PCOS and Insulin Resistance

Risk of diabetes runs high if left untreated

Insulin is a hormone that is produced by the pancreas, a gland in the abdomen responsible for digestion and blood sugar regulation. Insulin is typically secreted in response to large amounts of sugar (glucose) in the blood. Once produced, insulin helps converts glucose into energy and thereafter stores it in your muscles, fat cells, and liver for later use.

Women with polycystic ovary syndrome (PCOS) frequently have insulin resistance, meaning that their bodies do not respond as quickly to the hormone. The sluggish response can cause glucose to accumulate in the blood and eventually change the way in which the body deals with sugar. Worsening insulin resistance can eventually lead to diabetes.

In women with PCOS, the risk of insulin resistance runs higher if you are over 40, overweight, have high blood pressure, live a sedentary lifestyle, and have high cholesterol. By and large, women of Hispanic, African American, or Native American origin are at higher risk of insulin resistance than either white or Asian women.

symptoms of insulin resistance
Illustration by Jessica Olah, Verywell

Symptoms of Insulin Resistance

Women with insulin resistance often have little, if any, symptoms. When they do, they are not unlike those experienced by any other woman with the condition. Symptoms may include:

  • Fatigue
  • Increased hunger or thirst
  • Cravings for sweets and salty foods
  • Frequent or increased urination
  • Tingling sensation in the hands of feet
  • Darkening of skin in the groin, armpits, or behind the neck

If experiencing these symptoms, your doctor will likely order blood tests to see how well your body deals with sugar. These include the fasting glucose level and glucose tolerance tests.

Tests Used to Diagnose Insulin Resistance

For a fasting glucose level, you would need to suspend eating and drinking at least eight hours before the test. After a blood sample is drawn and sent to the lab, a diagnosis can be made based on the following results:

  • Below 100 mg/dl is a normal result.
  • 100 mg/dl to 125 mg/dl is considered prediabetes.
  • Above 125 mg/dl can serve as a diagnosis of diabetes.

The glucose tolerance test also requires an eight-hour fast before the test can be performed. Upon arrival, your doctor will draw blood to use as a baseline reference. You would then be asked to drink eight ounces of fluid containing 75 grams of sugar. A second blood test would then be taken two hours later.

A diagnosis can be supported based on the following comparative values:

  • Prediabetes is defined as a fasting blood glucose of 100 mg/dl to 125 mg/dl followed by a blood glucose of 140 mg/dl to 199 mg/dl at two hours.
  • Diabetes is defined as a fasting blood glucose of 126 mg/dl to higher followed by a blood glucose of 200 mg/dl or higher at two hours.

Normally speaking, blood sugar will return to normal within three hours. The failure to do so is generally indicative of insulin resistance.

What to Do If You Have Insulin Resistance

If you are diagnosed with insulin resistance, there is a lot you can do to reverse the condition. In some cases, medications like metformin may be prescribed to help you better control your blood sugar levels.

Lifestyle changes can also help whether you are prescribed medications or not. These include:

  • A healthy diet rich in lean meat, high-fiber grains, vegetables, legumes, leafy greens, and fruit (ideally designed in consultation with a nutritionist)
  • Exercise of at least 30 minutes per day performed three times per week
  • Stopping smoking and reducing alcohol intake
  • Ample rest and stress management training to better manage insulin levels
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Article Sources

  • Rojas, J.; Chavez, M.; Olivar, L. et al. "Polycystic Ovary Syndrome, Insulin Resistance, and Obesity: Navigating the Pathophysiologic Labyrinth." International Journal of Reproductive Medicine. 2014; article ID719050: DOI: 10.1155/2014/719050.s