Levonorgestrel Intrauterine System Safe for Women with Type 1 Diabetes -- July 12, 2005

Research Triangle Park, NC — A recent study by Family Health International and the Research Center of Obstetrics, Gynecology, and Perinatology at the Russian Academy of Medical Science in Moscow reports that women with type 1 diabetes (also known as juvenile or insulin-dependent diabetes) can safely use the levonorgestrel-releasing intrauterine system (LNG-IUS). The findings, published in the journal Obstetrics and Gynecology, could expand contraceptive options for women with diabetes and provide important information for their health providers.

In the study, 62 women with uncomplicated type 1 diabetes were randomly assigned to use either an LNG-IUS or a nonhormonal, copper intrauterine device (IUD) for 12 months. Throughout that period, no important differences were found in glycosylated hemoglobin levels, fasting serum-glucose levels, or daily insulin requirements between the groups.

"Type 1 diabetes is a serious disease that has restricted the contraceptive options for some women, but today we have evidence that the LNG-IUS is not only effective but also safe for these women," says principal investigator Dr. Svetlana Rogovskaya, a senior researcher at the Russian Academy of Medical Science and a former research fellow at Family Health International. "This means that women with type 1 diabetes should now be able to take full advantage of both the contraceptive and noncontraceptive health benefits of this intrauterine system."

The authors hope that the results of this study might eventually lead to a revision of the criteria for LNG-IUS use in the World Health Organization's (WHO's) widely used Medical Eligibility Criteria for Contraceptive Use, which currently states—cautiously—that the benefits of LNG-IUS use by women with diabetes generally outweigh the risks. Based in part on the new evidence, the authors believe the WHO recommendation for the LNG-IUS should be changed to no restrictions on use among women with diabetes. This would then match the current recommendation for use of the copper IUD by this same population.

Type 1 diabetes is most common in South East Asia, followed by Europe and then North America. For more information about its incidence, which is increasing globally, click here.

To read more about the LNG-IUS, including its noncontraceptive health benefits such as decreased menstrual bleeding and pain, click here.

To access the current, third edition of the WHO's Medical Eligibility Criteria for Contraceptive Use, click here.

Source:

Rogovskaya S, Rivera R, Grimes DA, Chen P-L, Pierre-Louis B, Prilepskaya V, Kulakov V. Effect of a levonorgestrel intrauterine system on women with type 1 diabetes: a randomized trial. Obstet Gynecol 2005;105(4):811-815.

Family Health International is dedicated to improving lives, knowledge, and understanding worldwide through a highly diversified program of research, education, and services in family health and HIV/AIDS prevention and care. Since its inception in 1971, FHI has formed partnerships with national governments and local communities in countries throughout the developing world to support lasting improvements in the health of individuals and the effectiveness of entire health systems.

For more information, please contact media@fhi.org.