Effects of combined oral contraceptive ethinylestradiol (30 microg) and dienogest (2 mg) on carbohydrate metabolism during 1 year of conventional or extended-cycle use.
The effects of extended regimens of combined oral contraceptives (COCs) on carbohydrate metabolism are largely unknown. The present study compared the effects of a COC containing 30 microg ethinylestradiol and 2 mg dienogest (EE/DNG) in conventional and extended-cycle regimen over 1 year. Parameters of carbohydrate metabolism were measured in 59 women treated with EE/DNG either conventionally (13 cycles of 21+7 days) or in extended-cycle regimen (4 cycles of 84+7 days). Blood samples were taken in a control cycle, and at 3 and 12 months of treatment. The mean levels of HbA1c and fasting glucose levels remained stable in both conventional and extended-regimen of EE/DNG. The mean levels of fasting insulin and C-peptide underwent comparable increases in both regimens, suggesting a similar readjustment of glucose metabolism via slightly increased insulin secretion. For both regimens, the response to the oral glucose tolerance test (OGTT) showed a slightly impaired glucose tolerance and insulin resistance at 3 months. These changes improved or returned to baseline at 12 months. Accordingly, the mean index for insulin resistance (homeostasis model assessment of insulin resistance, HOMA-IR) increased and the mean insulin sensitivity index [ISI (composite)] decreased modestly in both groups. The present study demonstrates that there are no statistically significant differences between the effects of conventional and extended-cycle treatment on carbohydrate metabolism over 1 year of treatment. In general, the effects of both regimens were moderate and mostly transient.
Wiegratz
I
I
Center of Obstetrics and Gynecology, University Hospital of Frankfurt, Frankfurt am Main, Germany. inkawiegratz@hotmail.com
Stahlberg
S
S
Manthey
T
T
Sänger
N
N
Mittmann
K
K
Palombo-Kinne
E
E
Mellinger
U
U
Lange
E
E
Kuhl
H
H
D000293:Adolescent; D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D002096:C-Peptide / Q000097:blood; D050260:Carbohydrate Metabolism / Q000187:drug effects*; D003278:Contraceptives, Oral, Hormonal / Q000009:adverse effects*; D004997:Ethinyl Estradiol / Q000009:adverse effects*; D005260:Female; D005951:Glucose Tolerance Test; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance / Q000502:physiology; D008598:Menstruation / Q000187:drug effects; D009277:Nandrolone / Q000009:adverse effects / Q000031:analogs & derivatives*; D011446:Prospective Studies; D055815:Young Adult
D001786:Blood Glucose; D002096:C-Peptide; D003278:Contraceptives, Oral, Hormonal; D004997:Ethinyl Estradiol; D006442:Glycated Hemoglobin; D007328:Insulin; D009277:Nandrolone; C023635:dienogest