Health Promotion and Maintenance Q 88
A client with diabetes asks the nurse for advice regarding methods of birth control. Which method of birth control is most suitable for the client with diabetes?
A. Intrauterine device
B. Oral contraceptives
C. Diaphragm
D. Contraceptive sponge
Correct Answer: C. Diaphragm
The best method of birth control for the client with diabetes is the diaphragm. The diaphragm is a birth control (contraceptive) device that prevents sperm from entering the uterus. The diaphragm is a small, reusable rubber or silicone cup with a flexible rim that covers the cervix. Before sex, the diaphragm is inserted deep into the vagina so that part of the rim fits snugly behind the pubic bone. The diaphragm is effective at preventing pregnancy only when used with spermicide.
Option A: Permanent intrauterine device can cause a continuing inflammatory response in diabetics that should be avoided. Fibrinolytic activity is due in part to prostaglandin synthetase activation which was thought to be required for the efficacy of the copper IUD. Its absence was thought to be a possible reason why copper IUDs were less effective in diabetics (and in nondiabetics who became pregnant).
Option B: Oral contraceptives tend to elevate blood glucose levels. Choice of contraception should be made on the preference of the woman and individual risk factors identified such as the presence of vascular, nephropathy, neuropathy, or retinal disease. Choosing a safe and reliable method of contraception for a woman with DM needs careful consideration and practitioners need to make reference to the WHO Medical Eligibility Criteria for Contraceptive Use.
Option C: Contraceptive sponges are not good at preventing pregnancy. The contraceptive sponge is a type of birth control (contraceptive) that prevents sperm from entering the uterus. It is soft and disk-shaped, and made of polyurethane foam. The contraceptive sponge contains spermicide, which blocks or kills sperm.