In general, hormonal methods of birth control are safe for women with diabetes. If you are over 35 and smoke, or you have a history of heart disease, stroke, high blood pressure, peripheral blood vessel disease, or blood clots, these methods may be risky for you.

If you’ve found that your insulin sensitivity varies at certain times of the month, being on the pill, patch, ring, or injections may help smooth out your blood glucose levels. By providing a steady dose of hormones, blood glucose swings can be kept to a minimum.

Some women find that oral contraceptives increase insulin resistance. If your blood glucose levels are affected, your insulin or your dose of oral diabetes medication can be adjusted.
Taking the lowest possible dose or the mini pill can also help.

IUD. The IUD is a small T-shaped object that is placed into the uterus by a provider. IUDs prevent sperm from reaching the egg or from implanting in the uterus. One type contains copper and others contain progesterone. IUDs can remain in place for one, five, or ten years, depending on the type. IUDs are generally recommended for women who have had one or more children.

When properly inserted and retained, IUDs are about 95 to 98 percent effective in preventing pregnancy.

Barrier Methods. Barrier methods of birth control include the diaphragm, sponge, cervical cap, and condoms. Barrier methods prevent the sperm from reaching the egg. The diaphragm is a shallow rubber cup that fits tightly over the cervix,  the entrance to the uterus. The diaphragm is coated with spermicidal jelly before you insert it. The diaphragm is put into place just before intercourse and needs to be kept in place for at least 6 hours after intercourse and then removed. It is 80 to 94 percent effective for preventing pregnancy.  The effectiveness

depends on the user’s ability to place the device correctly, use of spermicidal jelly, and leaving it in place for the full time.

Your gynecologist will fit your diaphragm and teach you how to place it properly and check to be sure it is covering the cervix.

The sponge contains spermicidal jelly and is placed into the vagina over the cervix. It can be inserted up to 24 hours prior to intercourse and needs to be left in place for 6 hours afterward. Sponges are 80–91% effective.

The cervical cap is a small, thimble-shaped barrier device that fits tightly over the cervix to prevent sperm from entering the uterus. It is used with spermicidal jelly.

The female condom is another barrier method of contraception. It is a larger type of condom that you insert into your vagina up to eight hours before intercourse. You remove it afterward, taking the sperm with it. It can also help protect against sexually transmitted diseases. It is 74 to 79 percent effective.

Spermicides. These work by killing sperm and can be purchased without a prescription.  There are several types:  foam,  gel, cream, suppository, or tablet. They can be used alone or to increase the effectiveness of barrier methods. They are 72 to 90 percent effective.