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  • Title: Carbohydrate metabolism before and after Norplant removal.
    Author: Konje JC, Odukoya OA, Otolorin EO, Ewings PD, Ladipo OA.
    Journal: Contraception; 1992 Jul; 46(1):61-9. PubMed ID: 1424624.
    Abstract:
    Changes in carbohydrate metabolism, measured by oral glucose tolerance test, were studied in Norplant users before and after removal. The mean area under the glucose curve rose from 24.7 min mmol/L before Norplant insertion to 35.1 min mmol/L before removal and decreased to 26.1 min mmol/L four weeks after Norplant removal. The areas before insertion and after removal were not statistically different (95% confidence interval -3.3 to 0.56, P = 0.16). The mean areas under the insulin curves before insertion (53.14 min uU/L) and after removal (59.46 min uU/L), however, were significantly different (95% confidence interval -7.64 to -5.0, P less than 0.0001). We conclude that changes in carbohydrate metabolism induced by Norplant are reversible once the implants are removed. While the changes in glucose induced by Norplant returned to pre-insertion levels within 4 weeks after removal, insulin changes were slower to return to pre-insertion values. Physicians at the University College Hospital in Ibadan, Nigeria recruited 24 26-39 year old women who had use Norplant for 18-30 months between January 1986-July 1988 into a study to determine changes in carbohydrate metabolism before and after removal of Norplant. None of the women had diabetes mellitus. The women underwent a glucose tolerance test (GTT) before insertion, just before removal, and 30 days after removal. The mean area under the GTT curve increased from 24.7 min mmol/L before insertion to 35.1 min mmol/L before removal and decreased to 26.1 min mmol/L 30 days after removal (p.0001). Yet there was no statistical difference between the mean areas under the GTT curve before insertion and those after removal. Thus glucose levels returned to preinsertion levels shortly after removal. There were significant differences in the mean areas under the insulin curves between before insertion and after removal, however (5314 min uU/L vs. 59.46 min uU/L; p.0001). Thus insulin levels 30 days after removal did not return to preinsertion levels as rapidly as did glucose levels. These results suggest that carbohydrate metabolic changes may be significant in women with diabetes mellitus. Therefore physicians should monitor blood glucose levels in diabetics. The changes in carbohydrate metabolism caused by Norplant return to almost normal when it is removed.
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