The clinical performance of a Copper-T-200 intra-uterine device in insulin-dependent diabetic women [abstract]

Accurate planning of pregnancies needs the highest priority in insulin-dependent women. The IUD has previously been considered a better contraceptive method than hormonal compounds because no influence on the carbohydrate and lipid metabolism is induced. During the recent years efficacy of the IUD for diabetic women has been disputed however and the possibility of an increased risk for pelvic inflammatory disease pointed out. In light of these assertions the authors have examined the clinical performance of a Copper T-200 device in insulin-dependent diabetics and in nondiabetic women. During the 1975-80 period a Copper T-200 device was inserted in 105 insulin-dependent diabetics and in 125 nondiabetic women for fertility control. All devices were inserted postmenstrually or 8 weeks postpartum. The event and closure rates were assessed after a 12-month period. 2 insulin-dependent women and 6 of the controls were lost to follow-up and excluded from the study. Data obtained were analyzed by the life table method and differences in termination rates tested by the Students t test. The 1st segment net cumulative rates/100 women showed for the diabetic women an accidental pregnancy rate of 1.0 compared with 0.8 for the controls. The risk of pelvic inflammation or removal because of bleeding/pain episodes was 5.9 for the diabetics compared with 9.3 for the controls and the continuation rate 86.4 compared with 88.3. None of these differences is significant at the 0.5 level. The efficacy of the IUD as a contraceptive method in diabetic women seems to be comparable to the efficacy in nondiabetics. The removal rate because of bleeding/pain episodes including pelvic inflammation compares favorably also in diabetic women to what can be observed in nondiabetic women. (authors modified)