Women With PCOS Have A Higher Risk Of Developing Type 2 Diabetes (T2D)

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Polycystic Ovary Syndrome or PCOS has become a pervasive problem in India, affecting up to 22.5 percent of women in the reproductive age group. As PCOS involves hormonal imbalances, including higher amounts of hormones such as testosterone and androgen, it can give rise to a variety of symptoms and complications, including irregular or missing menstrual periods, weight gain, acne, hirsutism or excessive facial and body hair growth, and infertility. While managing PCOS and these symptoms can be challenging itself, women with PCOS must also take steps to protect against a higher risk of diabetes.

Evaluating The Risk Of Diabetes In PCOS

The relationship between PCOS and type-2 diabetes is not fully understood, but there are some things that we do know for sure. Both conditions have a common set of risk factors, including obesity, sedentary lifestyle, and highly processed diets, but research shows that PCOS is an independent risk factor for type-2 diabetes. In fact, research indicates that women with PCOS have a four times higher risk of developing type-2 diabetes as compared to women without PCOS. Moreover, women with PCOS tend to develop diabetes or prediabetes at an earlier age, with more than half developing diabetes before the age of 40.

Why Does PCOS Increase The Risk Of Type-2 Diabetes

The hormonal balances associated with PCOS, such as increased levels of testosterone, don’t just cause symptoms like irregular menstruation, hirsutism, and weight gain. They also stimulate increased insulin production, which then leads to insulin resistance and hyperinsulinemia. In fact, insulin resistance is regarded as one of the underlying physiological imbalances in most cases of PCOS. Under normal circumstances, insulin helps to lower blood sugar levels by storing glucose in cells. When insulin levels are constantly elevated, cells become more resistant to insulin and they require higher levels of insulin to lower blood sugar. As this resistance continues over time, it results in both high insulin and high blood sugar levels, which are responsible for the development of prediabetes or type-2 diabetes. 

Insulin is also described as a fat storage hormone that influences the fat building process. Insulin aids the absorption of glucose, but any excess glucose is converted into fat. If blood glucose levels remain high, this can result in increased accumulation of fat and weight gain. In addition to stimulating the creation of new fat cells, our bodies are also encouraged to retain this fat and fat burning is reduced. The relationship of PCOS with obesity is therefore bi-directional, with obesity increasing the risk of PCOS, and insulin resistance linked to PCOS further contributing to weight gain. Obesity itself is also a major risk factor for type-2 diabetes. 

Studies show that insulin also affects the ovaries and adrenal glands, triggering increased production of androgen and testosterone. This in turn produces PCOS symptoms, such as increased hair growth on the face and body. The complex interrelationship between PCOS, insulin resistance, and diabetes, therefore leads to a vicious cycle. 

What Can You Do To Lower Your Risk Of Type-2 Diabetes?

Although PCOS is regarded as an independent risk factor for diabetes, research shows that BMI and fasting blood glucose levels are the best predictors to assess one’s risk of developing type-2 diabetes with PCOS. Weight loss and blood sugar control are therefore effective strategies to protect against the risk of diabetes linked to PCOS. In addition to learning about diabetes symptoms, it’s important to treat PCOS and undergo regular monitoring of blood sugar levels. PCOS management strategies such as increasing physical activity levels and reducing the intake of processed foods, will not only help to control PCOS, but they also help with diabetes risk reduction.

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