PCOS and Type 2 Diabetes Risk
Women who have polycystic ovary syndrome (PCOS) may be at greater risk for type 2 diabetes even when they do not have one of the main classic risk factors for diabetes—overweight or obesity. This finding should be heeded by women who suffer with this hormonal imbalance disorder and the doctors who treat them.
The finding was made by a team of experts at Monash University, who evaluated data from women who participated in the Austrialian Longitudinal Study of Women’s Health. More than 6,000 women between the ages of 25 and 28 years were followed for nine years until they were 34 to 37. The group included 500 women who had been diagnosed with polycystic ovary syndrome.
As many as 20 percent of women have PCOS, which is usually (but not always) characterized by enlarged ovaries that are populated by small cysts. It strikes during a woman’s reproductive years (including adolescence) and can be accompanied by irregular or prolonged menstrual periods, acne, excessive hair growth, overweight or obesity, infertility, skin tags, sleep apnea, pelvic pain, and depression.
It’s been known that type 2 diabetes and heart disease can be long-term complications of PCOS. In this new study, the researchers discovered that
- the incidence and prevalence of type 2 diabetes was three to five times greater among the women who had PCOS, and
- the presence of obesity was not an important trigger for developing diabetes among the women who had PCOS
Why this study is important
If you are a woman who has PCOS, the findings of this study are important for several reasons.
- It suggests women with PCOS should be screened for diabetes, even if they are young and not overweight or obese
- Women with PCOS who are pregnant should be screened for diabetes, as undiagnosed cases may result in significant risks for both mothers and their infants
Complications of PCOS
In addition to an increased risk of developing type 2 diabetes, women who have PCOS also are more likely to have hypertension, high triglycerides, low levels of “good” cholesterol (high-density lipoprotein, HDL), high C-reactive protein levels (associated with cardiovascular disease), endometrial cancer, severe liver inflammation (nonalcoholic steatohepatitis), and gestational diabetes.
Women who have PCOS need to be aware of the potential complications and take steps to avoid them. Treatment of PCOS typically includes medications that address individual concerns, such as acne, irregular periods, and excessive hair growth. Oral contraceptives are often prescribed for women who are not trying to get pregnant. Metformin, an oral drug used to treat type 2 diabetes, also can be taken to help reduce insulin levels and regulate ovulation.
For women who want to get pregnant, medical options can include clomiphene citrate (an oral anti-estrogen drug), metformin (which may induce ovulation), or gonadotropins, which stimulate luteinizing hormone and follicle-stimulating hormone. Spironolactone may be prescribed to deal with excessive hair growth, although it should not be taken by women who are pregnant or trying to get pregnant.
Lifestyle changes that may help with PCOS symptoms include eating a high protein diet, engaging in regular exercise, and use of acupuncture. Women with PCOS also should ask to be screened for type 2 diabetes, even if they are young and not overweight or obese.