You may think that the only worrying things about polycystic ovarian syndrome are a few missed periods, some acne and trouble getting pregnant. Not that these aren’t pretty bothersome by themselves. But did you know that a PCOS diagnosis raises your risk to diabetes? Wait, what?! Yup, you heard us right. Even if you do manage to get successfully pregnant despite the PCOS, you need to be careful. Australian researchers have now found that women with PCOS are almost 5 times more at a risk of gestational diabetes and Type 2 Diabetes. Experts now believe that the link between PCOS and Diabetes Type 2 relates to two factors: insulin resistance and obesity. Because these factors are common for both these conditions.
PCOS – Could It Be A Precursor to Diabetes?
Scientists have long suspected a link between PCOS and Diabetes. Because both these conditions have a lot to do with insulin resistance.
PCOS or Polycystic Ovarian Syndrome happens due to an imbalance in female sex hormones. This imbalance is often caused by ovarian cysts. A woman’s ovaries contain tiny, fluid-filled sacs known as ‘follicles’ which hold the eggs. Every month, a mature egg is released by the follicles. This egg makes its way into the uterus for successful fertilization. For women with PCOS, immature follicles bunch together to form cysts. And these cysts make the release of mature eggs rather impossible.
Strangely, the real cause behind PCOS is still unclear. But scientists are now sure that there is a direct link between PCOS and Diabetes. Insulin resistance, high levels of circulating insulin (hyperinsulinemia), low-grade inflammation and obesity interlink these two conditions.
PCOS and Diabetes: How Are They Related?
Scientists have observed a high frequency of excess male-sex hormones and PCOS in women with Diabetes Type 1. They have concluded that intensive insulin treatment may be to blame for this condition. A possible reason may be that Type 1 Diabetics are insulin-dependent. Hence, the ovaries of these women are subjected to large swings in insulin levels via insulin injections. Hyperinsulinemia signals the ovaries to produce more androgens, like testosterone. These excess androgens (or male hormones) then cause hormonal imbalance, which is what leads to PCOS. Likewise, in women with Diabetes Type 2, the early stages of the disease is marked by increased levels of insulin. Because the body puts up a fight against insulin resistance, and this may trigger PCOS.
Scientific evidence suggests that women with PCOS have a unique disorder of insulin action. Also, these women are at increased risk to develop Diabetes Type 2. Further, diabetes mellitus in women with polycystic ovary syndrome has a substantially earlier age of onset (third to fourth decades) when compared to general population (sixth to seventh decades).
Research has found that PCOS is prevalent in up to 27% women with Diabetes Type 2. For some, both the conditions are genetic. But scientists are now increasingly of the opinion that lifestyle choices and body-weight may be an intrinsic part of the equation that connects PCOS to Diabetes.
While obesity does increase your risk to Diabetes Type 2, don’t assume that you’re off the hook only because you aren’t overweight. Scientists from UCSF Center for Reproductive Health, San Francisco found this in a study. They observed that normal-weight women with PCOS have a threefold higher odds of incident diabetes compared to those without PCOS.
Is There A Pathogenic Overlap Between PCOS and Diabetes?
Pathogens are bacteria or virus that cause a disease. Considering the connection of PCOS and Diabetes Type 2, it’s important to discuss the overlap between pathogens.
- Diabetes Type 2 is caused by insulin resistance in combination with β-cell dysfunction. β-cells are pancreatic cells that produce, store and release insulin. And any dysfunction in these cells leads to insulin deficiency and hyperglycemia (or high blood sugar levels).
- On the other hand, PCOS develops when the body produces sufficient insulin. However, the cells in your body lack adequate resources to allow for absorption of insulin at a cellular level. This leads to insulin resistance and compensatory hyperinsulinemia (excess insulin in the body). Eventually, these conditions trigger the ovaries to produce extra androgens.
Insulin resistance continues to be the key common element between PCOS and Diabetes Type 2, while the key difference is β-cell function. When hyperinsulinemia is left unchecked, it does lead to β-cell decline and failure. This can lead to insulin deficiency and hence Diabetes.
There is scope for future research on how β-cell function fares overtime in women with PCOS to better understand the connection between PCOS and Diabetes.
If You Have PCOS, You Can Prevent Diabetes Type 2
Yes, PCOS is a strong independent factor in the development of diabetes. Younger women with a PCOS diagnosis are even more at risk for both Diabetes Type 2 and heart disease later in life. This is primarily the reason behind doctors prescribing Metformin and other blood-glucose-lowering drugs for the treatment of PCOS as well. However, it’s important to know that you can prevent and reverse Type 2 Diabetes through diet and exercise.
If you have PCOS, it’s important to know if insulin resistance is the cause behind your imbalanced hormones. Insulin resistance increases your risk for type 2 diabetes, gestational diabetes (diabetes during pregnancy) and pre-diabetes.
You may be surprised to hear this, but not all women diagnosed with PCOS suffer from insulin resistance. Sometimes other factors come into play to trigger an overproduction of male-sex hormones.
However, for a majority of women, insulin resistance and chronic inflammation lie at the heart of PCOS. This is why it’s crucial to get regular blood tests to measure fasting glucose levels as well as insulin levels.
- If your fasting glucose levels are above 100 mg/dl, in the 100 mg/dl -125 mg/dl range, you probably have insulin resistance and are also pre-diabetic. Fasting glucose levels that are already above 125 mg/dl mean you already have Diabetes.
- While doctors across the globe don’t yet agree on what ideal fasting insulin levels should actually be, a fasting insulin level of 8.4mIU/ml is considered normal. If you have PCOS, you should aim to get this figure as low as possible. If your fasting insulin levels are higher, you have insulin resistance that makes your cells less sensitive to insulin over time, leading to Type 2 Diabetes.
PCOS & Diabetes Type 2: Treat One To Treat The Other
Is there a way to reverse PCOS as well as Diabetes Type 2? There sure is, and we aren’t talking about medication here! The right diet to reduce carbohydrate intake and the intake of good fats is recommended. These changes, coupled with the right exercise program, supplements and other lifestyle changes will go a long way towards normalizing your hormones and increasing insulin sensitivity. These changes must become a lifestyle choice to permanently reverse PCOS and its accompanying complications, like Diabetes.