medrogestone and Hyperglycemia

Information is lacking on the effects of hormone replacement therapy in women with diabetes, especially during moderate chronic hyperglycemia.. To study the effects of HRT on the lipid profile and the low density lipoprotein subclass distribution in women with type 2 diabetes under satisfactory and non-satisfactory glycemic control.. Fifty-four postmenopausal women after a 6 week run-in diet were randomized to receive either placebo (HbA1c < 8%, n = 13; HbA1c > 8%, n = 17) or HRT (HbA1c < 8%, n = 11; HbA1c > 8%, n = 13) for 12 weeks. HRT consisted of cyclical conjugated estrogens 0.625 mg/day plus medrogestone 5 mg/day. At the beginning and at the end of each treatment period the LDL subclass distribution was estimated by density gradient ultracentrifugation.. At the baseline and during the study, the HbA1c level was significantly higher in hyperglycemic patients than in the near-normoglycemic controls (baseline 10.2 +/- 2.9 vs. 6.5 +/- 0.7%, P < 0.01). They showed a trend for higher total and LDL cholesterol, triglycerides and lower high density lipoprotein-cholesterol compared to near-normoglycemic controls, as well as significantly higher triglyceride concentrations in very low density lipoprotein, intermediate density lipoprotein and LDL-1 particles and cholesterol content in LDL-1 and -2 particles. HRT decreased LDL-cholesterol in both groups. In the normoglycemic patients a small increase in HbA1c was observed (6.5 +/- 0.7 vs. 7.4 +/- 1%, P = 0.04). In all cases, HRT did not modify the proportion of LDL represented by denser LDLs.. HRT did not modify the LDL subclass distribution, even in the presence of moderate chronic hyperglycemia in women with type 2 diabetes.

Topics: Aged; Apolipoproteins B; Blood Glucose; Cardiovascular Diseases; Diabetes Mellitus, Type 2; Double-Blind Method; Estrogens, Conjugated (USP); Female; Follow-Up Studies; Hormone Replacement Therapy; Humans; Hyperglycemia; Lipoproteins, LDL; Medrogestone; Middle Aged; Postmenopause; Probability; Reference Values; Treatment Outcome

Medrogestone is a progestational agent that may reduce outflow obstruction secondary to benign prostatic hyperplasia. Five of 8 patients taking 15 mg. oral medrogestone twice daily and 5 of 7 patients taking 7.5 mg. oral medrogestone twice daily experienced an increase in mean urine flow (averaging 55.8 and 30.1 per cent, respectively), while no change was noted in 4 untreated patients. Five of the 8 patients taking 15 mg. and 6 of the 7 patients taking 7.5 mg. experienced an increase in peak urine flow (averaging 60 and 37.6 per cent, respectively), while 2 of the 4 controls had an improvement of only 12.2 per cent. Repetitive residual urines and digital examination were inaccurate to assay sequential changes in prostatic size. Certain side effects, such as hypertension, abnormal glucose tolerance and impotence, were encountered in isolated patients but in no instance was the side effect hazardous to the health of the test subject and in each instance it could be reversed by withdrawal of the medication.

Topics: Clinical Trials as Topic; Dose-Response Relationship, Drug; Glucose Tolerance Test; Humans; Hyperglycemia; Hyperplasia; Hypertension; Male; Medrogestone; Placebos; Pregnadienes; Prostate; Prostatic Diseases; Sexual Behavior; Urethral Diseases; Urination Disorders