Petersen K R, Skouby S O, Vedel P, Haaber A B
Diabetes Center, Rigshospitalet, University of Copenhagen, Denmark.
Diabetes Care. 1995 Jun;18(6):800-6. doi: 10.2337/diacare.18.6.800.
Safe and effective contraceptive methods are essential for women with insulin-dependent diabetes mellitus (IDDM), but opinions on the use of hormonal oral contraceptives by these women are conflicting. We evaluated the effects on glycometabolic control and lipoprotein metabolism in women with IDDM treated with an oral contraceptive not previously studied in a diabetic population.
A total of 22 women with IDDM received a monophasic combination of ethinyl estradiol and gestodene for 1 year; 20 women of comparable diabetic status using nonhormonal contraception were selected as control subjects. Evaluation was performed before and after 1, 3, 6, and 12 months of hormonal intake using nonparametric statistical methods.
Except for a higher median age of the control group, the baseline values for all clinical and metabolic variables were similar in the two groups, and in neither of the groups were changes in blood pressure, body mass index, or glycemic control observed. In the oral contraceptive group, decreased serum levels of low-density lipoprotein (LDL) cholesterol and increased levels of triglycerides and lipoprotein A were noted, whereas total cholesterol and high-density lipoprotein cholesterol levels were unchanged. In the control group, a decrease of LDL cholesterol was observed. No effect of tobacco smoking on glycometabolic control or lipoprotein metabolism could be demonstrated during hormonal intake.
No evidence of impaired glycometabolic control or adverse changes in serum levels of lipoproteins known to be associated with atherosclerosis was observed in women with well-controlled IDDM during 1 year of oral contraception with ethinyl estradiol and gestodene.
安全有效的避孕方法对胰岛素依赖型糖尿病（IDDM）女性至关重要，但对于这些女性使用激素口服避孕药的观点存在分歧。我们评估了一种此前未在糖尿病患者群体中研究过的口服避孕药对IDDM女性糖代谢控制和脂蛋白代谢的影响。
共有22名IDDM女性接受了炔雌醇和孕二烯酮的单相联合用药1年；选择20名糖尿病病情相当且使用非激素避孕方法的女性作为对照。在激素摄入1、3、6和12个月前后，采用非参数统计方法进行评估。
除对照组中位年龄较高外，两组所有临床和代谢变量的基线值相似，两组均未观察到血压、体重指数或血糖控制的变化。口服避孕药组中，低密度脂蛋白（LDL）胆固醇血清水平降低，甘油三酯和脂蛋白A水平升高，而总胆固醇和高密度脂蛋白胆固醇水平未变。对照组中，观察到LDL胆固醇降低。在激素摄入期间，未发现吸烟对糖代谢控制或脂蛋白代谢有影响。
在使用炔雌醇和孕二烯酮进行1年口服避孕期间，未观察到血糖控制良好的IDDM女性有糖代谢控制受损或已知与动脉粥样硬化相关的血清脂蛋白水平出现不良变化的证据。
