Prolonged progestin (quingestanol) therapy of menopausal diabetic women.

Abstract

The reduction of high serum LH levels toward or to normal in diabetic women in the menopausal range recorded during the first year of treatment with a synthetic progestin, 17-alpha-ethynyl-19-nortestosterone acetate, 3-cyclopentylenol ether (quingestanol acetate), was maintained during the second and third years of daily ingestion of this steroid. Normal LH and normal or high FSH levels prior to therapy were not affected. Other endocrine indices, including serum PBI and T4, plasma 11(OH) corticosteroids, serum growth hormone titers, insulin responses to oral glucose, and urinary excretion of 17-ketosteroids, Porter-Silber chromogens, and 11-desoxycortisol metabolites, estrogens, and creatinine remained relatively unchanged during quingestanol therapy. At the 36th month of treatment, a small increase in fasting blood glucose levels with greater hypoglycemia after oral carbohydrate was noted, but this probably reflected the natural history of treated diabetes mellitus. The decrease in urinary steroid responses to partial blockade of adrenal 11-beta hydroxylase by metyrapone observed in the 12th month of quingestanol therapy was not evident at the end of 24 and 36 months of treatment. Quingestanol therapy was associated with maintenance of the increase in serum sodium from low-normal to mid-normal concentrations noted during the first year of treatment. Serum chloride increases were less frequent. Other serum electrolytes, solutes, proteins and other nitrogenous constituents, lipids, and enzymes and formed blood elements generally fluctuated within the pre-therapy ranges. Body weight, blood pressure, pulse rate, electrocardiograms, and perception of vibrations were about the same prior to and at the completion of the three-year course of therapy. The steroid was well tolerated.