contraception >Contraception for women with diabetes: challenges and solutions
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Contraception for women with diabetes: challenges and solutions

机译：糖尿病女性避孕：挑战和解决方案

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Diabetes mellitus (DM), the most common of metabolic disorders, is a global public health concern. Numbers are rising with 383 million adults currently diagnosed with DM and another 175 million as yet undiagnosed. The rise in cases includes increasing numbers of women of a reproductive age whose reproductive health and contraception need careful consideration. Unintended pregnancy with poor glycemic control at the time of conception increases the chance of adverse pregnancy outcomes including stillbirth, congenital abnormalities, and perinatal mortality. In order to minimize complications, safe and effective contraception is paramount for all women with DM. This is a challenge as women have been found to be reticent to ask for advice, appear to lack understanding of risks, and are less likely to be using contraception than women without DM. The World Health Organization has developed Medical Eligibility Criteria to guide contraceptive choice. Women with DM without complications can choose from the full range of contraceptive methods including hormonal contraception as the advantages of use outweigh any risk. Women with diabetic complications may need specialist advice to assess the risk–benefit equation, particularly in respect of hormonal contraception. Women should be aware that there is no restriction to the use of oral and copper intrauterine emergency contraception methods. There is a need for an integrated approach to diabetes and reproductive health with improved communication between women with DM and their health care providers. Women need to be aware of advice and services and should make their own choice of contraception based on their needs and associated risk factors. Practitioners can offer nonjudgmental guidance working in partnership with women. This will enable discussion of risks and benefits of contraceptive methods and provision of advice dedicated to improving overall health and well-being.
机译：糖尿病（DM）是最常见的代谢紊乱，是全球性的公共卫生问题。人数正在上升，目前有3.83亿成年人被诊断患有DM，还有1.75亿尚未被诊断出的成年人。病例的增加包括育龄妇女人数的增加，她们的生殖健康和避孕需要认真考虑。怀孕时血糖控制不佳的意外怀孕增加了不良妊娠结局的机会，包括死产，先天性异常和围产期死亡率。为了最大程度地减少并发症，安全有效的避孕方法对于所有患有DM的女性至关重要。这是一个挑战，因为与没有DM的女性相比，发现女性不愿征求意见，似乎对风险缺乏了解并且使用避孕的可能性较小。世界卫生组织已经制定了《医疗资格标准》，以指导避孕的选择。没有并发症的DM妇女可以从包括激素避孕在内的各种避孕方法中选择，因为使用的好处大于任何风险。患有糖尿病并发症的女性可能需要专家的意见来评估风险与收益的关系，尤其是在激素避孕方面。妇女应意识到，口服和铜宫内紧急避孕方法的使用没有限制。需要一种糖尿病和生殖健康的综合方法，以改善患有糖尿病的妇女与其保健提供者之间的沟通。妇女需要了解建议和服务，并应根据自己的需要和相关的危险因素自行选择避孕方法。从业人员可以提供与女性合作的非判断性指导。这将有助于讨论避孕方法的风险和益处，并提供有关改善整体健康和福祉的建议。

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