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

24 Citations (Scopus)

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
StatePublished - Jan 1 1995
Externally publishedYes

Fingerprint

Levonorgestrel
Insulin
Glucose
Insulin Resistance
International System of Units
Contraceptive Agents
Fasting
Outcome Assessment (Health Care)

Keywords

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

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

Cite this

Shamma, F. N., Rossi, G., HajHassan, L., Penzias, A. S., Connoly-Diamond, M., Jones, E., & Diamond, M. P. (1995). The effect of Norplant on glucose metabolism under hyperglycemic hyperinsulinemic conditions. Fertility and Sterility, 63(4), 767-772.

The effect of Norplant on glucose metabolism under hyperglycemic hyperinsulinemic conditions. / Shamma, F. N.; Rossi, G.; HajHassan, L.; Penzias, A. S.; Connoly-Diamond, M.; Jones, E.; Diamond, Michael Peter.

In: Fertility and Sterility, Vol. 63, No. 4, 01.01.1995, p. 767-772.

Research output: Contribution to journalArticle

Shamma, FN, Rossi, G, HajHassan, L, Penzias, AS, Connoly-Diamond, M, Jones, E & Diamond, MP 1995, 'The effect of Norplant on glucose metabolism under hyperglycemic hyperinsulinemic conditions', Fertility and Sterility, vol. 63, no. 4, pp. 767-772.
Shamma FN, Rossi G, HajHassan L, Penzias AS, Connoly-Diamond M, Jones E et al. The effect of Norplant on glucose metabolism under hyperglycemic hyperinsulinemic conditions. Fertility and Sterility. 1995 Jan 1;63(4):767-772.
Shamma, F. N. ; Rossi, G. ; HajHassan, L. ; Penzias, A. S. ; Connoly-Diamond, M. ; Jones, E. ; Diamond, Michael Peter. / The effect of Norplant on glucose metabolism under hyperglycemic hyperinsulinemic conditions. In: Fertility and Sterility. 1995 ; Vol. 63, No. 4. pp. 767-772.
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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.",
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