Diabetologia

, Volume 35, Issue 10, pp 967–972 | Cite as

Oral contraceptive use and the risk of Type 2 (non-insulin-dependent) diabetes mellitus in a large prospective study of women

  • E. B. Rimm
  • J. E. Manson
  • M. J. Stampfer
  • G. A. Colditz
  • W. C. Willett
  • B. Rosner
  • C. H. Hennekens
  • F. E. Speizer
Originals

Summary

We examined the association between oral contraceptive use and incidence of Type 2 (non-insulin-dependent) diabetes mellitus among 115117 female nurses free of diabetes, cardiovascular disease and cancer in 1976 and followed-up for 12 years. During 1237440 person years of follow-up, 2276 women who provided information on oral contraceptive use were clinically diagnosed with Type 2 diabetes. Women who used oral contraceptives in the past had only a slight and marginally increased relative risk of 1.10 (95% confidence interval 1.01, 1.21) compared to those women who had never used oral contraceptives after controlling for known risk factors of disease. We found no evidence of increased risk with longer duration of use or with shorter interval since last use. Current users did not have an increased risk of Type 2 diabetes (relative risk = 0.86, 95% confidence interval 0.46, 1.61) when compared to women who had never used the drug. There was no effect modification by obesity, family history of diabetes, or physical activity. These data suggest that past or current oral contraceptive use does not substantially influence subsequent risk of Type 2 diabetes.

Key words

Oral contraceptives diabetes mellitus epidemiology prospective study 

References

  1. 1.
    Eschwege E, Fontbonne A, Simon D et al. (1990) Oral contraceptives, insulin resistance and ischemic vascular disease. Int J Gynecol Obstet 31: 263–269CrossRefGoogle Scholar
  2. 2.
    Godsland IF, Crook D, Simpson R et al. (1990) The effects of different formulations of oral contraceptive agents on lipid and carbohydrate metabolism. N Engl J Med 323: 1375–1381PubMedGoogle Scholar
  3. 3.
    Spellacy WN (1976) Carbohydrate metabolism in male infertility and female fertility-control patients. Fertil Steril 27: 1132–1141PubMedGoogle Scholar
  4. 4.
    Russell-Briefel R, Ezzati TM, Perlman JA, Murphy RS (1987) Impaired glucose tolerance in women using oral contraceptives: United States, 1976–1980. J Chronic Dis 40: 3–11CrossRefPubMedGoogle Scholar
  5. 5.
    Gespard UJ (1987) Metabolic effects of oral contraceptives. Am J Obstet Gynecol 157: 1029–1041PubMedGoogle Scholar
  6. 6.
    Mann JI, Vessey MP, Thorogood M, Doll R (1975) Myocardial infarction in young women with special reference to oral contraceptive practice. Br Med J 2: 241–245PubMedGoogle Scholar
  7. 7.
    Goldman JA (1978) Intravenous glucose tolerance after 18 months on progestogen or combination-type oral contraceptive. Israel J Med Sci 14: 324–327PubMedGoogle Scholar
  8. 8.
    Wynn V, Doar JWH (1966) Some effects of oral contraceptives on carbohydrate metabolism. Lancet II: 715–719CrossRefGoogle Scholar
  9. 9.
    Hannaford PC, Kay CR (1989) Oral contraceptives and diabetes mellitus. Br Med J 299: 1315–1316Google Scholar
  10. 10.
    Duffy TJ, Ray R (1984) Oral contraceptive use: prospective follow-up of women with suspected glucose intolerance. Contraception 30: 197–208CrossRefPubMedGoogle Scholar
  11. 11.
    Giovannucci E, Colditz GA, Stampfer MJ et al. (1991) The assessment of alcohol consumption by a simple self-administered questionnaire. Am J Epidemiol 133: 810–817PubMedGoogle Scholar
  12. 12.
    Manson JE, Rimm EB, Stampfer MJ et al. (1991) Physical activity and incidence of noninsulin-dependent diabetes mellitus in women. Lancet 338: 774–778CrossRefPubMedGoogle Scholar
  13. 13.
    National Diabetes Data Group (1979) Classification and diagnosis of diabetes mellitus and other categories of glucose intolerance. Diabetes 28: 1039–1057PubMedGoogle Scholar
  14. 14.
    Stampfer MJ, Colditz GA, Willett WC et al. (1988) A prospective study of moderate alcohol drinking and risk of diabetes in women. Am J Epidemiol 128: 549–558PubMedGoogle Scholar
  15. 15.
    Colditz GA, Willett WC, Stampfer MJ et al. (1990) Weight as a risk factor for clinical diabetes in women. Am J Epidemiol 132: 510–513Google Scholar
  16. 16.
    Coulter A, Vessey M, McPherson K, Crossley B (1986) The ability of women to recall their oral contraceptive histories. Contraception 33: 127–137CrossRefPubMedGoogle Scholar
  17. 17.
    Willett WC, Sampson LS, Stampfer MJ et al. (1985) Reproducibility and validity of a semiquantitative food frequency questionnaire. Am J Epidemiol 122: 51–65PubMedGoogle Scholar
  18. 18.
    Rimm EB, Stampfer MJ, Colditz GA, Chute EG, Litin LB, Willett WC (1990) Validity of self-reported waist and hip circumferences in men and women. Epidemiology 1: 466–473PubMedGoogle Scholar
  19. 19.
    Colditz GA, Martin P, Stampfer MJ et al. (1986) Validation of questionnaire information on risk factors and disease outcomes in a prospective cohort study of women. Am J Epidemiol 123: 894–900PubMedGoogle Scholar
  20. 20.
    Shapiro S, Slone D, Rosenberg L, Kaufman DW, Stolley PD, Miettinen OS (1979) Oral-contraceptive use in relation to myocardial infarction. Lancet I: 743–747CrossRefGoogle Scholar
  21. 21.
    Hennekens CH, Evans D, Peto R (1979) Oral contraceptive use, cigarette smoking and myocardial infarction. Br J Farn Plann 5: 66–67Google Scholar
  22. 22.
    Ory H (1977) Association between oral contraceptives and myocardial infarction: a review. JAMA 237: 2619–2622PubMedGoogle Scholar
  23. 23.
    Stampfer MJ, Willett WC, Colditz GA, Speizer FE, Hennekens CH (1988) A prospective study of past use of oral contraceptive agents and risk of cardiovascular disease. N Engl J Med 319: 1313–1317PubMedGoogle Scholar
  24. 24.
    Stampfer MJ, Willett WC, Colditz GA, Speizer FE, Hennekens CH (1990) Past use of oral contraceptives and cardiovascular disease: a meta-analysis in the context of the Nurses' Health Study. Am J Obstet Gynecol 163: 285–291PubMedGoogle Scholar
  25. 25.
    Russell-Briefel R, Ezzati T, Perlman J (1984) Impaired glucose tolerance and diabetes in women using oral contraceptives. Fed Proc Fed Am Soc Exp Biol 43: 666 (Abstract)Google Scholar
  26. 26.
    Gaspard UJ, Lefebvre PJ (1990) Clinical aspects of the relationship between oral contraceptives, abnormalities in carbohydrate metabolism, and the development of cardiovascular disease. Am J Obstet Gynecol 163: 334–343PubMedGoogle Scholar
  27. 27.
    Perlman JA, Russell-Briefel R, Ezzati T, Lieberknecht G (1985) Oral contraceptive tolerance and the potency of contraceptive progestins. J Chronic Dis 38: 857–864CrossRefPubMedGoogle Scholar
  28. 28.
    Philips N, Duffy T (1973) One-hour glucose tolerance in relation to the use of contraceptive drugs. Am J Obstet Gynecol 116: 91–100PubMedGoogle Scholar

Copyright information

© Springer-Verlag 1992

Authors and Affiliations

  • E. B. Rimm
    • 1
  • J. E. Manson
    • 4
  • M. J. Stampfer
    • 1
    • 4
  • G. A. Colditz
    • 1
    • 4
  • W. C. Willett
    • 1
    • 2
    • 4
  • B. Rosner
    • 3
    • 4
  • C. H. Hennekens
    • 4
  • F. E. Speizer
    • 4
  1. 1.Department of EpidemiologyHarvard School of Public HealthBostonUSA
  2. 2.Department of NutritionHarvard School of Public HealthBostonUSA
  3. 3.Department of BiostatisticsHarvard School of Public HealthBostonUSA
  4. 4.Channing Laboratory, Department of MedicineHarvard Medical School and the Brigham and Women's HospitalBostonUSA

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