PCOS and Diabetes – Is There a Link Between the Two?
Women with Polycystic Ovary Syndrome or PCOS already face enough challenges in life. To name a few – irregular menstrual cycles, infertility, weight gain, excessive facial & body hair, darkening of skin and much more!
In addition, PCOS can have long term health implications such as diabetes, lipid abnormalities, cardiovascular diseases, obstructive sleep apnea, endometrial cancer and others. Taking care of the body and healthy habits can actually prevent many health complications like diabetes.
In diabetes, blood sugar level rises because of the improper functioning of insulin hormone wherein the body develops resistance to insulin.
PCOS is strongly associated with diabetes. Research has shown that nearly 40% of women with PCOS are likely to develop prediabetes or borderline diabetes. And up to 10% of women with PCOS will develop diabetes.
So what could be the reason behind this strong association between PCOS and diabetes?
PCOS and Diabetes – Why are they associated together?
The relationship between PCOS and diabetes is somewhat complicated.
Women with PCOS have increased levels of testosterone, the male hormone. Elevated testosterone levels stimulate more insulin production. It causes hyperinsulinemia (increased insulin levels in the blood) which leads to insulin resistance as seen in patients with diabetes.
Increased insulin levels lead to the following:
- Stimulate ovaries to produce more testosterone that causes excessive hair growth, irregular periods and weight gain.
- Stimulates and triggers rise in the actual number of theca cells of ovaries to produce more androgens.
- Decrease the production of SHBG (sex hormone-binding globulin), which further leads to increased levels of male hormones.
- Increase in appetite.
- Impairs fatty acid oxidation, making it more challenging to burn fat and thereby causing weight gain.
The connection between PCOS and diabetes is bidirectional. Apart from being a side effect of PCOS, the high level of insulin plays a vital role in causing and maintaining PCOS. It is like a vicious cycle where one leads to another.
PCOS & 3 types of Diabetes
PCOS is linked to all three types of diabetes.
1. Type 1 Diabetes
Studies have shown a clear link between PCOS and type 1 diabetes. Research has shown about 1 in 4 women with type 1 diabetes will get PCOS at some point in their life.
So if you have type 1 diabetes in your childhood days or during your teenage years, then you should consult your doctor to screen you for PCOS symptoms.
2. Type 2 Diabetes
Results of a study conducted by Forslund et al (2020) show that 19% of the women with PCOS develop type 2 diabetes.According to the CDC (Centers for Disease Control and Prevention), more than half of women with PCOS who are overweight develop type 2 diabetes by 40 years of age.
3. Gestational Diabetes Mellitus (GDM)
During pregnancy, women with PCOS have a high risk to develop diabetes, also known as GDM. It can cause health concerns for both mother and the developing baby, if not managed well.GDM goes away once the baby is born, but the risk of getting type 2 diabetes later in life is very high for both mother and child.
NICE (National Institute for Health and Care Excellence) guidelines recommend that all women with PCOS should undergo a yearly screening of type 2 diabetes if they have one of the following:
- Family history of type 2 diabetes.
- If BMI is ≥ 30 kg/m2, that is if it falls in the obese category. (BMI ≥25 kg/m2 if of Asian background).
- If gestational diabetes has occurred in the past.
Managing Diabetes and PCOS together
Various drugs are available in the market to manage PCOS and diabetes. Oral contraceptives pills are used to regulate PCOS-related symptoms as they improve hormonal imbalance. Metformin is prescribed to manage type 2 diabetes as it reduces insulin resistance in women with PCOS.
However, to date, there is no cure either for PCOS or diabetes. Positive lifestyle changes and healthy weight management is recommended as first line therapy by various endocrinologists for improved health outcomes.
1. Lifestyle Therapy
Lifestyle changes under expert coaching can pull the plug off from the metabolic chaos created by PCOS. Several guidelines endorse lifestyle therapy as the first line of treatment to manage PCOS.
Click here to read about six lifestyle changes to manage PCOS. Diabetologists & endocrinologists strongly recommend healthy eating with a well-balanced diet and regular physical activity to manage blood sugar levels in patients with PCOS, diabetes or prediabetes.
2. Weight Management
PCOS and type 2 diabetes, both are obesity-related problems. Studies show that women with PCOS and the one with higher body mass index have the highest risk to get type 2 diabetes.
So if you lose some weight — even just 5% of your total body weight, it will improve your health and lower the diabetes risk considerably. However, you may get those extras kilos back after months of crash dieting and intense workouts.
A wrong approach to lose weight fails all previous weight loss attempts, and in most cases, you may end up heavier than where you started. Since weight gain in women with PCOS is due to hormonal imbalance, a scientific sustainable weight loss method under expert guidance must be followed.
Living with PCOS and diabetes together can be daunting for anyone, but under expert guidance, life can change. A health coach who understands your specific needs can help you take the right steps in the right direction.
Fittertake: PCOS is one of the conditions that makes it difficult to lose weight and achieve your health goals. Simple strategies that work for most people are not enough when it comes to those diagnosed with PCOS.
To help women with PCOS lose weight, for the first time in India. We have the Reset23 program. A unique, safe, scientific, and sustainable program designed by doctors.
With a comprehensive approach that includes diet, fitness, sleep & stress management. We can help you achieve your health goals and learn how to maintain it. Start your journey today! By enrolling into our Reset23 program or call us on 022 4897 1077 (ext 1)
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Hamman RF, Wing RR, Edelstein SL, Lachin JM, Bray GA, Delahanty L, Hoskin M, Kriska AM, Mayer-Davis EJ, Pi-Sunyer X, Regensteiner J, Venditti B, Wylie-Rosett J. Effect of weight loss with lifestyle intervention on risk of diabetes. Diabetes Care. 2006 Sep;29(9):2102-7. doi: 10.2337/dc06-0560. PMID: 16936160; PMCID: PMC1762038.
Forslund M, Landin-Wilhelmsen K, Trimpou P, Schmidt J, Brännström M, Dahlgren E. Type 2 diabetes mellitus in women with polycystic ovary syndrome during a 24-year period: importance of obesity and abdominal fat distribution. Hum Reprod Open. 2020;2020(1):hoz042. Published 2020 Jan 15. doi:10.1093/hropen/hoz042