PCOS or polycystic ovary syndrome is a chronic hormonal condition that affects certain women of reproductive age. It can cause unusual and irregular periods, imbalances in female reproductive hormones like estrogen, progesterone and follicle-stimulating hormone, as well as ovarian cysts, impaired egg release and elevated androgen levels. WHO states that people with PCOS are more likely to have other health conditions, including type 2 diabetes, hypertension, high cholesterol, heart disease and endometrial cancer (cancer of the inner lining of the uterus). “PCOS and diabetes are both driven by the same risk factors, like obesity and insulin resistance,” says Dr Belinda George, associate professor, department of endocrinology, St John’s Medical College Hospital, Bengaluru.
PCOS and insulin resistance
Experts state that women with PCOS can also have high insulin resistance. Dr Teji Dawane, senior consultant, obstetrician and gynecologist, Motherhood Hospitals, Whitefield, Bengaluru, explains that due to high insulin resistance, the secreted insulin cannot break down glucose and ensure that it is taken up by cells. The pancreas continues secreting insulin, leading to an increase in the insulin level (hyperinsulinemia) in the blood. According to a 2022 research article, hyperinsulinemia leads to excess ovarian androgen production, which is one of the main risk factors of PCOS in most women.
Dr Suruchi Desai, senior consultant, obstetrics and gynecology, Nanavati Max Hospital, Mumbai, says that prolonged insulin resistance ends up adversely affecting pancreatic insulin secretion. She adds that while the exact reason why PCOS leads to insulin resistance is not completely understood, it is believed that the hormonal imbalances associated with PCOS, including elevated levels of androgens, happen to impair the action of insulin on blood glucose.
PCOS may cause weight gain, increasing the risk of type 2 diabetes
“Hormonal imbalances associated with PCOS and particularly elevated levels of insulin or insulin resistance can make it harder for women to lose weight,” shares Dr Desai. At the same time, higher insulin levels result in additional fat storage around the belly, contributing to obesity and weight gain. Women with PCOS are more likely to experience food cravings and increased appetite, further contributing to weight gain.
Experts state that the extra weight can also get deposited on the surface of the ovaries, which hampers the process of ovulation or egg release. This leads to anovulation, where the egg is not released from the ovary. “If ovulation does not happen properly, the follicle fails to mature and keeps growing and an excessively grown follicle develops a cyst,” says Dr Dawane. She adds that this cyst also starts releasing male hormones. They, in turn, can cause receding hair, acne, difficulty in losing weight, facial hair and further weight gain. This weight gain further worsens PCOS and adds to the already heightened risk of diabetes. “When someone is obese, their ovarian hormonal production may get affected,” says Dr George. She adds that obesity is also a factor triggering insulin resistance. This causes hormonal imbalance, leading to PCOS.
Precautions for people with PCOS to reduce the risk of diabetes
A balanced diet rich in whole grains, lean proteins and vegetables can help manage blood sugar levels and reduce insulin resistance. “One should reduce their carbohydrate intake, as it causes insulin levels to go even higher,” says Dr Dawane. She adds that instead, they should have more whole grain cereals containing lots of fiber such as oats and millet and fluids.
An active lifestyle
Engaging in regular physical activity can improve insulin sensitivity and help with weight management. “Even a little weight loss can help improve insulin resistance and decrease the risk of diabetes and PCOS,” says Dr Desai.
Dr Dawane also adds that an hour of intense workout in an otherwise sedentary lifestyle will only lead to more hormonal buildup. So, it is important to be active throughout the day.
“Regular visits to a gynecologist or endocrinologist can help monitor PCOS symptoms and assess the risk of diabetes,” says Dr Desai. She adds that they might prescribe medications to improve insulin sensitivity. Dr George shares that it is important to get screened regularly as it can help in the early detection of any conditions and allow timely intervention.
Cutting down on tobacco and alcohol
“Consumption of tobacco and excess alcohol can exacerbate insulin resistance and other PCOS-related complications,” says Dr Desai.
Good quality sleep
Good sleep is crucial as the brain should get rest as well. “Overworking the brain will cause further hormonal imbalance,” says Dr Dawane. She adds that one should reduce screen time as it affects the quality of sleep, diet and exercise.
- Women with PCOS are usually insulin-resistant, which heightens the risk of diabetes in them.
- High insulin levels result in additional fat storage around the belly, contributing to obesity and weight gain.
- Excess weight gain also increases the risk of diabetes and hormonal imbalances, worsening PCOS.
- It is important to lead an active lifestyle with a healthy diet to reduce the risk of developing diabetes and other metabolic conditions.