Effect of low-dose oral contraceptives on carbohydrate and lipid metabolism in women with recent gestational diabetes: results of a controlled, randomized, prospective study.
Women with recent gestational diabetes mellitus were randomly assigned to one of two low-dose oral contraceptives to evaluate the effect of low-dose oral contraceptives on carbohydrate and lipid metabolism. A cohort of similar women requesting a non-oral-contraceptive method served as controls. The two oral contraceptives studied were ethinyl estradiol (0.035 mg)-norethindrone (0.40 mg) and ethinyl estradiol (0.030 to 0.040 mg)-levonorgestrel (0.050 to 0.125 mg). A 75 gm, 2-hour oral glucose tolerance test and a fasting lipid profile (total cholesterol, triglyceride, high- and low-density lipoprotein cholesterols) were performed at entry, after 3 months, and after 6 to 13 months of treatment. The prevalence of diabetes at 6 to 13 months (27/156 patients) was not significantly different between groups (non-oral-contraceptive group, 17%; ethinyl estradiol-norethindrone, 15%; ethinyl estradiol-levonorgestrel, 20%). When examined by prior gestational diabetes mellitus class, diabetes mellitus was present in 7% of prior class A1 and 29% of women with prior class A2 disease (p less than 0.001). Mean cholesterol and low-density lipoprotein cholesterol levels were significantly improved in all three groups at 3 months and at 6 to 13 months, whereas triglycerides remained unchanged. There were no differences in cholesterol, low-density lipoprotein cholesterol, or triglycerides levels between the groups. After 6 to 13 months, there was a significant increase in high-density lipoprotein cholesterol in the ethinyl estradiol-norethindrone group compared with the ethinyl estradiol-levonorgestrel and non-oral-contraceptive groups.
Kjos
S L
SL
Department of Obstetrics and Gynecology, University of Southern California Medical School, Los Angeles.
Shoupe
D
D
Douyan
S
S
Friedman
R L
RL
Bernstein
G S
GS
Mestman
J H
JH
Mishell
D R
DR
D000328:Adult; D050260:Carbohydrate Metabolism; D015331:Cohort Studies; D003276:Contraceptives, Oral / Q000008:administration & dosage / Q000009:adverse effects*; D004997:Ethinyl Estradiol / Q000008:administration & dosage / Q000009:adverse effects; D019304:Ethinyl Estradiol-Norgestrel Combination; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D050356:Lipid Metabolism; D009640:Norethindrone / Q000008:administration & dosage / Q000009:adverse effects; D009644:Norgestrel / Q000008:administration & dosage / Q000009:adverse effects; D049590:Postpartum Period / Q000187:drug effects / Q000378:metabolism; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000378:metabolism*; D011446:Prospective Studies
D003276:Contraceptives, Oral; D009644:Norgestrel; D004997:Ethinyl Estradiol; D019304:Ethinyl Estradiol-Norgestrel Combination; D009640:Norethindrone