Diabetes, Hormonal Contraception and the Risk of Thromboembolism
HealthDay News — For women with diabetes who are using hormonal contraception, the absolute risk of thromboembolism is low, with the lowest rates seen with use of intrauterine and subdermal contraceptives, according to a study published online in Diabetes Care.
Sarah H. O'Brien, MD, from The Research Institute at Nationwide Children's Hospital in Columbus, Ohio, and colleagues used data from 2002 to 2011 in Clinformatics Data Mart to identify women aged 14 to 44 years with diabetes and a prescription for a diabetes medication or device. Contraceptive claims were examined and the time to thromboembolism was compared among women dispensed hormonal contraception.
The researchers identified 146,080 women with 3,012 thromboembolic events. Twenty-eight percent of the women had claims for hormonal contraception, with most receiving estrogen-containing oral contraceptives. The highest rates of thromboembolism were seen for those using the contraceptive patch (16 per 1,000 woman-years); the lowest rates were seen among those using intrauterine and subdermal contraceptives (six per 1,000 woman-years and zero per 163 woman-years, respectively). Progestin-only injectable contraception correlated with increased risk of thromboembolism compared with use of intrauterine contraception (12.5 per 1,000 woman-years; adjusted hazard ratio, 4.69).
"Highly effective, intrauterine and subdermal contraceptives are excellent options for women with diabetes who hope to avoid the teratogenic effects of hyperglycemia by carefully planning their pregnancies," the authors write.