Contraception in perimenopausal women with diabetes mellitus

Grigoryan, O. R.; Grodnitskaya, E E; Андреева, Елена; Shestakova, Marina Vladimirovna; Мельниченко, Г. А.; Dedov, Ivan I.

doi:10.1080/09513590600624317

Cited by 32 publications

(33 citation statements)

References 10 publications

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“…Most, but not all (26;27), studies evaluating cyproterone- (28;29) , desogestrel- (30), drospirenone-(31) , norethindrone- (32), or levonorgestrel-(33) containing OC did not report increases in LDL, even in women with disorders associated with insulin resistance, such as polycystic ovary syndrome, history of gestational diabetes, or diabetes. One study reported an increase in mid-cycle LDL by 2.2% and 5.7% with ethinylestradiol 35mcg and norgestimate over 12 and 24 month (7).…”

Section: Discussionmentioning

confidence: 99%

Divergent effects of a combined hormonal oral contraceptive on insulin sensitivity in lean versus obese women

Cheang

Essah

Sharma

et al. 2011

Fertility and Sterility

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Objective To evaluate the effects of a commonly used combined hormonal oral contraceptive (OC) on carbohydrate metabolism in obese as compared with obese women. Design 6-month prospective study. Setting Clinical Research Center at an academic medical center. Patients Premenopausal non-diabetic women with BMI < 25 kg/m2 (n=15) or > 30 kg/m2 (n=14). Intervention Ethinyl estradiol 35mcg and norgestimate 0.18/0.215/0.25 mg for 6 cycles. Main Outcome Measures Insulin sensitivity (Si) by frequent sampling intravenous glucose tolerance test; other indices of insulin sensitivity (ISI HOMA, Matsuda index); fasting lipid panel. Results Si changed from 6.62±3.69 min−1/mu/L (baseline) to 8.23±3.30 min−1/mu/L (6 months) in lean women, and from 4.36±2.32 to 3.82±2.32 min−1/mu/L in obese women (p for interaction=0.0494). Divergent effects on insulin sensitivity were also observed with ISI HOMA (p=0.0128) and Matsuda index (p=0.0227). LDL increased by approximately 20 mg/dL in both groups (p<0.005 [lean]; p<0.01 [obese]). Conclusions Lean and obese women exhibit differential changes in insulin sensitivity when given 6 months of a commonly used OC. The mechanisms of these differences, and whether these divergent effects persist long-term, require further investigations. Capsule Lean and obese non-diabetic women exhibit differential changes in insulin sensitivity when given 6 months of a commonly used OC (ethinyl estradiol 35mcg and norgestimate 0.18/0.215/0.25 mg)

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Section: Discussionmentioning

confidence: 99%

Divergent effects of a combined hormonal oral contraceptive on insulin sensitivity in lean versus obese women

Cheang

Essah

Sharma

et al. 2011

Fertility and Sterility

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“…Three articles met the criteria for the evaluation of laboratory parameters in diabetic women while using an IUD [30–32]. The disposition of potential papers is given as a flow chart (Figure 1).…”

Section: Resultsmentioning

confidence: 99%

The Intrauterine Device in Women with Diabetes Mellitus Type I and II: A Systematic Review

Goldstuck

Steyn

2013

ISRN Obstetrics and Gynecology

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Background. Women with diabetes mellitus type I and type II need effective contraception for personal and medical reasons. Long acting reversible contraceptive (LARC) methods are among the most efficient and cost-effective methods. Study Design. We searched the Popline, PubMed, and clinicaltrials.gov databases from 1961 to March 2013 for studies on the efficacy of the IUD in diabetic women and the possible changes it may produce in laboratory parameters. Studies of at least 30 subjects with DM1 or DM2 who were studied for 6 to 12 months depending on the method of analysis were eligible. Results. The search produced seven articles which gave event rate efficacy evaluable results and three which evaluated the effect of the IUD on laboratory parameters. One of the earlier efficacy studies showed an abnormally high pregnancy rate which sparked a controversy which is discussed in the Introduction section. The remaining 6 studies produced acceptable pregnancy rates. The three laboratory studies showed that the copper and levonorgestrel releasing IUD/IUS do not affect the diabetic state in any way. Conclusions. The copper bearing and levonorgestrel releasing IUDs are safe and effective in women with diabetes type I and diabetes type II although the evidence in the latter is limited.

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“…Studies have also shown that COC and DMPA use among diabetic women affected lipid levels but did not impact risk for myocardial infarction [40][41][42]. Studies generally have not shown effects on other sequelae such as retinopathy or renal function in diabetic women using hormonal methods [43,44].…”

Section: Diabetesmentioning

confidence: 95%

“…Some studies have shown worsening of short-term markers of diabetes control, such as insulin requirements or blood glucose levels, in diabetic women using COCs [40,41]. Studies have also shown that COC and DMPA use among diabetic women affected lipid levels but did not impact risk for myocardial infarction [40][41][42].…”

Section: Diabetesmentioning

confidence: 96%

Putting risk into perspective: The US medical eligibility criteria for contraceptive use

Curtis

Tepper

Marchbanks

2011

Rev Endocr Metab Disord

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Unintended pregnancy remains a considerable problem in the United States, with health risks for both mother and infant. These risks may be increased among women with medical conditions, for whom pregnancy can lead to severe adverse outcomes. Highly effective and safe contraceptive methods are available to prevent unintended pregnancy. However, women with medical conditions and their providers also may be concerned about potential risks associated with contraceptive method use. Evidence-based guidance documents can be helpful tools for clinicians to efficiently use evidence and put risks into perspective. The US Medical Eligibility Criteria for Contraceptive Use, 2010, provides evidence-based recommendations for the safety of contraceptive use among women with medical conditions and other characteristics. While some contraceptive methods pose risks for some women, these must be considered in context and weighed against such considerations as the absolute risk of adverse events and the risks associated with pregnancy. Most women, even women with medical conditions, can safely use highly effective methods of contraception and promoting their use will further efforts to reduce unintended pregnancy.

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Contraception in perimenopausal women with diabetes mellitus

Abstract: Comparing lipid levels and hemostatic variables as a function of glycosylated hemoglobin level, we conclude that diabetes control has greater influence on these parameters than the type and dose of steroids involved in the contraceptive devices.

Cited by 32 publications

References 10 publications

Divergent effects of a combined hormonal oral contraceptive on insulin sensitivity in lean versus obese women

Divergent effects of a combined hormonal oral contraceptive on insulin sensitivity in lean versus obese women

The Intrauterine Device in Women with Diabetes Mellitus Type I and II: A Systematic Review

Putting risk into perspective: The US medical eligibility criteria for contraceptive use

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