Acquired Subclinical Diabetes Mellitus in Women Receiving Oral Contraceptive Agents

  • R. K. Kalkhoff
  • H. J. Kim
  • F. J. Stoddard


Although several conflicting observations have been reported concerning the effects of oral contraceptive agents on standard glucose tolerance tests, there is little doubt that the frequency of abnormal steroid-provocative glucose tolerance tests (GTT) is extraordinarily high among subjects on this regimen. diPaola and I co-workers (1) and Gershberg and associates (2) have observed independently that the incidence of positive steroid tests in: women receiving agents containing mestranol ranges from 45 to 85 percent or 10 to 20-fold greater than a general population. These findings imply that oral contraceptives induce an acquired form of subclinical diabetes mellitus. Possible etiologies of this defect and its reversibility after discontinuation of birth control medications are the subjects of this presentation.


Insulin Response Ideal Body Weight Negative Family History Birth Control Pill Cortisone Acetate 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    diPaola, G., Puchulu, F., Robin, M., Nicholson, R., and Marti, M.: Oral contraceptives and carbohydrate metabolism. Am. J. Obst, and Gynec. 101:206 (1968).Google Scholar
  2. 2.
    Javier, Z., Gershberg, H., and Hulse, M.: Ovulatory suppressants, estrogens, and carbohydrate metabolism. Metabolism 1J:443 (1968).CrossRefGoogle Scholar
  3. 3.
    Fajans, S.S., and Conn, J.W.: The early recognition of diabetes mellitus. Ann. N. Y. Acad. Sci. 82:208 (1959).PubMedCrossRefGoogle Scholar
  4. 4.
    Hill, J.B., and Kessler, G.: An automated determination of glucose utilizing a glucose oxidase-peroxide system. J. Lab. Clin. Med. 57:970 (1961).PubMedGoogle Scholar
  5. 5.
    Morgan, C.R., and Lazarow, A.: Immunoassay of insulin: two antibody system. Diabetes 12:115 (1963).Google Scholar
  6. 6.
    Kalkhoff, R.K., Richardson, B.L., and Stoddard, F.J.: Defective plasma insulin response during prednisolone glucose tolerance tests in subclinical diabetic mothers of heavy infants. Diabetes 17:37 (1968).PubMedGoogle Scholar
  7. 7.
    Rull, J., Floyd, J.C., Jr., Fajans, S.S., and Conn, J.W.: Insulin response to glucose in nondiabetic patients with negative and positive cortisone glucose tolerance tests. Clin. Res. 13:419 (1965).Google Scholar
  8. 8.
    Welt, M.H., Stetten, D., Jr., Ingle, D.J., and Morley, E.H.: Effects of cortisone on rates of glucose production and oxidation in the rat. J. Biol. Chem. 197:57 (1952).PubMedGoogle Scholar
  9. 9.
    Riddick, F.A., Jr., Riesler, D.M., and Kipnis, D.M.: The sugar transport system in striated muscle. Diabetes 11:171 (1962).PubMedGoogle Scholar
  10. 10.
    Ingle, D.J.: Effects of administering cortisone acetate and diethylstilbesterol to normal and force-fed rats. Am. J. Physiol. 172:115 (1953).PubMedGoogle Scholar
  11. 11.
    Nelson, D.H., Tanney, H., Mestman, G., Gieschan, V., and Wilson, L.P.: Potentiation of the biologic effect of administered Cortisol by estrogen treatment. J. Clin. Endocr. 23:261 (1963).PubMedCrossRefGoogle Scholar
  12. 12.
    Fajans, S.S., and Conn, J.W.: Comments on the cortisone- glucose tolerance test. Diabetes 10:63 (1961).PubMedGoogle Scholar
  13. 13.
    Peterson, R.E., Nokes, G., Chen, P.S., and Black, R.L.: Estrogens and adrenocortical function in man. J. Clin. Endocr. 20:495 (1960).PubMedCrossRefGoogle Scholar
  14. 14.
    Plager, J.E., Schmidt, K.G., and Staubitz, W.J.: In- creased unbound Cortisol in plasma of estrogen-treated subjects. J. Clin. Invest. 43:1066 (1964).PubMedCrossRefGoogle Scholar
  15. 15.
    Katz, F.H., and Kappas, A.: The effects of estradiol and estriol on plasma levels of Cortisol and thyroid hormone- binding globulins and on aldosterone and Cortisol secretion rates in man. J. Clin. Invest. 46:1768 (1967).PubMedCrossRefGoogle Scholar
  16. 16.
    Wynn, V., and Doar, J.W.H.: Some effects of oral con- centractions on carbohydrate metabolism. Lancet ii:715 (1966).CrossRefGoogle Scholar
  17. 17.
    Spellacy, W.N., and Carlson, K.L.: Plasma insulin and blood glucose levels in patients taking oral contraceptives. Am. J. Obst, and Gynec. 95:474 (1966).Google Scholar
  18. 18.
    Yalow, R.S., and Berson, S.A.: Plasma insulin concentrations in nondiabetic and early diabetic subjects. Diabetes 9:254 (1960).PubMedGoogle Scholar
  19. 19.
    Perley, M., and Kipnis, D.M.: Plasma insulin response to glucose and tolbutamide of normal weight and obese diabetic and nondiabetic subjects. Diabetes 9: 867 (1966).Google Scholar
  20. 20.
    Seltzer, H.S., Allen, E.W., Herron, A.L., Jr., and Brennan, M.T.: Insulin secretion in response to a glycemic stimulus: relation of delayed initial release to carbohydrate intolerance in mild diabetes nföllitus. J. Clin. Invest. 46:323 (1967).PubMedCrossRefGoogle Scholar
  21. 21.
    Spellacy, W.N., Buhi, W.C., Spellacy, C.E., Moses, L.C., and Goldzieher, J.W.: Carbohydrate studies in long-term users of oral contraceptives. Diabetes 17: (supplement)344 (1968).Google Scholar

Copyright information

© Plenum Press, New York 1969

Authors and Affiliations

  • R. K. Kalkhoff
    • 1
  • H. J. Kim
    • 1
  • F. J. Stoddard
    • 1
  1. 1.Department of Medicine, Department of Obstetrics and Clinical Research CenterMarquette School of Medicine and Milwaukee County General HospitalMilwaukeeUSA

Personalised recommendations