Hemoglobin Alc Research Articles

Inappropriate Hemoglobin A<sub>lc</sub> Level, Interference or Bonus?

Inappropriate Hemoglobin A<sub>lc</sub> Level, Interference or Bonus?

Acarbose: its role in the treatment of diabetes mellitus.

To review the clinical pharmacology of acarbose, an alpha-glucosidase inhibitor, and to summarize its role in the pharmacotherapy of diabetes mellitus. A MEDLINE search identified all relevant articles, including reviews; Bayer Pharmaceuticals. Due to the large number of clinical trials available, specific criteria were used to narrow the focus of this review: (1) randomized, double-blind, placebo-controlled, parallel-group study design; (2) a minimum of 25 patients enrolled per treatment arm; (3) a treatment duration of 90 days or more; and (4) adherence to Food and Drug Administration Good Clinical Practice guidelines. All clinical trials that were available up to December 1995 were reviewed. Preliminary trials and unpublished reports were not reviewed. Acarbose is effective in reducing postprandial hyperglycemia. It does not stimulate endogenous insulin secretion and, therefore, will not cause hypoglycemia when used as monotherapy. The enhanced glycemic control achieved with acarbose is additive to that of sulfonylureas. It lowers postprandial serum glucose and insulin concentrations and does not promote weight gain. Acarbose can be used as first-line therapy with diet and exercise, or it can be used in combination with sulfonylureas to lower hemoglobin A1c concentrations an additional 0.5-0.9%. Acarbose is not a cure for diabetes, nor is it a substitute for diet, exercise, oral hypoglycemic agents, or insulin. Adverse effects are gastrointestinal and can be diminished by starting with an initial dosage of 25 mg tid. Depending on patient response, the dosage can be increased up to a maximum of 100 mg tid over time. Acarbose, through its unique mechanism of action, appears to be a safe and effective adjunctive agent to diet/exercise therapy or sulfonylurea therapy for treatment of non-insulin-dependent diabetes mellitus.

Carbohydrate metabolism in children receiving growth hormone for 5 years

Carbohydrate metabolism was evaluated by fasting and postprandial glucose, insulin, and hemoglobin (Hb)Alc levels in children with chronic renal insufficiency and various other growth disorders treated with growth hormone. Mean fasting and postprandial glucose remained unchanged throughout the 5-year study period in all four study groups. Median fasting insulin levels rose from low-normal levels into the normal range after 5 years of growth hormone. Average fasting insulin level after 5 years was 10 mU/l. Median postprandial insulin values also rose, yet remained within the normal range at the 5-year mark. Mean Hb Alc levels remained within low to middle end of the normal range in the patients with growth hormone deficiency, Turner syndrome, and idiopathic short stature. Mean Hb Alc levels at the 5 years were slightly elevated to 6.3% for the patients with chronic renal insufficiency.

Urinary albumin excretion rate and its determinants after 6 years in non-insulin-dependent diabetic patients

The present study was undertaken to clarify the progression of urinary albumin excretion rate (UAER) in non-insulin-dependent diabetic (NIDD) patients 6 years after diagnosis, and to elucidate the risk factors of nephropathy. This is a population-based controlled (baseline) cohort study. The prospective evaluation utilized the diabetic patients as internal controls. The setting was an urban primary health care centre. Main outcome measures were the UAER-24 h and fractional urinary albumin excretion rate (FAC) and their relation to mean blood pressure, haemoglobin Alc, fasting serum insulin and cholesterol and renal size. UAER (mg/24 h) was increased (geometric mean, quartile 1 and 3) in the diabetic patients at baseline, compared to the non-diabetic control subjects; 21 (10 and 33) versus 12 (8 and 15), P = 0.0001 (Wilcoxon's rank test). The UAER-24 h was not increased in diabetic subjects at follow-up; 24 (7 and 49) P = 0.3791 versus diabetic subjects at baseline. Eighteen per cent of normoalbuminuric (UAER < 30mg/24 h) patients developed microalbuminuria (UAER = 30-300 mg/24 h) and 3% clinical nephropathy (UAER > 300 mg/24 h). Of the microalbuminuric subjects 19% progressed to clinical nephropathy, 46% remained microalbuminuric and 35% remitted to normoalbuminuria. Serum insulin concentration, after assessment of confounding factors, measured at the baseline predicted the UAER for all diabetic subjects at follow-up in multiple linear regression analysis in an independent and significant way (P = 0.01). Serum insulin concentration (P = 0.034) and diuretic therapy (P = 0.050) at baseline independently predicted the outcome of the categorical variable progressor/nonprogressor (n = 22/86) based on the UAER-24 h at baseline and at follow-up. Progression of the UAER during the first 6 years is found among approximately every fifth NIDD subject who develops either microalbuminuria (from normoalbuminuria) or clinical nephropathy (from microalbuminuria). The role of serum insulin (insulin resistance) or some factor associated with it, is suggestive in the genesis of kidney disease.

The effect of dietary treatment on lipid peroxidation and antioxidant status in newly diagnosed noninsulin dependent diabetes

Increased lipid peroxidation and reduced antioxidant status may contribute to the development of complications in diabetes. The aim of this study was to assess the effects of dietary treatment of noninsulin-dependent diabetes on these parameters. Twenty patients with newly diagnosed noninsulin-dependent diabetes were recruited along with 20 age, sex, and smoking-status-matched control subjects. Dietary intake was assessed by food frequency questionnaire and 24-h dietary recall and blood collected for biochemical analyses before and 2 months after dietary treatment was initiated. Carbohydrate, fat, and protein intake fell in patients following dietary advice. Among micronutrients, intakes of vitamins C, E, and A, carotene, selenium, copper, zinc, and iron were similar in patients and controls. Vitamin C intake in patients rose following dietary advice (44.6 ± 11.7 vs. 49.5 ± 5.5 mg/d, p < .05), while there was no change in intake of other micronutrients. Fasting plasma glucose in diabetic subjects fell from 13.6 ± 1.1 μmol/1 at recruitment to 9.7 ± 1.1 μol/1 after diet ( p < .01), and this was accompanied by a fall in hemoglobin Alc from 7.44 ± 0.67% to 5.91 ± 0.57% ( p < .01). Serum malondialdehyde was higher in patients than controls at TO (2.39 ± 0.55 μ,mol/1 vs. 1.48 ± 0.33; p < .01), and fell following diet to 1.42 μmol/1 ( p < 0.01). Ascorbate was lower in patients than controls (12.7 ± 2.9 μmol/1 vs. 41.4 ± 9.3; p < .01) at baseline and rose after diet to 27.8 ± 6.4 ( p < .01). β-Carotene also rose after diet in patients (0.13 ± 0.04 μmol/1 vs. 0.17 ± 0.04; p < 0.05), as did lipid corrected a-tocopherol (4.39 ± 1.09 μmol/mmol cholesterol vs. 5.16 ± 1.18; p < .05). Reduced lipid peroxidation and improved antioxidant status may be one mechanism by which dietary treatment contributes to the prevention of diabetic complications.

Glucose metabolism and Alzheimer's dementia

Blood glucose levels are abnormally low in Alzheimer's dementia. We therefore examined glucose metabolism before death in relation to Alzheimer's dementia as determined at autopsy in 106 men and 161 women. The mean age was 81.8 +/- 8.6 years for men and 85.8 +/- 7.9 years for women (p < 0.001). The fasting plasma glucose level and hemoglobin Alc levels did not differ by sex. Alzheimer's dementia was detected in 88 patients (25.5%). More women than men had the disease, but the difference was not significant. Only 8.8% (3/34) of patients with diabetes mellitus had Alzheimer's dementia, as compared with 27.9% of patients without diabetes mellitus (65/233, p < 0.03). The fasting plasma glucose level was 89.9 +/- 13.4 mg/dl in patients with Alzheimer's dementia and 102.9 +/- 34.5 mg/dl in those without the disease. The hemoglobin Alc level was 5.7 +/- 0.8% in patients with Alzheimer's dementia and 6.4 +/- 1.5% in those without the disease. Both the fasting glucose level and hemoglobin Alc level were significantly lower in patients with Alzheimer's dementia than in those without the disease, p < 0.01. These data suggest that the development of Alzheimer's dementia is suppressed by the high plasma glucose levels in patients with diabetes mellitus.

Elevated levels of heat-shock protein 70 (HSP70) in the mononuclear cells of patients with non-insulin-dependent diabetes mellitus

Increased free radicals and reduced levels of antioxidants have been reported in diabetes mellitus. Since heat-shock protein 70 (HSP70) is a stress-induced protein and is suggested to play a protective role against oxidative stress, we have investigated whether HSP70 acts as one of the defense systems against this stress. We separated mononuclear cells from diabetic patients ( N = 12) and age- and sex-matched healthy controls ( N = 12), and detected HSP70 by western blot analysis. The results were expressed by the ratio of the density determined by laser densitometry, to that of 10 μg of purified HSP70. HSP70 levels in the mononuclear cells of diabetic patients (0.78 ± 0.56) were significantly high, compared with healthy subjects (0.43 ± 0.23) ( P < 0.05). No correlation was found between HSP70 and hemoglobin Alc, fasting plasma glucose, duration of diabetes or diabetic complications except age. A negative correlation was found between HSP70 and age ( r = −0.658, P < 0.05). These results suggest that HSP70 levels in the mononuclear cells are elevated reflecting increased oxidative stress in patients with diabetes.

Economic Benefits Of Medical Nutrition Therapy In Non-insulin-dependent Diabetes Mellitus

Published cost-benefit analyses have shown nutrition intervention reduces health care costs. In this retrospective study, cost-benefit analysis was completed for 19 hospital outpatients with non-insulin-dependent diabetes mellitus. The group had a total of 102 (per patient range, 3-16) individual/family consults with a dietitian. Monetary savings resulted from reduced or discontinued medication, reduced food costs because of lower calorie intake associated with weight loss, and/or avoiding use of oral hypoglycemic agents or insulin/ syringes. Food savings were figured conservatively as $0.72/yr/lb. body weight loss. Costs were calculated for insulin as $0.015/unit at a dose of 0.75 units/kg/day, for syringes as $0.17/day, and for oral medication. Dietitians' charges totalled $ 1290. Patients adhering to recommendations saved $153 for food, $924 for reduced/discontinued medications, $3770 for avoiding insulin and syringes, and $997 for avoiding oral hypoglycemic agents. Economic benefit of medical nutrition therapy was $4554 after 1 year, or $240 per patient. Positive health outcomes included weight loss; decreased blood sugars, hemoglobin Alc, lipid levels, and intake of sugars and fats; and increased consumption of fruits, vegetables, exercise levels, and feelings of well-being. These findings suggest that substantial monetary savings and improved quality of life can be achieved by medical nutrition therapy.

Glycated Hemoglobin in Pregnancy: Affinity Versus Ion Exchange Chromatography

The objective of this study was to facilitate use of existing hemoglobin (Hgb) Alc prognostic tables for adverse perinatal outcomes by determining the correlation with glycated Hgb. We prospectively performed both assays on blood samples from 78 pregnant diabetic patients over 6 months, using only the first determined level for each patient. Glycated Hgb was highly correlated with HgbAIc (r = 0.92), a relation not significantly affected by gestational age. The regression equation was: HgbAlc = 0.66 × glycated Hgb + 2.7. In conclusion, estimates of HgbAlc levels can be calculated from glycated Hgb determinations.

Hearing thresholds in insulin-dependent diabetic patients

Hearing thresholds were studied in 53 patients with insulin-dependent diabetes mellitus (IDDM) and 42 randomly selected non-diabetic control subjects, aged between 20 and 40 years. The hearing level tended to be worse in diabetic patients than in control subjects, but the differences were statistically significant only at frequencies of 6,000 and 8,000 Hz. Microvascular complications (retinopathy and nephropathy), and the duration of diabetes were associated with the elevated hearing thresholds. In contrast, poor metabolic control (high fasting blood glucose and glycated haemoglobin A1c) was not associated with increased hearing thresholds. The changes caused by diabetic neuropathy appeared simultaneously with microvascular complications and a long duration of the diabetes, and thus a causative role of diabetic neuropathy in the pathogenesis of elevated hearing thresholds remained unsolved. It was concluded that elevated sensorineural hearing thresholds at the frequencies of 6,000 and 8,000 Hz in patients with IDDM are probably caused by the long duration of diabetes and the microvascular complications associated with it.

Increased IGFBP-1 Levels Relating to Low IGF-I in Diabetic Children

It is known that retarded growth is caused by low IGF-I due to poor metabolic control in children with insulin-dependent diabetes mellitus (IDDM). Our study aims to clarify whether increased levels of insulin-like growth factor binding protein-I (IGFBP-1) reflect low IGF-I production. Nine prepubertal and 25 adolescent IDDM patients were studied in a fasting condition, early on the same morning. IGF-I, IGFBP-1, IGFBP-3, free insulin (IRI), blood glucose and other metabolic parameters were assayed. IGF-I levels were low, with high IGFBP-1 and low IGFBP-3, in IDDM according to pubertal stages. IGFBP-1 showed inverse correlation with IGF-I in adolescent IDDM. Since both IGFBP-1 and IGF-I showed closer correlation with fasting blood glucose than hemoglobin (Hb) Alc levels, the co-factors may be involved in fasting metabolic disturbance rather than overall hyperglycemia. IGFBP-1 showed inverse correlation with fasting free IRI whose levels themselves were not so low, while free fatty acids were not so high and correlated positively with IGFBP-1. These findings indicate that attention should be paid to hepatic insulin deficiency and overnight hypoglycemia in the treatment of IDDM.

Individual perception of education and treatment versus actual outcome. A theoretical model exemplified by an interventional study on patients with insulin-dependent diabetes mellitus.

An educational model is presented that stresses the importance of the interaction between individual characteristics and intentional educational influences on outcome variation. This model is exemplified by an interventional study of patients with insulin-dependent diabetes mellitus who, despite long-term conventional medical treatment, had been unable to achieve satisfactory hemoglobin Alc levels. Treatment modes and their importance for understanding variations in outcomes are discussed from the interactional perspective suggested in the model.

Blood viscosity and plasma proteins influencing it are increased in Type I diabetes in the DCCT

The Diabetes Control and Complications Trial (DCCT), an NIH-sponsored study at 29 institutions in the U.S. and Canada, was designed to examine the effects of intensive management in type I diabetes. Between 1983 and 1989, 1441 patients with and without mild retinopathy (primary and secondary) were randomized into two major treatment groups, intensively and conventionally treated patients. Retinopathy, nephropathy, and neuropathy were assessed periodically in each patient. In this study, levels of fibrinogen, haptoglobin, albumin and total protein were measured and viscosity of fresh blood was simultaneously evaluated in 45 local DCCT patients. Viscosity was measured at 17 rotation rates arranged logarithmically from .03 to 300 inverse seconds shear rate on blood adjusted to 41 % hematocrit by the addition or removal of its own plasma. Blood's time-based flow properties --- transient resistance and viscoelasticity --- were also assessed. Blood viscosity showed the greatest elevation (10 to 19%) in the 0.08-2.0 inverse second shear rate range. Increased low shear rate blood viscosity was found to be linked to fibrinogen and hemoglobin Alc levels. In addition to steady flow blood viscosity measurement, blood's time-based flow properties were also assessed at 15 inverse seconds shear rate. Transient resistance was increased 30% in diabetes; its elevation was found to be linked to both fibrinogen level and low shear blood viscosity. Diabetic blood's viscoelasticity at this high shear rate was much less strikingly increased than its transient resistance. Viscoelastic strain energy was correlated with fibrinogen, low shear viscosity, haptoglobin, and albumin level. Interleukin-6 (IL-6), a potent stimulator of fibrinogen and haptoglobin synthesis in hepatocytes in culture, was found to be elevated in diabetes, indicating that it is the likely mediator of the observed plasma protein changes. The altered blood flow properties observed in this well-characterized group of type 1 diabetes mellitus patients may playa role in development of diabetic complications.

The reappraisal of the association of glycosylated hemoglobin Alc (HbAlc) and blood pressure: A hypertension and diabetes study in a Taiwan rural area

The association of age, body weight, body mass index (BMI) and glycosylated hemoglobin Alc (HbAlc) to blood pressure in the general population of the Ho-long area in Taiwan was examined. A total of 1341 subjects, 746 men and 595 women, aged 40–90 years, were studied. Sex-specified multiple regression analyses were carried out on variables both univariately and significantly associated with blood pressure. Results show HbAlc to be significantly associated with SBP in both males and females before age, weight and/or BMI are adjusted ( p < 0.05). After controlling for these confounders, the strength of SBP-HbAlc association was slightly reduced in males, but remained significant. In contrast, there was no significance in females. Moreover, no significant relationship in DBP-HbAlc was found in either sex group. These findings suggest that although a positive correlation was found between HbAlc and SBP, HbAlc or glucose status appeared to be a less important contributing factor in hypertension than age or body weight.

Proteinuria, Hematuria, Hypertension, and Decreased Renal Function in a Patient With Diabetes for 9 Years

The patient is a 29-year-old white man with a history of insulindependent diabetes mellitus (100M) for 9 years. He had been previously healthy until the age of 20 and was found to be diabetic during a hospitalization for a pilonidal cyst. He has required insulin ever since. A 24-hour urine collection 2 years ago demonstrated 150 mg of protein. Three months ago, a repeat 24-hour urine collection contained 650 mg of protein. Mild hypertension was noted at that time and he was started on captopril. He was told that the onset of hypertension and proteinuria portended a poor prognosis and he sought a second opinion. There is no history of rash, fever, arthralgias, weight loss, photophobia, flank pain, gross hematuria, or drug or nonsteroidal antiinflammatory agent use. His medications include captopril12.5 mg twice daily, insulin (units): 18 NPH, 8 regular in the AM, 8 NPH, 4 regular in the PM , and 325 mg aspirin daily. Diabetic retinopathy had been diagnosed 2 years earlier by an ophthalmologist, but he had not received laser therapy. There is no family history of diabetes, renal disease or deafness. On physical examination, the patient's blood pressure was 140/90 mm Hg with a pulse of80/min. He was well developed and well nourished; his height and weight were 185 cm and 95 kg, respectively. His optic fundi demonstrated bilateral microaneurysms without hemorrhages, exudates, proliferative changes, or cataracts. Examination of the heart, lungs, and abdomen was normal. The vascular examination demonstrated strong pulses in all extremities. A mild sensory deficit of the feet was noted with decreased pinprick sensation in the toes. There was no edema. Laboratory results were sodium 144 mmol/L, K+ 4.3 mmol/ L, Cl\04 mmol/L, HCO)28 mmol/L, blood urea nitrogen (BUN) 5.7 mmol/L (16 mg/dL), creatinine 115 ILmol/L (1.3 mg/dL), albumin 4.3 g/dL, cholesterol 167 mg/dL, hemoglobin Alc 8.7% (5% to 8%), hemoglobin I 5A g/dL, white blood cell count 10,200/ ILL, and platelet count 178,000/ ILL. Twenty-four-hour urine collection showed 575 mg of pro-

Antihypertensive and metabolic effects of long-term treatment with amosulalol in non-insulin dependent diabetics.

In this open study, 41 hypertensive patients with non-insulin dependent diabetes mellitus were treated with the combined alpha- and beta-adrenoceptor blocker amosulalol hydrochloride for 24 weeks, either alone or added to existing antihypertensive therapy. The effects on blood pressure, glucose and lipid metabolism were examined. Daily administration of 20 to 60 mg amosulalol caused a significant reduction in both systolic and diastolic blood pressure within 2 weeks. This effect was stable, lasting for the entire trial period. The mean systolic and diastolic blood pressure decreased from 174 +/- 13/92 +/- 9 mmHg at the beginning to 148 +/- 16/80 +/- 11 mmHg at the end of the trial. Heart rate was not affected. Plasma glucose and haemoglobin Alc levels showed a tendency to decrease without any statistical significance. Total and HDL-cholesterol and triglyceride levels also remained unchanged. Although 3 patients had complained of dizziness, all were easily manageable. The results indicate that amosulalol is effective in the treatment of hypertension in non-insulin dependent diabetics and does not affect glucose and lipid metabolism.

The combined insulin and sulfonylurea therapy in diabetes of elderly people

The usefulness and safety of the combined insulin-sulfonylurea (gliclazide) therapy were investigated in 70 elderly diabetic patients poorly controlled by insulin alone. More than half (45 diabetics, 64% of total) ameliorated significantly their metabolic control after six months of the combined treatment: not only the glycemic profile and glycated hemoglobin Alc were significantly decreased, but the daily insulin dose was reduced by approx. 35% ( p < 0.01). These positive results in terms of improved glycemic control as well as reduction of daily insulin needs were still present after a mean period of follow-up of 5 years. The good percentage of positive results, the small incidence of hypoglycemic episodes and the consistent reduction of peripheral hyperinsulinism make this intervention (insulin-gliclazide) a safe strategy that can be adopted in a population of elderly diabetics, poorly controlled on insulin alone.

Prevalence of micro- and macroalbuminuria, arterial hypertension, retinopathy and large vessel disease in European Type 2 (non-insulin-dependent) diabetic patients

The prevalence of micro- and macroalbuminuria was determined in Type 2 (non-insulin-dependent) diabetic patients, less than 76 years of age, attending a diabetic clinic during 1987. All eligible patients (n = 557) were asked to collect a 24-h urine sample for quantitative albumin analysis. Urine collections were obtained in 296 males and 253 females (96%). Normoalbuminuria were defined as urinary albumin excretion less than or equal to 30 mg/24 h (n = 323), microalbuminuria as 31-299 mg/24 h (n = 151), and macroalbuminuria as greater than or equal to 300 mg/24 h (n = 75). The prevalence of macroalbuminuria was significantly higher in males (20%) than in females (6%), while the prevalence of microalbuminuria was almost identical in males (26%) and females (29%). The prevalence of arterial hypertension increased with increased albuminuria, being 48%, 68%, and 85% in patients with normoalbuminuria, microalbuminuria, and macroalbuminuria respectively. Prevalence of proliferative retinopathy rose with increasing albuminuria, being 2%, 5% and 12% in patients with normoalbuminuria, microalbuminuria, and macroalbuminuria respectively. Prevalence of coronary heart disease, based on Minnesota coded electrocardiograms, was more frequent in patients with macroalbuminuria (46%) compared to patients with microalbuminuria (26%) and patients with normoalbuminuria (22%). Foot ulcers were more frequent in micro- and macroalbuminuric patients, being 13% and 25%, respectively, compared to 5% in patients with normoalbuminuria. This cross-sectional study has revealed a high prevalence of microalbuminuria (27%) and macroalbuminuria (14%) in Type 2 diabetic patients. Patients with raised urinary albumin excretion are characterized by obesity, elevated haemoglobin Alc, increased frequency of arterial hypertension, proliferative retinopathy, coronary heart disease and foot ulcers.(ABSTRACT TRUNCATED AT 250 WORDS)

Effect of dietary fat on diabetes-induced changes in liver microsomal fatty acid composition and glucose-6-phosphatase activity in rats.

Experimental diabetes may manifest itself in a defect in liver microsomal fatty acid desaturation and increased activity of glucose-6-phosphatase (G-6-Pase). The present study was designed to determine whether these changes could be normalized by a change in the dietary fat consumed. Control and streptozotocin-induced diabetic rats were fed nutritionally adequate diets which varied in fatty acid composition. Fatty acid analysis of liver microsomal phospholipids revealed that non-diabetic control animals fed saturated fat (beef tallow) or a diet high in omega 3 fatty acids (fish oil) exhibited a significantly higher level of 18:2 omega 6 and a lower level of 20:4 omega 6 in the phosphatidylcholine and phosphatidylethanolamine fractions compared with diabetic animals. Control and diabetic animals fed the high linoleic acid diet had similar levels of 18:2 omega 6 in the microsomal phosphatidylcholine and phosphatidylserine fractions. Microsomal G-6-Pase activity was higher in diabetic than in control animals. Activity of G-6-Pase was lower in microsomes of control animals fed the soybean oil or the fish oil diet, but was not significantly reduced in diabetic animals fed high polyunsaturated fats. Blood glucose levels were similar in control groups fed the different diets, but the plasma hemoglobin Alc level was lower in diabetic animals fed the soybean oil diet. Cholesterol and triglyceride levels were lower in diabetic animals fed the fish oil-based diet. The results suggest that dietary fat manipulation has the potential to change at least some of the abnormalities in the microsomal membrane in experimental diabetes.

An open prospective study on the effects on carbohydrate metabolism of an oral monophasic contraceptive containing gestodene (WL-70)

The effects of a monophasic oral contraceptive (gestodene 75mcg + ethinylestradiol 30mcg) on plasma glucose (PG) and insulin (IRI) responses to an oral glucose load (OGTT) and on glycosylated haemoglobin Alc (HbAlc), fructosamine (Fr), total cortisol (FT) and transcortin (CBG) were studied in 30 healthy women. Blood samples were taken before treatment and after 6 and 12 cycles. After 6 and 12 months, OGTT-PG and IRI levels showed substantially unchanged values; for HbAlc and Fr the same behaviour was seen with the exception of the latter between 6 and 12 months; FT and CBG showed significant rises. All recorded values were in the normal range. The basal and dynamic PG and IRI behaviour failed to show any significant variations between pre-treatment values and those after 6 and 12 months of OC administration. Other data showed a substantial neutrality for this oral contraceptive containing gestodene.