PCOS and Diabetes: What Risk Does Insulin Resistance Carry For Women? 


I always knew diabetes would come for me.

My father had diabetes, and my grandmother before him. With a pretty strong genetic predisposition, it was just a matter of when I’d start showing symptoms. 

But before I could even hit adulthood to experience diabetes symptoms, its younger sister, PCOS came for me. With over 10 million people living with some form of it across the world, I couldn’t say I was surprised. 

But even with these alarming statistics in play, and the high volume of PCOS awareness campaigns, there is still a lot of conflicting opinions, and even social stigma surrounding it. 

But I have learnt the hard way that the right information can act as a great weapon that one can use to cut through the noise of misinformation and find reliable guidance. 

PCOS is a condition that can affect the whole body and when left unchecked, can lead to insulin resistance and/or much-dreaded diabetes. 

But What Exactly Causes PCOS? 

Most people treat PCOS merely as a lifestyle disease – a result of poor nutrition, or a sedentary lifestyle. But there are also emerging studies that consider it as a metabolic malady that could be caused by other factors like genetics, environment, chronic inflammation or even poor immunity. 

Whether I’d chalk up my PCOS to poor lifestyle, genetics, or something else altogether, the impact on my health has been massive. Symptoms such as poor mental health, reduced energy, and irregular menstrual cycle were the first signs. 

And like most women, I took these in my stride until I started experiencing more obvious and problematic symptoms like gaining weight, losing hair, and missing an entire menstrual cycle. 

But the moment I sat down with my gynaecologist, she had an answer for me – PCOS. The tests soon revealed that I had met the three necessary criteria for this diagnosis, such as having an ovary with multiple small cysts, some form of ovulatory dysfunction, and excessive secretion of the male hormone androgen.  

The Connection Between Insulin and PCOS

Soon after my diagnosis, my doctor put me on metformin – a common diabetes medication that can help in regulating the insulin levels in the body, thus helping with PCOS management. 

In a normal healthy body, insulin increases after eating to encourage the breakdown of consumed sugars and starch and its conversion into energy. As soon as this process is complete, the insulin levels will become low again. Normally, both blood sugar and insulin levels will be low during a fasting blood test. 

But in those with PCOS, blood sugar may be normal, but insulin stays high. This is because the body needs the pancreas to work harder and make more insulin to initiate the breakdown of sugars. But the other side is that this increased amount of insulin in the body can lead to inflammation and weight gain. 

But as a young girl of 20 being diagnosed with PCOS, I was bombarded with advice that threw me off track. I was advised to try everything from acupuncture to naturopathy to fix my PCOS. Making lifestyle changes and being more active helped did help in losing weight, but I was still experiencing extreme period irregularities. 

And soon enough, I started experiencing other symptoms that seemed unrelated – extreme hunger and thirst pangs. Only after extensive research is when I realised that I could be experiencing insulin resistance, and this is the reason why I was put on metformin in the first place. 

5 years after my initial diagnosis and many kilos and treatment approaches later, I’ve found an endocrinologist who could truly help me understand my PCOS, the many contributing factors associated with it, and the risk of improper management tactics. 

What Happens When PCOS and Insulin Resistance Is Too Far Gone?

While I have managed to change my lifestyle to better manage my PCOS, I am far from having it under control, or safe from eventually developing diabetes. Research from 2017 suggested that those with PCOS are four times more likely to develop type 2 diabetes. And this statistic is what often keeps me up at nights, while I’m still struggling to find management tactics that are just right for me. 

PCOS is a primarily hormonal condition, affecting even the production of the insulin hormone. When insulin production is disrupted, it can eventually lead to dreaded complications like diabetes. 

Obesity and poor nutrition are only risk factors for PCOS and not a cause. The condition is affecting women across all health conditions and lifestyles. Therefore, the conversation regarding PCOS mustn’t be restricted to a particular group of people. Women across ages, and health status, should do regular PCOS and diabetes screenings, to rule out these conditions. 

Without preventive care, PCOS can become too far gone, and lead to severe diabetes, as well as other conditions like diabetes and even heart conditions. 

But since the initial symptoms of diabetes are mild, there is a chance that it could go undiagnosed, until it’s way too late. This is why it is important to raise awareness about PCOS, and it’s risk factors. Only regular screening and ample information can help in early diagnosis and effective management. 

My personal history with being diabetes-prone is the only reason why I was tuned into what was happening within my body, and this is what helped in my diagnosis. Even after an early diagnosis, it took me years to find practices that can help in being healthier. 

Summing up….

With PCOS, even drastic lifestyle changes are not enough to reverse the condition and prevent diabetes. PCOS management and diabetes prevention can only happen when good nutrition, physical activities, and other preventive practices like constant screening comes together. 

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