Contraception in diabetic women: comparative metabolic study of Norplant, depot medroxyprogesterone acetate, low dose oral contraceptive pill and CuT380A

Abstract

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.

Conclusion: In diabetics, Norplant results in minimal metabolic alterations followed by OCs while DMPA has unfavorable outcome.