Exploring the Connection Between PCOS and Diabetes

Polycystic ovary syndrome (PCOS) is a hormonal condition that affects women and results in a specific set of symptoms, including irregular periods and infertility. Type 2 diabetes, a disorder that affects how the body regulates blood sugar, is more common in women with PCOS.

What Is PCOS?

In women of reproductive age, i.e., between late adolescence and before menopause, polycystic ovarian syndrome (PCOS) is the most prevalent hormonal disorder. PCOS affects 6-15% of women worldwide and is a major contributor to female infertility.1-3 PCOS also increases the risk of other medical conditions like heart attack, sleep apnoea, heart diseases, and increase in bad cholesterol levels.

A major factor associated with PCOS is higher than normal androgen (male hormone) levels in women. Additional associated factors include being overweight and family history, both of which are connected to insulin resistance. Insulin resistance, which increases the risk of type 2 diabetes by preventing the body from using the insulin it produces, is a common trait in PCOS-afflicted women.

The symptoms of PCOS include:

• Irregular periods
• Excessive hair growth or hair loss
• Difficulty becoming pregnant
• Acne
• Weight gain (particularly around the midsection) and difficulty reducing weight

Women with PCOS are seen to have multiple small follicles in the ovaries. Several hormonal and other blood chemistry changes have also been identified in PCOS studies, including:

• Elevated insulin levels
• Abnormal blood lipids (low HDL-C [good cholesterol], high triglycerides)
• Abnormal glucose metabolism
• Elevated androgens (although referred to as "male hormones," these are normally present in small amounts in women)

Understanding PCOS and Diabetes Relationship

PCOS is linked with insulin resistance, which gives rise to elevated insulin levels in the blood.2,3 Individuals with type 2 diabetes, gestational diabetes (diabetes during pregnancy), and pre-diabetes are all at risk of PCOS due to insulin resistance. Gestational diabetes puts the mother and unborn child at risk and increases the likelihood of the child developing type 2 diabetes in later life.

When blood sugar levels are above normal but not yet high enough to be classified as type 2 diabetes, it is known as prediabetes. You have a higher risk of getting type 2 diabetes, heart disease, and stroke if you have prediabetes.

The hormone insulin produced by the pancreas allows the body’s cells to absorb blood sugar and use it as fuel. However, if you have prediabetes, the cells in your body don't react to insulin normally. This is called insulin resistance. In response to this, your pancreas produces more insulin. Eventually, blood sugar levels rise as the sugar cannot be absorbed in the body cells, which can lead to prediabetes and type 2 diabetes in the future.

In type 1 diabetes, the autoimmune damage to the pancreas causes the production of insulin to cease. Type diabetes and PCOS may go along. Similar to insulin-resistance disorders, an increase in insulin levels in the blood contributes to androgen excess in susceptible women, resulting in PCOS.

Additionally, high insulin levels and abnormal blood lipids promote fat accumulation. This can contribute to obesity, a higher risk of heart disease and stroke.

According to endocrinologists, there are a lot of lifestyle adjustments that can help you escape PCOS. These can also help lower your risk of acquiring other associated disorders including diabetes, heart disease, hypertension, anxiety, depression, and infertility. It is advised that all PCOS-afflicted obese women undergo type 2 diabetes testing. Women with PCOS are also advised to maintain insulin levels less than 10 and fasting glucose levels under 90.6

How to Lower the Risk of Diabetes Associated With PCOS?

The medical history, symptoms, hormone tests, and occasionally an ultrasound are all carefully examined before a diagnosis of PCOS is made. Depending on these findings, the course of treatment can fluctuate. However, PCOS is frequently treated with lifestyle changes.

These lifestyle changes include giving up smoking; adopting a low-fat, low-glycaemic diet; and engaging in regular physical activity, which can aid in weight control and enhance insulin sensitivity.

These lifestyle modifications can aid in managing other risk factors as well, such as high blood pressure, excessive blood cholesterol levels, and hormone levels. Male hormone levels decline in many women, lowering health risks in the future.

Women with PCOS may occasionally be prescribed the drug metformin, along with the suggested lifestyle modifications, to reduce insulin resistance. Oral contraceptive pills, which control menstruation, and anti-androgen medications like cyproterone, which lessen the effects of male hormones including acne and excessive hair growth, are possible further treatments.

Conclusion

The connection of PCOS with the increased risk of diabetes is comparatively strong and should not be ignored or neglected in women. By taking drugs like metformin and making the prescribed lifestyle changes like decreasing weight, eating a healthy diet, and exercising regularly, both health conditions can be managed.

If a woman with PCOS is pregnant or planning a pregnancy, they should discuss the probability of gestational diabetes with their doctor.