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

The use of oral contraceptive appears to be associated with alterations in glucose tolerance and slight increases of plasma free fatty acids and triglycerides. In this study, the glucose disappearance constant and the plasma levels of nonesterified fatty acids were studied in 63 women, carefully selected with respect to age (20-30 years), parity (less than 4), normal body weight for height and age, absence of obstetric or family precedents suggesting diabetes mellitus, and absence of other pathological conditions. The oral contraceptive (Norlestrin, Parke Davis) was administered during 1 year, starting between the 7th and 9th week of puerperium. Clinical and laboratory tests were performed before the administration of the drug, and after 3, 6, and 12 months. The number of patients was reduced to 36 at the 1st control, 30 at the 2nd, and 24 at the 3rd. A progressive deterioration of the glucose disappearance constant was observed, with significant differences (p less than .001) between the values before and 12 months after treatment. Diabetic-level values were absent. The plasma nonesterified fatty acids showed a progressive and significant increase, interrupted only during the glucose tolerance tests. There was an average increase in body weight of 4 kg at the 1st control, followed by normalization at the 12th month of treatment. The study discusses the possible causes of such alterations, emphasizing the role of many functi ons that maintain metabolic homeostasis.
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PMID:[Study of various metabolic effects of a contraceptive used for a prolonged period]. 508 48

For some time it has been recognized that postovulatory exacerbation of hyperglycemia contributes to the instability of diabetes in many women of reproductive age. It has been suggested that increasing plasma levels of progesterone and estrogen may induce insulin resistance and consequently lead to increased hyperglycemia during the luteal phase of the menstrual cycle. Due to the fact that menstrual cycles in a given woman may vary in length and that it takes patients several days on intermediate or long-acting insulin to achieve a steady state with regard to any dosage adjustment, it is difficult to design an insulin regimen that maintains euglycemia throughout the menstrual cycle in these labile patients. Recognition of this problem led to trying a nonsequential low estrogen contraceptive as adjunctive therapy in a 20-year old woman with insulin dependent diabetes mellitus. The patient consistently suffered an exacerbation of hyperglycemia after ovulation in each cycle, lasting until the onset of menses. On 1 occasion the patient developed frank diabetic ketoacidosis. For the first 2 cycles on Lo Ovral, the hyperglycemia was postponed from the 1st postovulatory day until day 18-19 of the cycle. It was reasoned that the serum estrogen and/or progestin level might be building cumulatively, and the oral contraceptives (OCs) were subsequently withdrawn at day 19 of the cycle rather than day 21. A maximum blood glucose level of 400 mg/dl was attained at day 19 and was treated with additional regular insulin. Levels in excess of 240 mg/dl did not recur during that cycle. The following cycle OC therapy was interrupted at day 18; no blood glucose level in excess of 240 mg/dl occurred that month. Hemoglobin A1c fell from a pre-OC treatment value of 12.4% to the current A1c of 9.7%. A modest increase in blood pressure has occurred, but this is easily managed with a 2 g sodium diet and 25 mg of hydrochlorothiazide daily. On the basis of this experience, a controlled trial is warranted of low dose estrogen nonsequential OCs in lean, nonsmoking, 18-30 year old women with insulin dependent diabetes mellitus with postovulatory hyperglycemia.
Diabetes Care
PMID:Oral contraceptives abolish luteal phase exacerbation of hyperglycemia in type I diabetes. 676 14

Eleven cases of bacteremia in diabetic patients with infected lower extremities at Rancho Los Amigos Hospital (RLAH) were observed over a 34-mo period. The yearly incidence was 0.6% of admissions to the Ortho-Diabetes service. Aerobic bacteria were recovered in six cases and anaerobic bacteria in five. Bacteroides fragilis was isolated four times, Staphylococcus aureus three times, and nonfragilis Bacteroides sp., Escherichia coli, group B streptococcus, and viridans streptococcus were each seen once. Ten of the 11 patients were febrile at the time of bacteremia. Clinical, laboratory, radiologic, and ultrasonographic parameters were comparable in patients with aerobic and anaerobic bacteremia, and between bacteremic patients and nonbacteremic controls. Fever, however, was significantly more frequent in bacteremic patients. Foul-smelling lesions were seen in two of the five patients with anaerobic bacteremia, and in none of the patients with aerobic bacteremia. Postoperative B. fragilis bacteremia was observed to be transient and resolved without definitive therapy in one patient. Appropriate antibiotic therapy in 10 patients together with surgical intervention in eight cases resulted in resolution of the infection in the remaining patients.
Diabetes Care
PMID:Bacteremia in diabetic patients with infected lower extremities. 692 18

The present study investigated the impact of high estrogen doses on melatonin blood concentrations in healthy young girls. Melatonin secretion was investigated in 7 girls (chronological age 13.2 +/- 0.2 years; bone age 12.8 +/- 0.2 years) before and during treatment with ethinylestradiol (EE2, daily dose 0.5 mg/d orally) aimed at the reduction of final prospective height in familial tall stature. Melatonin, LH, FSH, E2 and EE2 were measured by radioimmunoassay. In all subjects, LH and FSH were completely suppressed, but melatonin secretion, day/night plasma values as well as the area under the curve (AUC) remained unchanged under pharmacological administration of ethinylestradiol. We therefore conclude that melatonin secretion is not affected by pharmacological doses of the synthetic estrogen derivative ethinylestradiol in healthy young girls. The decrease of melatonin blood concentrations during puberty is not caused by increasing concentrations of estrogens but must be due to some other process.
Exp Clin Endocrinol Diabetes 1995
PMID:No effect of ethinylestradiol treatment on melatonin secretion in healthy pubertal girls. 762 Nov 5

The first 24-cycle study of the metabolic effects of triphasic oral contraceptives (OCs) recorded significant changes in lipid values, yet none of these values moved outside the normal range. Included in the study were 69 non-smoking Canadian women 19-29 years of age with no history of obesity, diabetes, or alcohol misuse. Subjects were randomly assigned to receive either an ethinyl estradiol-norethindrone formulation (Ortho 7/7/7) or an ethinyl estradiol-levonorgestrel preparation (Triphasic). 25 controls underwent periodic blood samplings for lipid and lipoprotein levels. The only significant change recorded among controls was a 42% increase in the plasma apo B level resulting from changes in the low density lipoprotein (LDL) apo B subfraction. In the Ortho 7/7/7 and Triphasic groups, both plasma and LDL triglycerides were increased above baseline and above values for controls at the 24-month point. In Ortho 7/7/7 acceptors, LDL cholesterol increased by 28%, high density lipoprotein (HDL) decreased by 11%, and plasma cholesterol increased by 14%; other cholesterol levels decreased significantly. In the Triphasic group, HDL decreased by 8%, but no other significant changes occurred. Apo A1 increased by 15% in the Ortho 7/7/7 group, but not among Triphasic users; all apo B values increased significantly in both treatment groups. Although these changes in lipid profiles among triphasic OC users do not seem to increase the risk of cardiovascular disease, there is potential for adverse health effects when other cardiovascular risk factors, especially smoking, are present.
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PMID:A two-year clinical study of the effects of two triphasic oral contraceptives on plasma lipids. 782 Jan 62

We performed oral glucose tolerance tests and frequently sampled iv glucose tolerance tests in a cross-sectional sample of women taking monophasic norgestrel containing oral contraceptives (OC). The goal of the study was to quantify the individual factors that determine glucose tolerance to assess responsibility for the reduced glucose tolerance associated with the use of OCs. Subjects were selected using stringent criteria to exclude confounding effects of ethnicity, adiposity, or conditions that may predispose subjects to metabolic disorders. Users of the low dose OC (Lo/Ovral and Nordette) and high dose OC (Ovral) were compared to controls, who were required to never have used OCs or to have discontinued OC use for at least 24 months. Oral glucose tolerance tests results confirmed the development of impaired glucose tolerance in both pill groups. Frequently sampled iv glucose tolerance test data were analyzed using the minimal model method to estimate parameters of insulin sensitivity, glucose effectiveness (SG), and beta-cell function. Lo/Ovral users had lower insulin sensitivity and SG compared to controls and inappropriately low beta-cell function in relation to the insulin resistance. Ovral users had metabolic parameters that were not different from controls. Based upon comparisons between normal and impaired glucose tolerant subjects combined with stepwise regression analysis, we conclude that Lo/Ovral use results in insulin and glucose resistance, which is not compensated by increased beta-cell function. The reduced glucose tolerance is due primarily to the defect in SG, and these OC users may place themselves at higher risk for the development of diabetes or cardiovascular disease. The reduced tolerance in Ovral users cannot be explained by the parameters measured in this study. We speculate that these latter subjects represent a special self-selected population in which tolerance is regulated by other factors. Ovral appears to be well tolerated by these women.
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PMID:Defects in carbohydrate metabolism in oral contraceptive users without apparent metabolic risk factors. 796 20

Hypothalamo-hypophyseo-gonadal system functional activity was studied in rats with streptozotocin diabetes. In intact rats concentrations of sex hormones nuclear receptors were measured in the hypothalamic preoptic-anterior, mediobasal segments and in the adenohypophysis, as were blood serum gonadotropins and sex hormones. Estradiol and progesterone were injected to ovariectomized females and LH-RH levels measured in preoptic-anterior segment of the hypothalamus, arcuate nucleus, and median eminence, as well as LH and FSH concentrations in the blood in order to detect disorders in basal and cyclic gonadotropin secretion. Streptozotocin injection to cycling females disordered the estrous cycle and was associated with reduction of LH, FSH, and sex hormones basal and cyclic secretion. Estradiol nuclear receptors concentrations reduced in the preoptic-anterior hypothalamus and hypophysis, the count of nuclear testosterone-binding sites reduced only in the hypophysis. Gonadotropin wave stimulated with sex steroids in ovariectomized females was reduced in diabetes because of changed activity of LH-RH-producing system. We believe that changes in basal and cyclic secretion of gonadotropins in rat females with experimental diabetes is explained by reduced activity of LH-RH-producing system and receptor binding at the level of the hypothalamo-hypophyseal complex.
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PMID:[Analysis of hypothalamo-hypophyseal-gonadal interrelationships in female rats in experimentally induced diabetes]. 816 17

In vitro insulin effect on basal and LH-RH-stimulated gonadotropin secretion in oophorectomized female rats with streptozotocin diabetes administered estradiol as replacing hormone therapy was studied. The results were compared to those obtained after a similar incubation of adenohypophyses of oophorectomized rats and of oophorectomized rats administered estradiol. Estradiol was found to change the type of LH-RH-stimulated gonadotropin secretion in oophorectomized animals. Basal, but not LH-RH-stimulated gonadotropin secretion, was increased in rats with experimental diabetes as against other groups. Insulin inhibited basal and increased LH-RH-stimulated gonadotropin secretion in oophorectomized rats with streptozotocin diabetes administered estradiol. A conclusion is made about impaired sensitivity of hypophyseal gonadotrophs to LH-RH in streptozotocin diabetes and about a possible contribution of insulin to regulation of body reproductive system at the level of hypophysis.
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PMID:[Basal and luliberin-stimulated gonadotropin secretion in ovariectomized female rats with streptozotocin-induced diabetes]. 816 16

Although many studies indicate that increased androgenicity is associated with insulin resistance and hyperinsulinemia in both premenopausal and postmenopausal women, relatively few data are available on this relationship in men. We examined the association of sex hormone-binding globulin (SHBG), total and free testosterone, dehydroepiandrosterone sulfate (DHEA-SO4), and estradiol to glucose and insulin concentrations before and during an oral glucose tolerance test in 178 men from the San Antonio Heart Study, a population-based study of diabetes and cardiovascular disease. Total and free testosterone and DHEA-SO4 were significantly inversely associated with insulin concentrations. Free testosterone and DHEA-SO4 were also significantly inversely correlated with glucose concentrations. SHBG was weakly positively associated with glucose concentrations. Estradiol was not related to glucose or insulin concentrations. After adjustment for age, obesity, and body fat distribution, insulin concentrations remained significantly inversely correlated with free testosterone (r = -.23), total testosterone (r = -.21), and DHEA-SO4 (r = -.21; all P < .01). In conclusion, we observed that increased testosterone and DHEA-SO4 are associated with lower insulin concentrations in men. This is in striking contrast to women, where increased androgenicity is associated with insulin resistance and hyperinsulinemia.
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PMID:Decreased testosterone and dehydroepiandrosterone sulfate concentrations are associated with increased insulin and glucose concentrations in nondiabetic men. 817 48

To investigate the effects on glucose and insulin metabolism of the slightly E-dominant, monophasic, low-dose oral contraceptive (OC) Diane-35, which contains 35 mcg ethinyl estradiol and 2 mg cyproterone acetate, a 17 alpha-hydroxyprogesterone derivative, the euglycemic hyperinsulinemic glucose clamp technique test was performed in 7 health young women after a one-year trial. The 7 subjects had a mean age of 22 years, a body mass index of 20.4 kg/m sq., had either never used OCs or had discontinued use at least 8 weeks before the study, were not taking medication, had no history of obesity or diabetes, and had normal glucose tolerance. The metabolic test was performed within the last 7 days before the presumed onset of menstruation during the last pretreatment cycle and within the last 5 days of OC intake during the sixth and twelfth cycle of continuous treatment with the OC. It was found that the glucose infusion rate, glucose metabolic clearance rate, and glucose infusion rate divided by plasma insulin plateau levels were not significantly affected by the OC. The metabolic clearance rate of the exogenous insulin infused during the clamp technique test was significantly increased after 6 cycles but not after 12. It was concluded that a 1-year treatment with Diane-35 does not alter peripheral (and presumable muscular) insulin sensitivity significantly, but increases insulin (presumably hepatic) clearance slightly.
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PMID:Effects of a 1-year treatment with a low-dose combined oral contraceptive containing ethinyl estradiol and cyproterone acetate on glucose and insulin metabolism. 845 99


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