Effect on carbohydrate metabolism and analysis of acceptability (menstrual cycle control) of extended regimens of the vaginally inserted hormone-releasing system ‘NuvaRing’ as compared with the standard 21/7 regime in reproductive-age women with type 1 diabetes mellitus

Aim. To evaluate the effect of the vaginally inserted hormone-releasing system ‘NuvaRing®’ on carbohydrate metabolism and acceptability (menstrual cycle control) of extended regimens of using as compared with the standard regimen (21/7) in women with type 1 diabetes mellitus (DM) in reproductive period during 24 months. Methods. The open randomised study included a total of 109 women with type 1 DM, using ‘NuvaRing®’ in different regimens (21/7, 42/7, 84/7 and 357/7). Average daily insulin requirements, the levels of glycosylated haemoglobin were determined at baseline, after 6, 12, 18 and 24 months of contraception. The control group was composed of 22 age-matched women with type 1 DM using no methods of contraception. Results. Using the contraceptive system ‘NuvaRing®’ in type 1 DM women in the reproductive period has proved to exert no clinically significant effect on carbohydrate metabolism in prolonged regimens, as well as in standard regimen. The overall number of bleeding days and spotting days was comparable in different groups. Longer regimens with fewer breaks were associated with fewer days of bleeding but a larger number of spotting days as compared with the shorter regimens, with a tendency towards a gradual decrease in spotting days during a year. Conclusion. The releasing system ‘NuvaRing®’ proved to be a reliable and safe means of contraception for late reproductive age women with type 1 DM.

[1]  K. Elkind-Hirsch,et al.  Contraceptive vaginal ring use for women has less adverse metabolic effects than an oral contraceptive. , 2007, Contraception.

[2]  C. F. Guazzelli,et al.  Bleeding patterns of women using extended regimens of the contraceptive vaginal ring. , 2007, Contraception.

[3]  D. Sacks Preconception care for diabetic women: background, barriers, and strategies for effective implementation. , 2006, Current diabetes reviews.

[4]  S. Killick,et al.  A comparative study on the effects of a contraceptive vaginal ring NuvaRing® and an oral contraceptive on carbohydrate metabolism and adrenal and thyroid function , 2004, The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception.

[5]  T. Kuehl,et al.  Acceptance of altering the standard 21-day/7-day oral contraceptive regimen to delay menses and reduce hormone withdrawal symptoms. , 2002, American journal of obstetrics and gynecology.

[6]  E. Vicaut,et al.  Oral contraception: patterns of non-compliance. The Coraliance study , 2002, The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception.

[7]  D. Apter,et al.  Efficacy, tolerability and acceptability of a novel contraceptive vaginal ring releasing etonogestrel and ethinyl oestradiol. , 2001, Human reproduction.

[8]  C. Peterson,et al.  The art and science of maintenance of normoglycemia in pregnancies complicated by insulin-dependent diabetes mellitus. , 1996, Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists.

[9]  S. Skouby,et al.  Hormonal Contraception in Women With IDDM: Influence on glycometabolic control and lipoprotein metabolism , 1995, Diabetes Care.

[10]  R. Klein,et al.  Oral Contraceptives in Women With Diabetes , 1990, Diabetes Care.