IMPE2023 Poster Presentations Diabetes and Insulin (16 abstracts)
Effect on insulin sensitivity of combined oral hormonal contraceptives and progestin implant use in young women with T1D
Franco Giraudo 1,2 , Germán Iñiguez 1 , Paulina M Merino 1,2 , Patricia López 1,2 , Gabriel Cavada 3 , Fernando Cassorla 1 & Ethel Codner 1
1Institute of Maternal and Child Research (IDIMI), School of Medicine, University of Chile, Santiago, Chile. 2San Borja Arriarán Clinical Hospital, Santiago, Chile. 3Public Health, School of Medicine, University of Chile, Santiago, Chile
Introduction: Insulin sensitivity is a marker of cardiovascular health. Young women in reproductive age with type 1 diabetes (T1D) have an increased risk of cardiovascular disease. The metabolic effects of combined oral hormonal contraception (OC) and progestin implant (implant) on insulin sensitivity in young women with T1D are unknown.
Objective: To determine the effect on insulin sensitivity in young women with T1D of using an OC and implant.
Methodology: 20 and 19 young women (20.6 ± 3.3 and 19.3 ± 3 years; P=0.19) used OC (150 mg desogestrel and 30 ug ethinyl estradiol) and implant of 68 mg etonogestrel for 24 months, respectively. Adiponectin and estimated insulin sensitivity (eIS) were evaluated at baseline, 3, 6, 12, 18, and 24 months. eIS was obtained by Duca equation which consider waist circumference, daily insulin dose per kilogram of body weight, adiponectin, triglycerides, and diastolic blood pressure for people with T1D. Evaluation of differences was performed using Multilevel mixed-effects linear regression.
Results: Both groups had a similar initial BMI (24.65 ± 2.6 and 24.67 ± 3.5 kg/m2 for OC and implant; P=0.9). BMI increase 0.26 and 1.5 kg/m2 at the end of 24 months of use, respectively (P<0.01 from 12 months, P>0.05 between groups). Insulin sensitivity and adiponectin were comparable at basal and during follow-up in both groups and increase from 12 months. Time in months since start of use of contraception. Data are shown as mean ± standard deviation. P>0.05 between OC and implant. * P<0.05 compared to baseline.
| OC | Implant | |||||||||||
| Basal (n=20) | 3 m (n=20) | 6 m (n=20) | 12 m (n=20) | 18 m (n=16) | 24 m (n=13) | Basal (n=19) | 3 m (n=19) | 6 m (n=19) | 12 m (n=19) | 18 m (n=15) | 24 m (n=13) | |
| Adiponectin, ng/mL | 10.72±4.3 | 11.38±5.3 | 10.86±5.3 | 15.95±8.3* | 13.75±9* | 20.82±12.5* | 10.69±5.3 | 11.29±4.3 | 13.30±8.7 | 17.95±10.7* | 19.37±21.4* | 14.49±8.9* |
| eIS, mg/kg/FFM/ min | 4.74±2.4 | 4.22±1.6 | 3.55±2 | 4.54±2.3 | 6.52±5.5* | 9.30±10.1* | 4.51±2.3 | 4.41±1.9 | 4.46±2 | 5.22±2.7 | 9.72±8.6* | 10.56±11.8* |
Conclusions: The use of OC and implant does not cause insulin resistance in this population. Even with an increase in BMI, insulin sensitivity improves after 12 months of use of both methods. The OC and implant probably do not increase insulin needs in adolescents with T1D (FONDECYT Grant 1170895, CONICYT Grant 21160500).
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