Search

Prospective studies of carbohydrate metabolism were performed by means of an oral glucose tolerance test in 29 women. The studies were performed before and after 3 months of treatment with an oral contraceptive that contained 0.035 mg of ethinyl estradiol and 0.4 mg of norethindrone. The 24 women with a "normal" control test had no significant alteration in any of their blood glucose and plasma insulin values, except that the fasting glucose level decreased with treatment. Three of these women (12.5%) had a slight deterioration of their glucose curves into a "borderline abnormal" grouping during treatment. There were five women with "borderline abnormal"control glucose curves, and in four of these (80%) the curves returned to "normal" during treatment, whereas one curve stayed "borderline abnormal." These data suggest that this low-estrogen oral contraceptive has minimal short-term adverse effects on the carbohydrate metabolism.

Twenty-four women were prospectively evaluated for their carbohydrate metabolic status before and after six months of using an oral contraceptive containing 0.035 mg ethinyl estradiol and 0.4 mg of norethindrone. At each testing, a 100-gm oral glucose load was administered and blood glucose and plasma insulin values were measured over a three-hour period. Nineteen women with "normal" control tests demonstrated a significant decrease in their fasting glucose values and two of these women (10.5%) had a slight deterioration of their glucose curves. There were no other significant glucose or insulin changes. They had no change in weight and there was a significant reduction in their blood pressure during the treatment time. Five women had "borderline abnormal" control glucose tests, and four of these (80%) improved during the six months of treatment, and two of them (40%) became "normal." Thus, there is no evidence of an adverse effect of this low-estrogen oral contraceptive on carbohydrate metabolism during six months of therapy.

The lymphocyte HLA types were determined for 13 women, who were then separated into a subgroup of those having a "high" risk for insulin-dependent diabetes mellitus (B8, B15, AW30) and a "low-risk" subgroup (B7, BW35). A 3-hour oral glucose tolerance test was conducted on each woman before starting on oral contraceptives (OC) and then 6 months after using them. Both blood glucose and plasma insulin levels were measured. The OC contained 0.035 mg of ethinylestradiol and 0.4 mg of norethindrone. There was a significantly higher 0.5-hour glucose value in the control test in the "high risk" group. There was a significant elevation of the 1-hour plasma insulin value in the 6-month test for the "high-risk" group. The usefulness of the HLA prescreening of women prior to use of OC needs more study.

A prospective study of carbohydrate metabolism was done with 56 "normal" women who were 4 to 11 weeks post partum. Each had a 3 hour oral glucose tolerance test performed before and after 6 months of using an intrauterine contraceptive device (IUCD). The results showed only slight changes in blood glucose and plasma insulin levels between the two tests. There were elevations of the fasting and 0.5 hour glucose values and the 2 hour plasma insulin value at the 6 month test. These data provide a further understanding of the changing metabolic parameters associated with pregnancy and they also give the "control" baseline information for comparison with other postpartum studies on the metabolic effects of contraceptive steriods.

Forty-four women were prospectively evaluated with a 3-hour oral glucose tolerance test while they used a new weekly oral contraceptive drug, R2323. The blood tests were carried out before the drug was administered and again 3 months after its use. Both blood glucose and plasma insulin levels were measured. In the 40 women with a "normal" control glucose tolerance test, it was found that only the 1-hour blood glucose value was significantly elevated after 3 months of drug use and the plasma insulin values were unchanged. The tests of three of the four women with borderline abnormal to abnormal control test curves converted to normal with 3 months of treatment and that of one remained unchanged. The fasting plasma cholesterol and triglyceride levels were unchanged over the 3 months' time. These results suggest that this steroid contraceptive has no effect on lipid metabolism. It also has minimal adverse effects on normal carbohydrate metabolism and may possibly improve abnormal metabolism.

A prospective study of carbohydrate metabolism was carried out on seven women by using an oral glucose tolerance stimulation test and measuring blood glucose and plasma insulin values over a 3-hour time period. The test was performed before and after 6 months of treatment with a "low-estrogen" oral contraceptive containing 0.4 mg of norethindrone and 35 micrograms of ethinylestradiol. There was no change in the weight or diastolic blood pressure of the women, but there was a slight elevation of the systolic blood pressure with treatment. There was no significant change in the plasma insulin values or in four of five blood glucose values. The 1-hour blood glucose value was significantly lower after 6 months of treatment. These results suggest that the "low-estrogen" oral contraceptives may reduce the secondary effects on carbohydrate metabolism seen with regular oral contraceptives.

Twenty-nine menstrual age women who had a hysterectomy and oophorectomy were treated cyclically with 80 micrograms of mestranol per day for 2 yr. Their carbohydrate metabolism was evaluated prospectively by doing a 3 hr oral glucose tolerance test after a 100 g glucose load and measuring both blood glucose and plasma insulin levels. The tests were performed before drug treatment and after 2 yr of drug use. Those women that had a "normal" predrug test had some carbohydrate metabolism changes at the 2 yr test with significant elevations of the fasting, 1 and 2 hr blood glucose values, and also significant elevations of the 2 and 3 hr plasma insulin values. Those women with a "borderline abnormal" predrug test had no significant change in either parameter of carbohydrate metabolism however a trend toward similar changes was noted.

A prospective study of lipid and carbohydrate metabolic parameters was made in 22 women who had taken a daily oral dose of 0.5 mg of megestrol acetate for contraception for 1 year. Studies of the fasting blood cholesterol and triglyceride levels demonstrated no significant change. A 3-hour oral glucose tolerance test was performed before and after 1 year of treatment. After therapy, the fasting blood glucose levels were normal but the 0.5- and 2-hour levels were elevated. All but one of the plasma insulin levels were elevated at the 1-year test. Since body weights and the fasting levels of plasma growth hormone were unchanged, they were probably not involved in the carbohydrate alteration. These results point out the need for long-term studies and the necessity for investigating the metabolic effects of all progestogen contraceptives.

Studies of carbohydrate metabolism were conducted before and after 18 months of daily use of a 0.075-mg norgestrel preparation by 50 "normal" women. Each study involved a 3-hour oral glucose tolerance test. There was a significant increase in the weights of the women over the time of study. In addition, all of the plasma insulin values and all of the blood glucose values were significantly elevated at the 18-month test. All of the control glucose tolerance tests were normal initially, but eight (16%) of the glucose curves were abnormal at the 18-month test. These data suggest a systemic metabolic effect of norgestrel which may play a role in accelerating atherogenesis.

A prospective study of the effects of a conjugated estrogen (Premarin, 1.25 mg.) was performed in 36 women over a 1 year period. Each subject received a 3 hour oral glucose tolerance test before starting the medication and another after 1 year of use. The blood glucose levels were similar at five times during the two tests except for a significant elevation of the 1 hour value at the 1 year test. There were no changes in the plasma insulin, growth hormone, or fasting triglyceride levels. These results suggest that the cyclic administration of this estrogen does not alter lipid or carbohydrate metabolism.

Carbohydrate and lipid metabolism were studied with the use of a three-hour oral glucose tolerance test in 71 women before and after one year of daily oral norgestrel, 0.075 mg., treatment. There was no significant change in weight or fasting plasma triglyceride and cholesterol levels. There was a significant elevation of both the blood glucose and plasma insulin levels after one year of treatment. This was true for both the fasting and the glucose-stimulated values. Whereas all of the individual glucose tolerance curves at the pretreatment control test were normal by selection, 15.5 per cent of the curves were borderline abnormal to abnormal at the one-year test. The significance of these metabolic alterations is discussed.