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Dr. Andrew Rynne

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Overweight with pcos and type two diabetes. Trying to conceive. What should I do?

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Dr. Madhuri Patil

Diabetologist

Practicing since :1999

Answered : 362 Questions

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Posted on Wed, 9 Jan 2013 in Getting Pregnant
Question: Hi. I'm overweight wit pcos and diabetes type two. Been trying to get pregnant wit my husband for almost 2 years now. I had gotten pregnant 2 yrs ago for the time time on the first try but miscarried.
I have always had a regular period every 36 days up until 6 months agO. Since 6 months ago When i was diagnosed wit diabetes type 2 i have had no period, but non stop very light bleeding on and off every 2 days - non stop for last 5 -6months. This is ruining my marriage. I Must get pregnant, my husband is much older n getting older and having a big family was the most important thing to him, since before we evEn met. So not getting pregnant is effecting my marriage badly. What can Ido to get pregnant asap. I've been going to the gym, got membership. Work 40 hours a week with an active job. . . . . .am I ovulating when lightly spotting still due to the diabetes ?
doctor
Answered by Dr. Madhuri Patil 1 hour later
Dear XXXXXXX,

Before you try for pregnancy, let us think on setting all the things right. PCOS tends to make your cycles irregular and uncontrolled diabetes adds to the irregularity. This affcts ovulation.
You are working out at gym, do you also follow dietary instructions very strictly? This is very very important because whatever insulin sensitivity you bring down by exercise has to remain stable once you conceive. If you work out at gym then because of the prior history of abortion you'd be told to be careful about gym exercises once you conceive. Then stopping or reducing your body exercise will make your sugars go up very badly and there is chance of another abortion in 1st trimester itself. Hence please make sure you do exercises which you'd be able to do during pregnancy also like- brisk walking. Walk for 45 to 60 minutes everyday at a stretch. Best results are when you can walk for 60 minutes in the morning and another 30-35 minutes in the evening. And follow dietary guidelines strictly now and once you become pregnant. This will keep insulin sensitivity up and increase chances of ovulation with regularity in menstrual cycles also.
The bleeding you are suffering with can be due to either increased size of your endometrial thickness due to PCOS or due to infection of the endometrium, The former is more likely. So please get you pelvic scan done as get back to me for further advice on this.
Be positive about your marriage. Do not worry about your husband's age at this stage. Let your sugars be srtictly controlled and let your menstrual cycles be regular then things will fall in place. After that you can follow the ovulation studies closely for getting pregnant.
I hope you understand. Take care.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Madhuri Patil 1 hour later
You mentioned abortion..... I've never had an abortion...
I did have a misscarriage.

I just had a whole bunch of ultrasounds down this past month and they see absolutley nothing wrong,infact I may have either produced an egg or ovulated...

Otherwise they say I'm just suffering from diabetes the doctor said...
doctor
Answered by Dr. Madhuri Patil 26 minutes later
Miscarriage is spontaneous abortion- not induced by the patient or medicos.
Diabetes as such is never a problem to conceive normally if you seem to have normal endometrium and if you are ovulating fine. The spotting can then be, yes, due to your ovulation.
Now make sure you see your Diabetologist and be on insulin before pregnancy itself as anyway, your sugars will need insulin all through the pregnancy and also pre-conceptionally as best sugar control helps the egg to survive in uterus longer for fertilization.
Also please rule out thyroid disorder, even a slightest variation in TSH level results in delayed conception in many ladies.
To know more for your sugar control, please let me know your latest fasting, post breakfast, post lunch, post dinner sugars with HbA1c and TSH levels. Shall be able to guide you.
Take care.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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