It is particularly important for diabetic women given a higher pregnancy risk for the woman and the child, when unplanned. Lesser effects on lipid

and carbohydrate metabolism and on the coagulation system should be sought when selecting the method. Progestins potentially compromise lipid and carbohydrate metabolism. It seems that progestin mini-pill with the 3rd generation progestin is safe in diabetic women. Hormonal contraception p38 MAPK assay should not be recommended to patients with labile blood sugar, de novo diagnosed diabetes, patients with diabetic complications (retinopathy, nephropathy, coronary disease or lower limb atherosclerosis), high cholesterol or TG level with hypertension. IUDs with copper (no progestins) might be an alternative for diabetic patients. Intense climacteric symptoms may also be another reason for a gynecological

selleck chemical appointment. Menopausal Hormonal Therapy (MHT) reduces climacteric symptoms but diabetic patients are often afraid that diabetes management can worsen. A combination of transdermal estradiol and norethisterone acetate seems to be the best MHT choice in diabetes, considering no important influence on carbohydrate metabolism and its TG reducing effect. Transdermal application causes no rise in TG and blood pressure levels, which is particularly important in type 2 diabetes patients with frequently concomitant dyslipidemia and high BP levels, as in metabolic Akt activity syndrome. It is estimated that the so-called vaginal symptoms, resulting from atrophic vaginitis, occur in almost every third woman in the perimenopausal period and in almost every second woman in the postmenopausal period. Diabetes results in a 2.5-fold increase in the risk of incontinence but this mechanism is still a mystery. More and more data indicate that type 2 diabetes is a risk factor for cancer and cancer induced deaths. Meta-analysis of type 2 diabetes and cancer concomitance pointed to a relative risk factor for endometrial cancer of RR 1.2, breast cancer of 1.20 and colorectal cancer of 1.30.”
“This study aimed

to assess the persistence of basal supported oral treatment with insulin glargine (BOT) compared to standard combination therapy with NPH insulin and oral antidiabetic drugs in patients with type 2 diabetes. This study used a representative German database (IMS (R) Disease Analyzer). Patients with type2 diabetes who were taking oral hypoglycemic agents and who started basal insulin therapy with glargine or NPH insulin between 1/2003 and 8/2006 were included. The documentation period lasted between 12 and 57 months. Persistence was measured as the time until regular human insulin or rapid-acting insulin analogs were added to basal insulin therapy. The study included a total of 1242 patients with type 2 diabetes. Among those, 896 patients started with glargine and 346 patients with NPH insulin.