Contraception in diabetic women: comparative metabolic study of Norplant, depot medroxyprogesterone acetate, low dose oral contraceptive pill and CuT380A.
OBJECTIVE
To evaluate the long-term intake of Norplant, depot medroxyprogesterone acetate (DMPA) and low dose oral contraceptive pill (OCs) on glycemic control, lipoprotein metabolism and coagulation profile in diabetic women.


METHODS
Prospective comparative study including 80 uncomplicated controlled diabetic women. Twenty women allocated to each group. Clinical, metabolic and coagulation status were followed up at 3, 6 and 9 months' visits.


RESULTS
Fasting blood sugar increased in OCs and DMPA users. Total cholesterol (TC) and LDL-cholesterol (LDL-C) decreased in all groups except DMPA where it increased. Triglyceride (TG) only increased in OCs group. HDL-cholesterol (HDL-C) increased with OCs and decreased with Norplant and DMPA. Compared to IUD users, significantly higher percentage TG and HDL-C and lower LDL-C were observed in OCs users, while DMPA users had significantly higher TC and LDL-C and lower HDL-C. Partial thromboplastin time was prolonged in Norplant users.


CONCLUSIONS
In diabetics, Norplant results in minimal metabolic alterations followed by OCs while DMPA has unfavorable outcome.
Diab
K M
KM
Department of Obstetrics and Gynaecology, Ain Shams University, Cairo, Egypt.
Zaki
M M
MM
D000328:Adult; D001777:Blood Coagulation / Q000187:drug effects; D001786:Blood Glucose / Q000187:drug effects; D001794:Blood Pressure / Q000187:drug effects; D002784:Cholesterol / Q000097:blood; D003271:Contraceptive Agents, Female / Q000494:pharmacology*; D003277:Contraceptives, Oral, Combined / Q000494:pharmacology*; D003280:Contraceptives, Oral, Synthetic / Q000494:pharmacology; D003922:Diabetes Mellitus, Type 1 / Q000097:blood*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood*; D004343:Drug Implants; D045166:Estradiol Congeners / Q000494:pharmacology; D004997:Ethinyl Estradiol / Q000494:pharmacology; D005260:Female; D006801:Humans; D007435:Intrauterine Devices, Copper; D016912:Levonorgestrel / Q000494:pharmacology*; D008074:Lipoproteins / Q000187:drug effects / Q000378:metabolism; D017258:Medroxyprogesterone Acetate / Q000494:pharmacology*; D009652:Norpregnenes / Q000494:pharmacology; D011446:Prospective Studies
D001786:Blood Glucose; D003271:Contraceptive Agents, Female; D003277:Contraceptives, Oral, Combined; D003280:Contraceptives, Oral, Synthetic; D004343:Drug Implants; D045166:Estradiol Congeners; D008074:Lipoproteins; D009652:Norpregnenes; C033273:Gestodene; D004997:Ethinyl Estradiol; D016912:Levonorgestrel; D002784:Cholesterol; D017258:Medroxyprogesterone Acetate