Use of the levonorgestrel intrauterine device in women with type II diabetes mellitus
Lang, Benjamin Andrew
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OBJECTIVE: To determine the safety, effectiveness, and impact on glycemic control of the levonorgestrel-releasing intrauterine device (LNG-IUD) among women with type II diabetes. STUDY DESIGN: We conducted a retrospective chart review of women diagnosed with type II diabetes who had an LNG-IUD placed within the University of Washington Medical Center system between 2007 and 2012. We abstracted and analyzed the patient demographics, indications for placement, complications, and changes in glycemic control as measured by hemoglobin A1c before and after placement. RESULTS: We identified 115 women under the age of 55 with type II diabetes who had an LNG-IUD placed during the study period. The mean age was 37.2 years and the mean weight was 252.2 pounds. Fifty-seven percent were using the LNG-IUD primarily for contraception, while 30.4% were using it primarily to treat heavy menstrual bleeding. There were no documented pregnancies with the LNG-IUD in place. Expulsions were noted in 3.5% of women. Adverse effects included abdominal or pelvic pain in 13.9%, and pelvic inflammatory disease (PID) in 1.7% of women during the study period. Thirty-nine patients had A1c data before and up to 2 years after placement, and there was no significant change in A1c (mean A1c decrease of 0.17, CI -0.76 to +0.43). CONCLUSION: The LNG-IUD appears to be safe and effective in women with type II diabetes, with few complications and no significant effect on glycemic control.
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