Effects of a 1-year treatment with a low-dose combined oral contraceptive containing ethinyl estradiol and cyproterone acetate on glucose and insulin metabolism.
OBJECTIVE
To study the effects of the slightly estrogen-dominant monophasic low-dose oral contraceptive (OC) Diane-35 (Schering AG, Berlin, Germany) (35 micrograms ethinyl estradiol [EE2] + 2 mg cyproterone acetate, a 17 alpha-hydroxyprogesterone derivative [17-OHP]) on glucose and insulin metabolism.


METHODS
Seven healthy young women were investigated by using the euglycemic hyperinsulinemic glucose clamp technique (insulin delivery rate = 100 mU/kg per hour for 120 minutes). This test was performed, after an overnight fast, during the last 7 days of a spontaneous cycle and within the last 5 days of pill intake during the sixth and twelfth cycle of a continuous treatment with Diane-35 in each subject.


RESULTS
The three indexes measuring the insulin-induced glucose disposal during the clamp (glucose infusion rate, glucose metabolic clearance rate, and glucose infusion rate divided by plasma insulin plateau levels) were not significantly affected by Diane-35. In contrast, the metabolic clearance rate of the exogenous insulin infused during the clamp tended to be slightly increased with Diane-35 (significant after 6 but not after 12 cycles).


CONCLUSIONS
These results suggest that a 1-year treatment with the OC Diane-35, which contains EE2 + a 17-OHP rather than a 19-nortestosterone derivative as the progestogen compound, does not significantly alter peripheral (presumably muscular) insulin sensitivity but slightly increases insulin (presumably hepatic) clearance.
Scheen
A J
AJ
Centre Hospitalier Universitaire (CHU) de Liège, Belgium.
Jandrain
B J
BJ
Humblet
D M
DM
Jaminet
C B
CB
Gaspard
U J
UJ
Lefèbvre
P J
PJ
D000328:Adult; D002096:C-Peptide / Q000032:analysis; D003277:Contraceptives, Oral, Combined / Q000494:pharmacology*; D017373:Cyproterone Acetate / Q000494:pharmacology*; D004338:Drug Combinations; D004997:Ethinyl Estradiol / Q000494:pharmacology*; D005260:Female; D005947:Glucose / Q000378:metabolism*; D005951:Glucose Tolerance Test; D006801:Humans; D007328:Insulin / Q000378:metabolism* / Q000494:pharmacology; D008657:Metabolic Clearance Rate
D002096:C-Peptide; D003277:Contraceptives, Oral, Combined; D004338:Drug Combinations; D007328:Insulin; D004997:Ethinyl Estradiol; D017373:Cyproterone Acetate; C032640:Cyproterone acetate, ethinyl estradiol drug combination; D005947:Glucose