Intrauterine Contraceptive Devices in Diabetic Women

Effectiveness, Safety, and Acceptability of a Copper Intrauterine Device (CU Safe 300) in Type I Diabetic Women

“…In our study, < 100 women were included so that classic rates (events/100 women-yr, i.e., Pearl index) could only be extrapolated, and CIs for rates as determined by life table analysis were wide. Nevertheless, we suggest that, despite the small number of participants, our results give valid new information about the long-term use of copper-medicated IUDs in diabetic women, because the cumulative time of use of 1754 mo was longer than that evaluated in any of the four previous studies on IUD use in diabetic women (9)(10)(11)(12).…”

“…In our study, most patients, including the two patients who became pregnant, were in good to moderate glycemic control. Data on glycemic control in the other studies are not given or are inconclusive (9)(10)(11)(12). Obviously, based on these data, the issue whether the level of glycemic control has any influence on the efficacy of lUDs in diabetic women cannot be resolved.…”

“…Intrauterine contraception could represent an acceptable method of contraception for diabetic women when the improved models of copper-medicated IUDs are used, because in nondiabetic and in diabetic women, such devices have already been proven to be safer and more effective than older models (3)(4)(5)(6). However, largely based on studies using nonmedicated IUDs and older models of medicated IUDs (7), concern exists about the safety and efficacy of IUDs in women in general and in diabetic women in particular (1,8,9). Widespread belief exists that diabetic women are more prone to pelvic infections associated with IUD use than nondiabetic women (8).…”

“…Widespread belief exists that diabetic women are more prone to pelvic infections associated with IUD use than nondiabetic women (8). So far, no studies have evaluated the safety and efficacy of IUDs in diabetic women beyond 1 yrofuse (1,(9)(10)(11)(12).…”

Risques vrais et faux des appareils intra-utérins

“…2) Le respect minutieux des contre-indications: infection gynécologi que: cervico-vaginite, endocervicite, endométrite, annexite même ancien ne; passé de grossesse ectopique; anomalie congénitale ou acquise de l'uté rus: béance isthmique, malformation, hypoplasie (hystérométrie inférieure à 6 cm), agrandissement (hystérométrie supérieure à 9 cm), déformation, synéchies, rétroflexion fixée; troubles importants de la erase sanguine; tumeur ou suspicion de tumeur endo-utérine bénigne ou maligne; diabète insulinodépendant: contre-indication relative [7], 3) Une certaine rigueur dans le choix des indications: méthode sûre, efficace, non contraignante et en général bien tolérée l'AIU devrait être réservé aux multipares qui désirent espacer les naissances, qui ont donné une dimension définitive à leur famille, qui ont des rapports conjugaux stables, qui ne sont pas exposées à des maladies sexuellement transmissi bles, qui présentent une intolérance, une contre-indication ou une lassitude vis-à-vis de la contraception hormonale; aux nullipares de plus de 35 ans, n'ayant aucun désir de maternité ou qui sont négligentes vis-à-vis de toute autre forme de contraception et, après échec de toute tentative d'orientation du choix vers une autre méthode.…”