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Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A large biracial cross-section of 1038 healthy children aged 6-18 yr with 519 blacks, 519 whites, 678 males, and 360 females was evaluated for Tanner stage and serum levels of androstenedione, dehydroepiandrosterone-sulfate, estradiol, progesterone, and testosterone. The anthropometric values of the blacks and whites were very similar at each Tanner stage with only minor differences in age, height, and weight related to an earlier onset of puberty in blacks. The hormones dehydroepiandrosterone-sulfate, progesterone, and testosterone did not exhibit any racial differences. Estradiol showed a significantly higher level among black males compared to white males (P less than or equal to 0.05) whereas androstenedione was significantly higher in both white males (P = 0.0001) and females (P less than or equal to 0.01) compared with blacks. Many hormones are known to effect insulin resistance and others have reported a correlation between insulin levels and androstenedione. Blacks suffer disproportionately from diabetes. Since puberty is a time of dramatic changes in insulin resistance, racial (black-white) differences in steroid hormone changes were explored. This study shows that a racial difference in androstenedione levels exist during puberty, at a time when racial differences in insulin resistance are becoming manifest.
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PMID:Steroid hormones during puberty: racial (black-white) differences in androstenedione and estradiol--the Bogalusa Heart Study. 163 61

Of the contraceptive choices open to a post-partum woman with gestational diabetes, this discussion concentrates on low-dose oral contraceptives. Although gestational diabetes usually clears at delivery, 75% of these women will go on to developed impaired glucose tolerance or overt diabetes, especially if they are obese or if their glucose level had been high. Many elect permanent sterilization, but those requiring reversible contraception usually choose the IUD or the pill. IUDs carry a high risk of infection and are less effective in diabetics. The author compared a low-dose combined pill with 400 mcg norethindrone and 35 mcg ethinyl estradiol (Ovcon 35), and a pill containing levonorgestrel (Triphasil), to barrier contraception in 230 women with recent gestational diabetes. After 6-13 months of use 11-17% of each group had impaired glucose tolerance, and 15-20% of each group had diabetes (n.s.). Insulin levels rose from 28.5 mIU/mL to 59.7 in controls, 32.0 to 71.8 in Ovcon 35 users, and from 40.2 to 85.1 in Triphasil users (p0.05). HDL values rose significantly in the group taking Ovcon, and LDL values fell significantly in all 3 groups. These low-dose pills can be used safely in postpartum gestational diabetic women, as long as they do not smoke, are encouraged to lose weight, and have no sign of cardiovascular disease as evidenced by albuminuria and an ophthalmoscopic exam.
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PMID:Contraceptive options for the gestational diabetic woman. 167 21

Effective contraceptives contribute to the regulation of births, protect the health of women, reduce maternal and perinatal mortality and gynecological diseases, and prevent abortion-related complications. Complications after abortion average 30%, and among primigravidas the rate reaches 45%. Abortion can result in sterility and in the inability to carry out the pregnancy. Oral contraceptives (OCs) are used by 150 million globally. In new preparations ethinyl estradiol (EE) and levonorgestrel (LNG) are the most common components. In the 2-phase and 3-phase preparations Sequilar, Anteovin, and lipid profile safe Triquilar the gestagen component was reduced 40%. Continuin and Famulen are minipills, and Postinor is a postcoital contraceptive. Absolute contraindications of OCs include thromboembolytic diseases, severe cardiovascular system diseases, liver disorders, cirrhosis, cerebral vascular diseases, grave diabetes, jaundice, and malignant tumors of the mammae and sexual organs. Rigevidon, Triquilar, and Trisiston have high steroid content with minimal side effects. The protective effect of OCs are: 2-3 times lower risk of inflammation of the small pelvis, lower risk of malignant and benign ovarian tumors that lasts even after discontinuation, uterine cancer prevention (antiproliferation effect on the endometrium and inhibition of mitotic activity of the myometrium), and reduced risk of benign breast neoplasms. The finding that estrogen-induced risk of breast cancer increases with longterm contraceptive use in young nulliparas has not been persuasively proven. The optimal duration of uninterrupted OC use is 1-1.5 years. Monophasic estrogen-gestagen preparations include Bisecurin, Non-Ovlon, Ovidon, Rigevidon, Minisiston, and Demulen with low dosages of EE, LNG, norethisterone acetate, and diacetate ethonodiol. Norplant is a subdermal silastic capsule with effectiveness for up to 5 years.
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PMID:[Hormonal contraception]. 178 55

Researchers followed 68 women who attended the Family Welfare Clinic at the Kenyatta National Hospital in Nairobi, Kenya to determine if the low estrogen combined oral contraceptive (OC) Microgynon, a progestogen only OC, and Depo-Provera induce changes in the oral glucose test. These women did not take any steroidal contraceptives before entry into the study. Blood glucose levels were significantly higher after 60, 90 and 120 minutes than the control levels for women taking Microgynon. In addition, the mean areas under the glucose curves were substantially elevated after 1, 3, and 6 months above the control (p.002, .005, and .01 respectively). The only significant change in blood glucose levels in women taking the progestogen only OC occurred at 30 minutes after 6 months. Yet the mean areas under the curve were significantly higher than the control after ,1 2, and 3 months (p.005, .05 and .002 respectively). As for Depo-Provera, significantly lowered blood glucose levels only occurred after 1 month at 30, 50, and 90 minutes although no significant changes occurred after 1, 3, and 6 months in the mean areas under the glucose curves. Metabolic change occurred earlier and more often in Microgynon users than progestogen only OC users. This could be due to the progestogen levonorgestrel which has been shown to interrupt glucose metabolism. These changes could possible adversely effect women who are predisposed to developing diabetes, since 1 woman did develop a diabetic curve after 1 month of using Microgynon. Nevertheless no pattern towards abnormal glucose tolerance existed. Standard deviations of areas under the curves indicated that the number of women who develop glucose intolerance may increase with duration of use.
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PMID:The effect of low-oestrogen combined pill, progestogen-only pill and medroxyprogesterone acetate on oral glucose tolerance test. 214 46

A review of the pharmacology of oral contraceptives is presented with emphasis on selection and management for primary care physicians. The paper is introduced with illustrations and diagrams of the menstrual cycle. Orals are 97-99.9% effective in the 1st year of use, which puts them between injectables and IUDs in efficacy, although failure rates are about 4.7% in women 21 years or less. The estrogens and progestins in current pills are described, and their biological effects defined. The actual estrogenic or androgenic effects of combined pills on different organs is complex, but often useful. All pills marketed in the U.S. from 1960-1987 are tabulated with their composition. Triphasic pills are currently popular, primarily because of marketing: they probably do have fewer systemic effects due to lower overall steroid doses. The generic pills now available are Norethin, NII and Genora, with norethindrone and ethinyl estradiol in 1.35 or 1.50 dosages. Contraindications are listed. Specific pills must be started according to packaging, usually with back-up contraception for the 1st cycle. Women must be taught the serious adverse effects to watch for: a mnemonic "ACHES" is suggested. Mortal risks of cardiovascular disease primarily affect women over 35 who smoke. Risks for older nonsmokers are similar to those of pregnancy. Pills present no known cancer risks; may uncover existing susceptibility to to diabetes; and reduce risk of pelvic infection. Management of spotting and of other minor side effects is described. Noncontraceptive benefits of oral contraceptives prevent estimates 50,000 hospitalizations and 1210 deaths per year in the U.S.
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PMID:Oral contraceptives. 223 39

With oral contraceptives (OCs), estrogen and progestogen doses, as well as the type of progestogen used, seem to directly affect glucose tolerance and insulin resistance. Other factors that influence these parameters are a patient's weight and age, family history of diabetes, and previous gestational diabetes. In normal-weight women with previous gestational diabetes, low-dose OCs do not appear to directly affect glucose tolerance, plasma insulin levels, or insulin binding to monocytes. This paper reports the initial data from a study employing low-dose OC formulations in obese patients with a history of either Class A1 or A2 gestational diabetes. Although results are preliminary, they do suggest that Ovcon 35, a low-dose norethindrone-containing OC, may be safe in Class A1 diabetics; in Class A2 diabetics, Ovcon 35 is associated with significantly less change in oral glucose tolerance at 3 months than is the triphasic Triphasil.
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PMID:Effects of oral contraceptives on the borderline NIDD patient. 290 38

The metabolic effects of 4 oral contraceptives (OCs) with different estrogen/progestogen profiles (monophasic nonalkylated estrogen/norethindrone, low-dose monophasic ethinyl estradiol (EE2)/norethindrone, progestogen only treatment with norethindrone, and triphasic EE2/levonorgestrel) were examined in 27 insulin-dependent diabetic women who were assigned at random to 1 of the 4 regimens. The women ranged in age from 17-30 years, and their age range at onset of diabetes was 1-9 years. During treatment, diabetes control was performed by a trained diabetologist. All of the women lived in the Copenhagen (Denmark) city area and had comparable socioeconomic status. None had used hormonal contraceptives for at least the 6 weeks before entering the study. The OCs used were selected in part on the basis of their potency as determined by the pharmacologic profile and in part on the basis of the amount of hormone ingested during 1 treatment cycle. All treatment regimens were administered in 6-month periods. No significant differences in mean body weight were observed between the groups before treatment, and no significant changes were found within the groups during treatment. Before and during treatment, no differences in systolic and diastolic blood pressure were observed between the groups, and the OCs had no influence on the blood pressure in the individual groups. None of the participants experienced specific difficulties with their diabetes control during the hormonal intake. During the 6-month study period, no differences were found in fasting plasma glucose, 24-hour insulin requirements, glycated hemoglobin, free fatty acids, low-density lipoprotein cholesterol concentrations, or high-density lipoprotein cholesterol/total cholesterol ratio between the patients in each treatment group. Compared with the nonalkylated estrogen/norethindrone and the triphasic EE2/levonorgestrel formulations, the low-dose EE2/norethindrone combination resulted in small but significant increases in plasma triglyceride and very low-density lipoprotein cholesterol levels, which seemed unfavorable from a clinical point of view.
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PMID:Oral contraceptives in diabetic women: metabolic effects of four compounds with different estrogen/progestogen profiles. 378 Oct 3

Estradiol benzoate (EB) treatment of male and female C57BL/6J ob/ob mice for 32 days led to decreased body weight (20%), percentage body fat (8%) and carcass protein content (12%) when compared with non-EB-treated obese control mice. Estradiol reduced the caloric intakes of both genders by 25-35%, but did not affect body temperature regulation. Circulating glucose and insulin concentrations were also lowered by estrogens, although hyperinsulinemia persisted. Since post-treatment body weight changes correlated with daily food intakes (r = 0.81) rather than to rectal temperatures (r = -0.19), it appears that hypophagia provided a greater contribution to the estrogen-mediated reductions of growth and carcass fat than did altered energy expenditure for thermoregulation. While these data show that EB treatment does reduce the severity of some metabolic disturbances in a genetic model of type II diabetes, long-term estrogens do not appear to offer substantial advantages in the treatment of obesity or diabetes when compared with the effects of caloric restriction alone.
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PMID:Effects of estrogen on food intake, body weight, and temperature of male and female obese mice. 390 58

The article offers a general interpretation of the influence of oral contraceptive agents on glucose tolerance, emphasizing comparisons of synthetic sex hormones. Although there are conflicting reports on steroid-induced diabetes in normal women, their glucose curves are often higher when under oral contraceptive treatment, suggesting that oral contraceptives may induce a form of subclinical diabetes melitus that is reversible. Evidence from diabetic women suggests definite deliterious effects from contraceptive administration. Estradiol, estriol, and estrone may improve glucose tolerance in nondiabetic women and reduce insulin requirements in diabetics. Progesterone has little effect on carbohydrate tolerance, as did synthetic progestin. Conjugated equine estrogens (equilenine or Premarin) may provoke mild to moderate deterioration of carbohydrate tolerance. Parenterally administered natural estrogens and orally administered synthetic derivatives appear to differ sharply in their effects. Sex hormones' effects on carbohydrate metabolism likely involve interactions with insulin and endogenous glucocorticoids.
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PMID:Effects of oral contraceptive agents and sex steroids on carbohydrate metabolism. 456 89

2 young, menstruating females without any of the major risk factors (hypertension, diabetes mellitus, hyperlipidemia) developed acute myocaridal infarctions while taking oral contraceptives; their clinical histories and laboratory and arteriographic studies are presented. In the first patient (aged 29) who took Ortho-Novum 2 mg. for 11 months prior to infarction and who had an abnormal glucose tolerance test, selective coronary angiography revealed a segmental occlusion of the proximal left anterior descending coronary artery. In the second patient (aged 38) who took Enovid for several years prior to infarction, selective coronary angiography showed slight irregularity of the left anterior descending coronary artery; no evidence of akinesis or dyskinesis of the ventricular wall was noted. Although incidence of coronary artery disease in young, menstruating women has always been very low, recently there have been scattered case reports of women with acute myocardial infarction in absence of major risk factors; all cases shared the common features of oral contraceptive use prior to infarction, and unusual distribution and peculiar appearance of lesions in coronary arteries. Such reports, although rare, in young females taking synthetic estrogen do suggest that a relationship may exist between oral contraceptive agents and thromboembolic phenomena, especially coronary thrombosis. Mechanisms by which oral contraceptives might precipitate thrombosis are discussed. It is suggested that coronary artery disease should be suspected in young oral contraceptors suffering chest pain even though they are still menstruating and are free of major risk factors.
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PMID:Coronary thrombosis in young women on oral contraceptives: report of two cases and review of the literature. 470 63


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