To determine the metabolic effects of the subcutaneous etonogestrel implant compared with an oral contraceptive in adolescents and young adults (AYAs) with type 1 diabetes (T1D) on body weight, body composition, glucose, lipids, and C-reactive protein levels. This was a non-randomized, interventional, prospective study. Thirty-nine AYAs with T1D participated; 20 used the implant (Implant-T1D), and 19 used an oral combined contraceptive (OC-T1D). Body composition, HbA1c, intermittent continuous glucose monitoring, lipids, and high-sensitivity C-reactive protein (hsCRP) levels were evaluated. All participants were followed for at least 12 months, and 26 completed the 24-month follow-up. No women discontinued the intervention due to adverse effects. Body weight increased by 0.8 ± 3.5 and 1 ± 2.9 kg in the OC-T1D and the Implant-T1D group at 12 months and by 2.6 ± 3.9 and 3.3 ± 3.6 kg at 24 months, respectively. OC-T1D and Implant-T1D had similar HbA1c, mean interstitial glucose levels, and time in range throughout the study; no significant difference over time was observed. hsCRP levels increased in both groups and were associated with BMI and HbA1c ( < .001 for both variables). Women in the OC-T1D group had higher total cholesterol, HDL-C, and triglyceride levels compared with the Implant-T1D. Glucose levels were similar in youth using the subdermal progestin implant and an OC. However, both AYA groups showed increased BMI, fat mass, and subclinical inflammation. Changes in lipid levels were associated with the OC method. These data highlight the importance of weight gain prevention in young women with T1D using hormonal contraception.

中文翻译：

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皮下黄体酮植入剂和口服复方激素避孕药治疗 1 型糖尿病青少年

目的 确定皮下埋植依托孕烯与口服避孕药相比，对患有 1 型糖尿病 (T1D) 的青少年和年轻人 (AYA) 对体重、身体成分、葡萄糖、血脂和 C 反应蛋白水平的代谢影响。这是一项非随机、干预性、前瞻性研究。 39 名患有 T1D 的 AYA 参加了； 20 人使用了埋植剂 (Implant-T1D)，19 人使用了口服复方避孕药 (OC-T1D)。评估了身体成分、HbA1c、间歇性连续血糖监测、血脂和高敏 C 反应蛋白 (hsCRP) 水平。所有参与者都接受了至少 12 个月的随访，其中 26 人完成了 24 个月的随访。没有女性因不良反应而停止干预。 OC-T1D 和 Implant-T1D 组的体重在 12 个月时分别增加了 0.8 ± 3.5 和 1 ± 2.9 kg，在 24 个月时分别增加了 2.6 ± 3.9 和 3.3 ± 3.6 kg。 OC-T1D 和 Implant-T1D 在整个研究过程中具有相似的 HbA1c、平均间质葡萄糖水平和时间范围；随着时间的推移没有观察到显着差异。两组的 hsCRP 水平均升高，且与 BMI 和 HbA1c 相关（两个变量均 < .001）。与 Implant-T1D 组相比，OC-T1D 组女性的总胆固醇、HDL-C 和甘油三酯水平较高。使用皮下孕激素植入物和口服避孕药的青少年的血糖水平相似。然而，两个 AYA 组均表现出 BMI、脂肪量和亚临床炎症增加。脂质水平的变化与 OC 方法相关。这些数据强调了使用激素避孕药预防 1 型糖尿病年轻女性体重增加的重要性。