TY - JOUR
T1 - The effect of Norplant on glucose metabolism under hyperglycemic hyperinsulinemic conditions
AU - Shamma, F. N.
AU - Rossi, G.
AU - HajHassan, L.
AU - Penzias, A. S.
AU - Connoly-Diamond, M.
AU - Jones, E.
AU - Diamond, Michael Peter
PY - 1995
Y1 - 1995
N2 - Objectives: To assess the impact of a levonorgestrel-releasing implant contraceptive (Norplant; Wyeth Ayerst Laboratories, Philadelphia, PA) on glucose metabolism. Design: Prospective evaluation of insulin action and secretion in women under hyperglycemic hyperinsulinemic clamp conditions in the midfollicular phase before and 8 weeks after Norplant placement. Setting: Yale University Clinical Research Center. Participants: Seven previously normally cycling, nonobese, nondiabetic women participated in the study. Interventions: Norplant insertion. Main Outcome Measures: Basal levels of glucose and insulin, as well as glucose-mediated insulin secretion, glucose uptake, and tissue sensitivity to insulin were assessed using the hyperglycemic hyperinsulinemic clamp technique before and after Norplant insertion. Results: Norplant placement did not alter the fasting glucose or insulin levels. However, it was associated with a significant 37% increase in the first phase insulin response from a control level of 51 ± 8 to 70 ± 10 μU/mL (conversion factor to SI unit, 7.175), and a significant 48% increase in the second phase insulin response from 60 ± 5 to 89 ± 8 μU/mL. In association with this increase in insulin levels after Norplant insertion, total mean body glucose uptake (M) increased from 8.08 ± 0.91 to 9.53 ± 0.95 mg/kg per minute. However, when expressed as the total body glucose uptake per unit of insulin, the M:I ratio (a measure of tissue sensitivity to insulin) decreased significantly from a mean of 0.12 ± 0.02 to 0.10 ± 0.01 mg/kg per minute per μU/mL. Conclusion: Although Norplant insertion does not alter basal glucose and insulin levels, tissue sensitivity to insulin under hyperglycemic hyperinsulinemic conditions is decreased after Norplant insertion.
AB - Objectives: To assess the impact of a levonorgestrel-releasing implant contraceptive (Norplant; Wyeth Ayerst Laboratories, Philadelphia, PA) on glucose metabolism. Design: Prospective evaluation of insulin action and secretion in women under hyperglycemic hyperinsulinemic clamp conditions in the midfollicular phase before and 8 weeks after Norplant placement. Setting: Yale University Clinical Research Center. Participants: Seven previously normally cycling, nonobese, nondiabetic women participated in the study. Interventions: Norplant insertion. Main Outcome Measures: Basal levels of glucose and insulin, as well as glucose-mediated insulin secretion, glucose uptake, and tissue sensitivity to insulin were assessed using the hyperglycemic hyperinsulinemic clamp technique before and after Norplant insertion. Results: Norplant placement did not alter the fasting glucose or insulin levels. However, it was associated with a significant 37% increase in the first phase insulin response from a control level of 51 ± 8 to 70 ± 10 μU/mL (conversion factor to SI unit, 7.175), and a significant 48% increase in the second phase insulin response from 60 ± 5 to 89 ± 8 μU/mL. In association with this increase in insulin levels after Norplant insertion, total mean body glucose uptake (M) increased from 8.08 ± 0.91 to 9.53 ± 0.95 mg/kg per minute. However, when expressed as the total body glucose uptake per unit of insulin, the M:I ratio (a measure of tissue sensitivity to insulin) decreased significantly from a mean of 0.12 ± 0.02 to 0.10 ± 0.01 mg/kg per minute per μU/mL. Conclusion: Although Norplant insertion does not alter basal glucose and insulin levels, tissue sensitivity to insulin under hyperglycemic hyperinsulinemic conditions is decreased after Norplant insertion.
KW - Levonorgestrel
KW - glucose
KW - glucose uptake
KW - hyperinsulinemic clamp
KW - insulin
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U2 - 10.1016/s0015-0282(16)57479-2
DO - 10.1016/s0015-0282(16)57479-2
M3 - Article
C2 - 7890060
AN - SCOPUS:0028970235
SN - 0015-0282
VL - 63
SP - 767
EP - 772
JO - Fertility and sterility
JF - Fertility and sterility
IS - 4
ER -