Konje J C, Otolorin E O, Ladipo O A
Department of Obstetrics and Gynaecology, University College Hospital, Ibadan, Nigeria.
Am J Obstet Gynecol. 1992 Jan;166(1 Pt 1):15-9. doi: 10.1016/0002-9378(92)91819-v.
Blood glucose and plasma insulin levels during an oral glucose tolerance test were measured in 20 women using continuous subdermal levonorgestrel (Norplant) for contraception over a 12-month period. Changes in carbohydrate metabolism occurred as early as 1 month but were most marked after 6 months. After 1 month the area under the glucose and insulin curves increased by 12.3% and 37.7%, respectively. This increase was more marked by 6 months, but by 12 months it was significantly less marked. Although changes in the blood glucose and plasma insulin levels at different times during the oral glucose tolerance test occurred, they were all within normal limits for normal women. The peak blood glucose and insulin levels after insertion of the implant occurred 60 minutes after the glucose load, as opposed to 30 minutes before insertion. Apart from this, there was a significant delay in the return of these levels to fasting values. We conclude that this product, like any other progesterone-containing contraceptive, alters carbohydrate metabolism, but these alterations are not clinically significant in normal women. It is, however, possible that in potential cases of diabetes it may predispose to frank diabetes.
对20名使用皮下埋植左炔诺孕酮（Norplant）避孕12个月的女性，在口服葡萄糖耐量试验期间测量了血糖和血浆胰岛素水平。碳水化合物代谢的变化早在1个月时就已出现，但在6个月时最为明显。1个月后，葡萄糖曲线下面积和胰岛素曲线下面积分别增加了12.3%和37.7%。这种增加在6个月时更为显著，但到12个月时则明显减弱。虽然在口服葡萄糖耐量试验期间不同时间点血糖和血浆胰岛素水平出现了变化，但这些变化均在正常女性的正常范围内。植入后血糖和胰岛素水平的峰值出现在葡萄糖负荷后60分钟，而植入前为30分钟。除此之外，这些水平恢复到空腹值的时间明显延迟。我们得出结论，该产品与任何其他含孕酮的避孕药一样，会改变碳水化合物代谢，但这些改变在正常女性中无临床意义。然而，在潜在糖尿病患者中，它可能会诱发显性糖尿病。
