Effects of ethinyl estradiol combined with desogestrel and cyproterone acetate on glucose tolerance and insulin response to an oral glucose load: a one-year randomized, prospective, comparative trial.
To investigate the effects of two slightly estrogen-dominant, monophasic, low-dose oral contraceptives on carbohydrate metabolism, 40 healthy young women were randomly allocated to receive either 30 micrograms of ethinyl estradiol + 150 micrograms of desogestrel, a 19-nortestosterone-derived progestin (Marvelon; n = 21) or 35 micrograms of ethinyl estradiol + 2 mg of cyproterone acetate, a 17-acetoxyprogesterone derivative (Diane-35; n = (19) for a prospective observation period of 1 year. At baseline, 6, and 12 months, blood glucose, plasma insulin, and plasma C-peptide levels were measured during an oral glucose tolerance test. Although the changes were absent (Marvelon) or minimal (Diane-35) at 6 months, both groups had a slight increase in blood glucose levels at 12 months; overall glucose tolerance remaining, however, within the normal range. Plasma insulin levels remained unchanged in the Diane-35-group, which suggested increased insulin resistance, but were significantly decreased in the Marvelon group despite significant rises in plasma C-peptide levels. Comparison of plasma C-peptide and insulin changes suggests enhanced pancreatic insulin secretion and increased hepatic insulin metabolism with both Marvelon and Diane-35.
Jandrain
B J
BJ
Division of Diabetes, CHU Sart Tilman, Liège, Belgium.
Humblet
D M
DM
Jaminet
C B
CB
Scheen
A J
AJ
Gaspard
U J
UJ
Lefebvre
P J
PJ
D000328:Adult; D001786:Blood Glucose / Q000378:metabolism*; D002096:C-Peptide / Q000097:blood; D003277:Contraceptives, Oral, Combined / Q000494:pharmacology*; D003534:Cyproterone / Q000031:analogs & derivatives* / Q000494:pharmacology; D017373:Cyproterone Acetate; D017135:Desogestrel; D004997:Ethinyl Estradiol / Q000494:pharmacology*; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D007328:Insulin / Q000097:blood*; D009652:Norpregnenes / Q000494:pharmacology*; D045167:Progesterone Congeners / Q000494:pharmacology*; D011446:Prospective Studies; D011897:Random Allocation; D012016:Reference Values
D001786:Blood Glucose; D002096:C-Peptide; D003277:Contraceptives, Oral, Combined; D007328:Insulin; D009652:Norpregnenes; D045167:Progesterone Congeners; D004997:Ethinyl Estradiol; D017373:Cyproterone Acetate; D017135:Desogestrel; D003534:Cyproterone