Insulin imbalance and high blood sugar are hallmark signs of diabetes. But these same symptoms in some women are associated with chronic menstrual problems, fatigue, weight gain, and infertility—a condition known as polycystic ovarian syndrome (PCOS).
Insulin, the hormone responsible for keeping glucose levels constant in the blood, is also important to reproductive health it turns out. Excess insulin seems to wreak havoc on the ovaries causing an over production of testosterone. This, in turn, leads to the irregular periods, obesity, inconsistent ovulation and benign ovarian cysts found in PCOS.
With PCOS now linked to insulin problems, new guidelines were recently published in the Journal of Clinical Endrocrinology and Metabolism that recommend routine diabetic testing for all women with PCOS.
Young women, in particular, may not show full diabetic symptoms when they are first diagnosed with PCOS. Researchers hope that early screening will help identify those who are at risk for diabetes. Patients then can make changes early on to their weight, diet and lifestyle to delay or possibly prevent the development of diabetes later in life.
The new guidelines state that all women diagnosed with PCOS should “be screened for glucose intolerance at the initial visit using an oral glucose tolerance test and that women be retested every two years.” For adolescents with PCOS, screening should be increased to once a year after a test reveals marginal glucose intolerance, or prediabetes.
In a separate 2007 report from the University of Pittsburgh published in the Journal of Women’s Health, researchers calculated the risk for diabetes in a group of women previously diagnosed with PCOS. The authors conclude from their results that as many as 15% to 36% of all type 2 diabetes cases in (Caucasian) women could be attributed to PCOS.
“These results support the recommendation that all women with PCOS should be periodically screened for diabetes,” the authors write. They also stress “the importance of the early identification of young women with PCOS and the need for early lifestyle intervention.”