Comparison of the Metabolic Effects of Chlormadinone Acetate and Conventional Contraceptive Steroids in Man1

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Abstract
Over a 6-month period, no significant changes in the mean plasma glucose or insulin responses to glucose were observed in 8 nondiabetic or 16 subclinical diabetic women treated with chlormadinone acetate (6-chloro,6-dehydro,17α-acetoxy,pregn-4-ene-3,20-dione),0.5 mg daily. When the glucose tolerance tests (GTT's) of each individual were compared before and after 6 months of chlormadinone acetate treatment, glucose tolerance became abnormal in only 2 subclinical diabetic subjects and deteriorated in 1 other. In addition, we compared the GTT's of 10 subclinical diabetic women treated alternately with conventional contraceptive steroids which contained synthetic estrogens and with chlormadinone acetate. After 2.5 months of treatment with conventional contraceptive steroids 2 of 10 subclinical diabetic subjects had abnormal glucose tolerance, and GTT's deteriorated in 3 others; by contrast, chlormadinone acetate administration for a comparable time in the same subjects produced 1 abnormal and 2 deteriorated GTT's. Chlormadinone acetate produced no significant alterations in fasting serum triglyceride or cholesterol concentrations, but decreased fasting serum growth hormone (HGH) levels were observed after 6 months of treatment. These findings indicate that, in the dosage employed, chlormadinone acetate produced no significant change in carbohydrate and lipid metabolism and suggest that this synthetic progestin in women may be less diabetogenic and less capable of elevating circulating triglyceride concentrations than conventional contraceptive steroids.

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