NEW YORK (Reuters Health) – Neither injectable nor oral contraceptives have a meaningful effect on glucose or insulin levels, researchers report in the January 2011 Obstetrics & Gynecology.

“The current data supports that these methods do not place women at significant risk of developing new onset diabetes mellitus,” Dr. Abbey B. Berenson from The University of Texas Medical Branch, Galveston, Texas told Reuters Health in an email.

“Decreases in bone density and weight gain, however, still remain concerns with DMPA (depot medroxyprogesterone acetate) use.”

Dr. Berenson and colleagues estimated the effects of injectable (DMPA) DMPA and an oral contraceptive (OCP) containing 20 mcg ethinyl estradiol and 0.15 mg desogestrel over 3 years on fasting insulin and glucose levels in 703 women (245 using OCP, 240 using DMPA, and 218 using a nonhormonal method).

Over the course of the study, fasting glucose levels increased by less than 1 mg/dL in the nonhormonal and OCP users but increased by 2.36 mg/dL in the DMPA users (P<0.001 for both comparisons). Similarly, fasting insulin levels increased by less than 1 international unit/mL in the nonhormonal group, just under 2 units/mL in the OCP group, and 3.47 units/mL in the DMPA group (P<0.001 nonhormonal versus DMPA; P=0.012 OCP versus DMPA). However, only 2 DMPA users who had normal baseline insulin experienced elevations that persisted throughout the study. “Although we did observe an increase,” the researchers note, “both glucose and insulin levels remained within a normal range for all DMPA users who exhibited normal levels at baseline. Furthermore, the magnitude of increase in fasting glucose levels we observed is actually less than that reported in some previous studies.” Most of the increases in glucose and insulin in the DMPA group took place during the first 6 months of treatment. DPMA users showed significantly greater increases than nonhormonal users in glucose and insulin levels with each increase in body mass index category. Asked whether these findings resolve concerns about the possible effects of injectable contraceptives on glucose and insulin metabolism, Dr. Berenson said, “Yes, I think that they show that any effects of DMPA on glucose and insulin metabolism are minimal, at least among women with a normal BMI. Additional research is needed on overweight and obese women, although the effects we observed in this population were not concerning.” “We plan to apply for funding to study whether these elevations resulted in diabetes mellitus by examining hemoglobin A1C levels among these women,” Dr. Berenson added. Reference:
Effect of Injectable and Oral Contraceptives on Glucose and Insulin Levels


Obstet Gynecol 2011;117:41-47.