The Effect of 12 Month Randomized Treatment with Oral Contraceptives and/or Metformin on GLP-1 in Polycystic Ovary Syndrome

Context: Insulin resistance could be associated with decreased GLP-1 secretion in PCOS. Treatment with oral contraceptives (OCP) and/or metformin (M) may affect GLP-1 levels and the increased risk of reactive hypoglycaemia (RH) in PCOS. Setting: Outpatient clinic. Patients and interventions: Randomized, controlled clinical trial. 90 patients with PCOS were randomized to 12 month treatment with OCP (150 mg desogestrel+30 microgram ethinylestradiol), M (2 g/day), or M+OCP. 5-hour oral glucose tolerance tests (5 h OGTT) were performed before and after the intervention period. 65 patients completed the study. 34 weight matched healthy women were included as controls. Main outcome measures: Changes in GLP1, insulin, C-peptide, and blood glucose during 5 h OGTT. Results: Treatment with M was superior to OCP regarding weight reduction (the median (quartiles) weight change during M treatment was -3.0 (-10.3; 0.6) kg) and decreased insulin and C-peptide levels during 5 h OGTT, whereas no significant changes were found in GLP-1 levels during 5 h OGTT. The prevalence of reactive hypoglycemia increased from 9/65 to 14/65 after medical treatment (P<0.01). Reactive hypoglycemia after medical intervention was more common after treatment with M+P, increased from 3/23 to 6/23 (p=0.01) and was associated with higher insulin and Cpeptide levels during 5 h OGTT, but was unassociated with BMI and GLP-1. GLP-1 levels were comparable in patients with PCOS vs. controls. GLP-1 levels were significantly lower in obese vs. lean patients (AUC GLP-1 during 5 h OGTT: 36.3 (30.8; 42.4) vs. 41.6 (37.2; 48.9) 102 mmol/l*h, p<0.001). 5 h AUC GLP-1 levels were inversely associated with BMI in patients with PCOS (r=-0.34, p<0.004). Conclusions: M treatment was associated with weight loss and increased insulin sensitivity compared to OCP, whereas GLP-1 levels were unchanged. Increased insulin levels during M+P treatment could be associated with increased risk of hypoglycemia. The Effect of 12 Month Randomized Treatment with Oral Contraceptives and/or Metformin on GLP-1 in Polycystic Ovary Syndrome Dorte Glintborg1*, Hanne Mumm1, Jens Juul Holst2 and Marianne Andersen1 1Department of Endocrinology and Metabolism, Odense University Hospital, 5000 Odense C, Denmark 2Department of Biomedical Sciences and NNF Centre for Basic Metabolic Research, The Panum Institute, University of Copenhagen, Copenhagen, Denmark *Corresponding author: Dorte Glintborg, Department of Endocrinology, Odense University Hospital, Kløvervænget 6, 3rd Floor DK-5000 Odense C, Denmark, Tel: +4526407697; Fax: +456611 3371; E-mail: [email protected] Received July 29, 2016; Accepted August 16, 2016; Published August 23, 2016 Citation: Glintborg D, Mumm H, Holst JJ, Andersen M (2016) The Effect of 12 Month Randomized Treatment with Oral Contraceptives and/or Metformin on GLP1 in Polycystic Ovary Syndrome. J Diabetes Metab 7: 695. doi: 10.4172/21556156.1000695 Copyright: © 2016 Glintborg D, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.