Issue 107 Item 9 Oral Contraceptive Use Lowers Blood Glucose and Risk for Diabet

Current use of OCs was associated with lower glucose levels in a racially diverse sample of young women The study looked at the associations between 1) current use of oral contraceptives (OCs) and 2) glucose levels, insulin levels, and diabetes in young women.

Subjects were women (n = 1,940) in the Coronary Artery Risk Development in Young Adults (CARDIA) study, a prospective observational study of African-Americans and whites aged 18–30 years at enrollment in 1985–1986. We analyzed the cross-sectional associations between 1) current use of OCs and 2) fasting glucose, fasting insulin, and presence of diabetes using generalized estimating equations to adjust for repeated measures. We also examined the effect of current use of OCs on incident diabetes at year 10 of the study.

In unadjusted analyses, current use was associated with lower fasting glucose levels [–3.1 mg/dl, 95% CI (-3.7, -2.5)] and reduction in the odds of diabetes [odds ratio 0.56 (0.32, 0.97)], but not lower fasting insulin levels, compared with nonuse in both African-American and white women. After adjustment for covariates, current use of OCs was still associated with lower fasting glucose levels and lower odds of diabetes. After adjustment, current use of OCs was associated with higher insulin levels. No association existed between pattern of use of OCs and incident diabetes at year 10, although the total number of new persons with diabetes at year 10 was small..

The study found that current use of OCs was associated with lower glucose levels in a racially diverse sample of young women. In cross-sectional analysis, current use of OCs was associated with a lower odds of diabetes. The association between use of OCs and incident diabetes was not significant in longitudinal analysis, although the number of women with incident diabetes at year 10 was low. To our knowledge, this analysis of current use of OCs and glucose levels, insulin levels, and diabetes involves the largest numbers of young African-American women to date. In the face of a type 2 diabetes epidemic, which disproportionately affects minorities and increasingly affects young women, the possibility that use of OCs may be associated with a lower odds of diabetes may have important clinical implications, although this finding must be replicated. Also, our results on glucose and insulin levels are somewhat reassuring, especially because previous analyses of current use of OCs and glucose and insulin levels have found either no significant association or an association with higher levels of glucose and insulin. Diabetes Care 25:1027-1032, 2002