The effect of Norplant on glucose metabolism under hyperglycemic hyperinsulinemic conditions

F. N. Shamma, G. Rossi, L. HajHassan, A. S. Penzias, M. Connoly-Diamond, E. Jones, Michael Peter Diamond

Research output: Contribution to journalArticle

25 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)767-772
Number of pages6
JournalFertility and sterility
Volume63
Issue number4
DOIs
StatePublished - 1995
Externally publishedYes

Keywords

  • Levonorgestrel
  • glucose
  • glucose uptake
  • hyperinsulinemic clamp
  • insulin

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

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