%0 Journal Article
%T The Intrauterine Device in Women with Diabetes Mellitus Type I and II: A Systematic Review
%A Norman D. Goldstuck
%A Petrus S. Steyn
%J ISRN Obstetrics and Gynecology
%D 2013
%R 10.1155/2013/814062
%X Background. Women with diabetes mellitus type I and type II need effective contraception for personal and medical reasons. Long acting reversible contraceptive (LARC) methods are among the most efficient and cost-effective methods. Study Design. We searched the Popline, PubMed, and clinicaltrials.gov databases from 1961 to March 2013 for studies on the efficacy of the IUD in diabetic women and the possible changes it may produce in laboratory parameters. Studies of at least 30 subjects with DM1 or DM2 who were studied for 6 to 12 months depending on the method of analysis were eligible. Results. The search produced seven articles which gave event rate efficacy evaluable results and three which evaluated the effect of the IUD on laboratory parameters. One of the earlier efficacy studies showed an abnormally high pregnancy rate which sparked a controversy which is discussed in the Introduction section. The remaining 6 studies produced acceptable pregnancy rates. The three laboratory studies showed that the copper and levonorgestrel releasing IUD/IUS do not affect the diabetic state in any way. Conclusions. The copper bearing and levonorgestrel releasing IUDs are safe and effective in women with diabetes type I and diabetes type II although the evidence in the latter is limited. 1. Introduction Diabetes mellitus is a ubiquitous disease. The affluent world is engulfed in an epidemic of diabetes mellitus type II (DM2) [1]. Before the discovery of insulin, diabetes mellitus type I (DM1) sufferers died very rapidly. Historically, short life spans and inadequate nutrition made diabetes mellitus type II (DM2) very uncommon. Initially DM2 was termed ˇ°aged onsetˇ± or ˇ°maturity onsetˇ± diabetes indicating that it appeared in later life. This is no longer the case. It is now prevalent even in the young [1] and it will affect many women who are of reproductive age and who may want to use contraception. Many will be suited to and may want to use a long acting reversible contraceptive (LARC) method such as the intrauterine device (IUD). During the late 1970s the possible problem of the IUD in Insulin dependent diabetes mellitus (IDDM) emerged. This was at a time when the concern was that IUDs could cause infection [2] and women with diabetes mellitus were also considered poor candidates for the combined oral contraceptives [3] that were available at the time. Diabetic women of reproductive age (almost exclusively with what is now termed DM1) were left with limited options as injectable contraception was not yet available in Europe and North America. This left only the
%U http://www.hindawi.com/journals/isrn.obgyn/2013/814062/