title: Effect of a levonorgestrel intrauterine system on women with type 1 diabetes: a randomized trial.
abstract: OBJECTIVE
  Women with diabetes need safe, effective contraception. Although intrauterine devices provide superior contraception, concerns remain that progestin absorbed systemically from the levonorgestrel-releasing device may impair carbohydrate metabolism. To examine the effect of the levonorgestrel-releasing intrauterine system on glucose metabolism in diabetic women.
  
  
  METHODS
  We randomly assigned 62 women with uncomplicated insulin-dependent diabetes mellitus to either a levonorgestrel-releasing or a copper T 380A intrauterine device. The primary outcome to assess glucose metabolism was glycosylated hemoglobin; fasting serum-glucose levels and daily insulin dose requirements over 12 months of observation were examined as well.
  
  
  RESULTS
  Outcome data were available for 29 women using the levonorgestrel-releasing and 30 using the copper device. At 12 months, mean glycosylated levels were similar for women of the 2 groups (6.3%, standard deviation [SD] +/- 1.5 compared with 6.3%, SD +/- 1.3, respectively). The same was true for mean fasting-serum glucose levels (7.4 mM, SD +/- 4.2 compared with 7.5 mM, SD +/- 4.2) and daily insulin doses (35.1 units, SD +/- 12.8 compared with 36.4 units, SD +/- 9.0). No important differences were noted at either 6 weeks or 6 months.
  
  
  CONCLUSIONS
  The levonorgestrel-releasing device had no adverse effect on glucose metabolism, even at the 6-week observation when systemic levels of levonorgestrel would have been higher than at later observations. Concern about a potential adverse effect of this contraceptive on glucose control is unwarranted, and its use in women with diabetes should be liberalized.
  
  
  METHODS
  I.
authors.affiliation: Research Center of Obstetrics, Gynecology, and Perinatology, Russian Academy of Medical Science, Moscow, Russia. srogovskaya@freemail.ru
authors.forename: Svetlana
authors.initials: S
authors.lastname: Rogovskaya
authors.forename: Roberto
authors.initials: R
authors.lastname: Rivera
authors.forename: David A
authors.initials: DA
authors.lastname: Grimes
authors.forename: Pai-Lien
authors.initials: PL
authors.lastname: Chen
authors.forename: Bosny
authors.initials: B
authors.lastname: Pierre-Louis
authors.forename: Vera
authors.initials: V
authors.lastname: Prilepskaya
authors.forename: Vladimir
authors.initials: V
authors.lastname: Kulakov
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000187:drug effects*; D003922:Diabetes Mellitus, Type 1; D005260:Female; D006442:Glycated Hemoglobin / Q000187:drug effects; D006801:Humans; D007435:Intrauterine Devices, Copper; D007436:Intrauterine Devices, Medicated; D016912:Levonorgestrel / Q000494:pharmacology*; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D016912:Levonorgestrel