Clinical Briefs
Does Contraception Lead to Diabetes in Latina Women?
By Sharon Myoji Schnare, RN, FNP, CNM, MSN
Research suggests postpartum use of progestin-only oral contraception may increase the risk of developing type 2 diabetes mellitus in Latina women who had gestational diabetes. A retrospective cohort of 904 Latina women with gestational diabetes mellitus (GDM) who gave birth between 1987 and 1994 was tested at 4-16 weeks postpartum and found to have no diabetes. The women were divided into three groups. Group one (443 women) chose no hormonal contraception at their initial postpartum visit. Group two (383) received low-dose combination (estrogen and a progestin) oral contraceptives (OCs). Group three (78) were breast-feeding and chose a progestin-only oral contraceptive. Because estrogen inhibits lactation, the drug manufacturers of combination OCs state it is not recommended for nursing women. These women were followed for up to 7.5 years with periodic glucose tolerance tests.
Researchers found the annual incidence rates for developing diabetes mellitus (DM) were 8.7% for Latina women using no hormones, 10.4% for women using low- dose combination OCs, and 26.5% for the women who used progestin-only oral contraceptives. Patients who used progestin-only OCs developed DM more rapidly within the first two years. The research showed the use of progestin-only OCs almost tripled the risk of type 2 DM compared with equivalent use of low-dose OCs. The risk increased with duration of uninterrupted use. The authors conclude that progestin-only OCs were associated with an increased risk of diabetes in breast-feeding Latina women with recent GDM and "should be prescribed with caution, if at all." Long-term use of low-dose OCs did not increase the risk of type 2 diabetes compared with use of nonhormonal contraception; "thus, combination OCs do not appear to increase the risk of diabetes in nonbreast-feeding women with recent GDM." (See patient handouts enclosed in this issue: "Diabetes in Hispanic Americans" and "Diabetes in African Americans.")
Source
Kjos S. Contraception and the risk of type 2 diabetes mellitus in Latina women with prior gestational diabetes mellitus. JAMA 1998;280.
You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
- Award-winning Medical Content
- Latest Advances & Development in Medicine
- Unbiased Content