Objective. To study the effect of modern hormonal contraceptives and intrauterine device on metabolism in women with type 1 diabetes mellitus. Material and methods. Single-center, open label prospective parallel-group randomized controlled trial, conducted in 162 women with type 1 diabetes, divided into five groups using different types of contraceptives: 20 mcg ethinyl estradiol/ 150 mcg desogestrel, 30 mcg ethinyl estradiol/150 mcg desogestrel, 20 mcg ethinyl estradiol/drospirenone with levomefolate calcium, T-shaped Cu-IUD, and LNG-IUS. Multiple parameters of metabolism were investigated. Comparative analysis after 12, 24, 48 and 60 months was performed. Results. The use of COC with 20 mcg ethinyl estradiol/drospirenone had no negative effect on lipid metabolism in women of reproductive age with T1DM and HbA1с <6.5%. The use of T-shaped Cu-IUD was associated with cholesterole decrease in all study groups after 12. Conclusion. Low-dosed combined oral contraceptives containing desogestrel or drospirenone are not contraindicated in women of reproductive age with T1DM because of strong metabolism compensation (according to WHO criteria, 2009). Microdosed COC with drospirenone does not affect carbohydrate and lipid metabolism in women with T1DM. The use of intrauterine contraception can be high-effective and psychologically adequate in patients with HbA1с38% and/or dyslipidemy and/or hypertriglyceridemia (BMI 30 кг/м2).