Effects of oral contraceptive agents on carbohydrate metabolism

Abstract

Most investigators agree that conventional oral contraceptive agents promote contra-insulin effects in the majority of normal and diabetic subjects. The physiologic significance of these changes is not known, because the majority of women manifesting this stress will revert to their original metabolic profiles when treatment is discontinued.Prospective studies do not support the view that oral contraceptives induce overt diabetes in truly nondiabetic subjects. There does appear to be a continuum of sensitivity to these steroids to an extent that they are often contra-indicated in most diabetic patients, particularly those who are not receiving exogenous insulin.It is difficult to define the role of progestins in the development of changes in carbohydrate metabolism until their in vivo metabolism and interactions with estrogens are clarified.It is tempting to speculate the sex steroids modify glucose metabolism in either an antagonistic or beneficial way depending on the balance between endogenous glucocorticoid-like and insulin-like effects and the preexisting status of endocrine pancreatic reserve of a specific individual.