USE OF NORPLANT IN WOMEN WITH OR AT-RISK FOR NONINSULIN-DEPENDENT DIABETES

This review addresses the use of Norplant in women with or at risk for noninsulin-dependent diabetes mellitus (NIDDM). Background informatio n on NIDDM is given, including pathogenesis, effect on glucose and lip id metabolism, and management. The effect of exogenous estrogen and pr ogestogens on glucose tolerance is briefly discussed. In reviewing the effects of Norplant on glucose metabolism, studies on women with norm al glucose tolerance were reviewed, along with the one study of Norpla nt use in women with a past history of gestational diabetes. Norplant does have a minor effect on glucose metabolism. Studies are contradict ory regarding lipid metabolism but most suggest that Norplant does not have a negative effect on the high density lipoprotein/total choleste rol ratio. Factors influencing contraceptive choice are reviewed. Prot ocols for management of Norplant in women with or at-risk for NIDDM ar e then presented, followed by a case study and a brief discussion.