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

The long-term (7-year) effects of oral contraceptive steroids including a combination of norethindrone and ethinyl estradiol, a sequential regimen of dimethisterone and ethinyl estradiol, and daily administration of megestrol acetate were studied in female beagle dogs at dose levels of 1, 10, or 25 times the projected human dose levels. The major findings included cystic endometrial hyperplasia and pyometra requiring hysterectomies and alopecia for the norethindrone-ethinyl estradiol and dimethisterone-ethinyl estradiol treated dogs. These groups did not have accentuated mammary development or treatment related hyperplastic or neoplastic changes. For dogs given dimethisterone-ethinylestradiol, numerous acnelike lesions occurred in the skin of the mammary areas. Dogs given the higher dose levels of megestrol acetate had marked mammary stimulation, hyperplastic and neoplastic changes in the mammary glands, and clinical and pathologic changes typical of diabetes mellitus. Mammary changes of nodular hyperplasia, benign tumor, and adenocarcinoma appeared as distinct entitles although constant and intense mammary stimulation may be a common denominator. The relevance of the canine mammary changes to projecting potential tumorigenisis in women is questioned.
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PMID:Problems in evaluating chronic toxicity of contraceptive steroids in dogs. 7 28

Sixty percent of DMBA-induced mammary tumors in Sprage-Dawley rats regress after the animals were made diabetic by treatment with streptozotocin. Administration of estradiol valerate, 1 mg/wk/animal, caused regression of 75% of tumors in intact rats but regression of all tumors in diabetic rats. Estrogen treatment appeared to enhance the effects of diabetes, which by itself resulted in decreased activities of glycolytic enzymes. A role of insulin in growth of DMBA-induced mammary tumors may be warranted.
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PMID:Effect of estrogen treatment on DMBA-induced mammary tumor growth and biochemistry in intact and diabetic rats (38535). 12 45

A summary of what is currently known about the negative side effects associated with oral contraceptive usage is presented, and recommendations for prescribing OCs (oral contraceptives) are made. According to the results of several investigations, 2-18% of all women who take OCs develop hypertension. For most of these women the effects are mild; however, for some the increase in blood pressure is marked and results in renal damage. Several studies demonstrate that the risk of peripheral venous thrombosis and pulmonary embolism is enhanced for women who use OCs compared to nonusers. The risk is somewhat reduced for those who take low estrogen OCs. Women aged 30-39, who take OCs, are 3 times more likely to suffer a myocardial infarction than those who do not use OCs. This risk is markedly increased among OC users who either smoke or suffer from hypertension, diabetes, or hypercholesterolemia. OC users have a 9.5 times greater risk of thrombolic stroke and a 2.0 times greater risk of hemorrhagic stroke than nonusers. For women over 27 years of age, OC usage is associated with the development of benign hepatic adenoma. This risk increases markedly with duration of pill use and is greater for women who take pills containing mestranol compared to those who take pills containing ethinyl estradiol. Occasionally cases of pulmonary hypertension, peripheral arterial occlusion, mesenteric vascular insufficiency, Budd-Chiari syndrome, and noninflammatory cholestatic liver injury are reported among OC users. Recommendations are: 1) women with thromboembolic disorders and women over 34 years old, who smoke or who are obese or hypertensive should be advised to consider other forms of contraception; 2) prescriptions should be written for a 6 month supply and renewed only after a follow-up visit; 3) women who experience elevated blood pressure readings should be advised to discontinue usage; 4) serum triglyceride and cholesterol should be checked every 6 months; and 5) consider the use of low dose heparin for OC users who are recovering from trauma or surgery or who are confined to bed for long periods of time.
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PMID:A review: adverse effects of oral contraceptives. 22 69

Silastic implants containing the progestin, levonorgestrel, were tested as long-term contraceptives in 101 women. After three full years of exposure and 2,998 woman-months of use, no pregnancies had occurred. The continuation rates were 87% at 12 months, 79% at 24 months and 66% at 36 months. The most important side effect was excessive or irregular bleeding during the first year. No treatment was offered for this side effect other than vitamins and iron or change of method, with the exception of 3 cases where ethinyl estradiol was used one time for 2 weeks each. Bleeding disturbances led 8 patients to ask for removal of implants. Other side effects were headache, acne and lower abdominal pain. Blood and urine analysis tested 17 different parameters and all but plasma cortisol remained within normal limits throughout the study. A general tendency toward lowered cortisol values was observed and two subjects had more than one value below the normal limit for the population during the study. Glucose tolerance tests during the second year were abnormal in two women with familial diabetes but they returned to normal values spontaneously at the next test. It is concluded that levonorgestrel implants offer effective protection against pregnancy during the first three years of continuous use. Their acceptability and few side effects justify larger trials, especially if treatment of bleeding irregularities is introduced.
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PMID:A three-year clinical trial with levonorgestrel silastic implants. 38 43

Estrogen replacement in menopause should be used for specific symptoms such as ovarian failure, hot flushes, vaginal atrophy, atrophy of the vulva, and atrophic urethritis. The dose should be as low as possible to be effective and perscribed for as short as time as possible, since there are possible risks of uterine cancer, breast cancer, increased blood pressure, gallstones, deep vein thrombosis, and thromboembolism. Estrogens should be administered to provide the maximum benefit with the minimum risk involved. Estrogens should not be given to patients with known contraindications such as: suspected breast or uterine cancer; undiagnosed genital bleeding; Dubin-Johnson syndrome; acute hepatic disease; previous or present thromboembolism; or severe thrombophlebitis. Careful evaluation should be made before administering estrogen to women with uterine myomata, hyperlipidemia, hypercholesterolemia, sevare varicose veins, chronic hepatic dysfunction, diabetes mellitus, porphyria, or severe hypertension.
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PMID:Estrogen replacement in the menopause. 39 Apr 56

Insulin and estrogen binding have been determined in 7,12-dimethylbenz(a)anthracene-induced mammary tumors of rats in various endocrine states. Hormonal therapy, such as diabetes and ovariectomy, resulted in differential effects on growth patterns and hormone binding of tumors coexisting in the same host or in different hosts. It was observed that tumors that continued to grow after the host was made diabetic (insulin independent) or started to regress after ovariectomy (ovarian dependent) demonstrated decreased insulin binding. Tumors that regressed in diabetic hosts (insulin dependent) or continued to grow in ovariectomized animals (ovarian independent) showed an increased insulin-binding capacity. No significant change in insulin binding was observed in tumors that remained static after ovariectomy or induction of diabetes. Estrogen binding in tumor cells from diabetic rats paralleled the pattern of tumor growth response to diabetes; insulin-independent tumors demonstrated a significant increase in binding compared to tumors from intact hosts, and insulin-dependent tumors showed decreased estrogen receptor levels. From these results, we conclude that (a) insulin plays a positive role in regulating estrogen-binding capacity, (b) ovarian hormones may play a role in regulating insulin-binding capacity, and (c) a relationship between insulin and ovarian hormones and the growth of 7,12-dimethylbenz(a)anthracene-induced tumors is strongly suggested and may have therapeutic implications.
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PMID:Relationship between insulin and estrogen binding to growth response in 7,12-dimethylbenz(a)anthracene-induced rat mammary tumors. 41 34

The results of 2 studies to determine the relationship between hormonal contraceptive (h.c.) use, hypertension, and nephritis are reported. 828 women, 16-50 years of age, were divided into 3 groups. 1 group had never used h.c.s., 1 group was presently using h.c.s., and 1 group had used h.c.s. for the last time more than a year prior to the study. Women 26-35 years of age who were using h.c.s. at the time of the study more often developed hypertension than other groups. The h.c. users who developed hypertension more often had a family history of hypertension or diabetes mellitus, more often had diabetes themselves, and more often suffered from preeclampsia or eclampsia during pregnancy. In a second study, ethinyl estradiol, norethisterone acetate, epsilon aminocapronic acid, desoxycorticosterone acetate, and table salt were administered singly or in combinations to 2 groups of rats. In one group, a Goldblatt-type hypertension was induced with a clamp on the nephric artery. No increase in blood pressure was observed in animals which received only an estrogenic or progestagenic agent. Significant increases in blood pressure were observed in animals that were given combinations of estrogenic and progestagenic agents, however. Significantly increased plasma-resin activity was observed in all animals which were given estrogen, while animals receiving desoxycorticosterone acetate showed a highly significant decrease in plasma-renin activity.
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PMID:[Oral contraceptives, hypertension and nephrosclerosis]. 62 80

In Europe, about 1% of the women using oral contraceptives develop hypertension. Predisposing factors seem to be age, hypertension problems in past pregnancies, family history of hypertension, personal histories of kidney disorders, diabetes mellitus or adipositas, or diastolic pressure over 80 mm Hg. An overactive renin-angiotensin-aldosterone system may be an important factor in the etiology of this type of hypertension. Oterh possible factors are: reduced excretion of angiotensin 2, increased sensitivity of the arterioles to substances such as angiotensin 2 and noradrenaline, direct effect of ethinyl estradiol and mestranol on the sodium and water system, cardiovascular changes, disorders in the adrenergic system (e.g., catecholamine metabolism). Blood pressure should be checked before beginning any treatment with oral contraceptives and every 3 months after that. For the purpose of differential diagnosis angiotensin 2 in the plasma and catecholanin and its by-products should be checked (24-hour urine samples). In cases of serious hypertension hormone therapy should be discontinued at once. Primary aldosteronism and renal artery stenosis must be excluded in the differential diagnosis, for although these hypertensive disorders exhibit similar biochemical changes, they should be treated by surgical intervention. Usually hypertension is reversible after cessation of therapy with contraceptive steroids. However, some cases of irreversible hypertention, kidney failure, and malignant nephrosclerosis have been described. Hypertensive somen who wish to use oral contraceptives may, under medical supervision try a modified hormonal contraceptive (minipill without estrogen) or sequential or lower dosages.
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PMID:[Clinical aspects of hypertension under contraceptive steroids]. 79 66

Copper IUDs, oral contraceptives, "morning-after' pills and injectables are discussed in general in this review. Small IUDs are less effective, but better tolerated. An exception is the Dalkon shield, which is no longer manufactured because several women died from latent infections when they became pregnant. The Copper T IUD is tolerated much better than the Copper 7, and has only a 3% failure rate. Copper Ts must be replaced every 2 years, however, and are difficult to remove. A beneficial effect of IUDs is cure of uterine adhesions; a subjective side effect if discomfort reported by husbands. Strict contraindications or oral contraceptives are history of cholostatic jaundice of pregnancy, thromboembolism, essential hypertension, tension, diabetes, gynecologic cancer and pregnancy. Relative contraindications are hyperthyroidism, hyperlipidemia, and depression. Depressions occuring soon after starting pills may be due to unconscious rejection; those appearing later may be due to the progestagen itself. The subjective sequelae of pills are more likely in maternal women, women raised to feel guilty for using contraception, women susceptible to believing sensational media reports about pills, and women dominated by their husband's views. Pills are beneficial for essential dysmenorrhea, menstrual irregularity, premenstrual syndrome, depression, frigidity due to fear of pregnancy, uterine hypotrophy, ovarian cyst, certain ovarian dystrophies such as Stein Levinthan syndrome, menopausal symptoms, acne and hirsutism. The morning after pill, 5 mg ethinyl estradiol for 3 consecutive days, is indicated only in exceptional cases such as rape. Injectables are more suitable for those who desire long-term contraception and whose who want no more children. A lower cancer rate has been reported for users of depot progestagens than for women notu sing contraception.
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PMID:[Subjective and objective aspects of modern methods of contraception]. 114 75

One hundred fifty-seven pregnancies complicated by different degrees of diabetes, toxemia, and hypertension were studied with serial urinary placental estrogen determinations. A simple and fast method for total placental estrogen determination was used. The level of total estrogen excretion was related to Apgar score in cases of class B diabetes, severe toxemia, and also in moderate toxemia when estrogen excretion was falling. Mean estrogen levels did not differ as a function of severity of diabetes. Levels did differ with severity of toxemia; however, only the difference in mean estrogen excretion between mild and severe toxemia was significant. Estrogen excretion was very low in hypertension but was not related to Apgar score. This study concludes that total urinary estrogens constitute only a single parameter necessary in the management of high-risk pregnancies.
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PMID:Total urinary estrogens in complicated pregnancies. 116 30


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