Introduction:
Polycystic ovarian syndrome (PCOS) is a condition related to endocrine gland problems. This condition occurs among women. This condition may pose a risk of developing type 2 diabetes. This issue is mainly characterized by irregular menstrual cycles among women. The cause of this condition is a hormonal imbalance. PCOS develops throughout adolescence.
What Is PCOS?
PCOS is a condition characterized by an imbalance of reproductive hormones. PCOS can be observed among 1 in 10 childbearing-age women. In such women, irregular menstrual cycles are common. Another characteristic feature is increased levels of androgen in the body.
In PCOS, small fluid-filled sacs are developed at the outer edge of the ovary. These sacs are called cysts. These sacs usually contain immature eggs. These are called follicles. These follicles fail to release eggs.
Symptoms of PCOS include:
Irregular Menstrual Cycles: Women experiencing fewer monthly cycles may struggle to become pregnant.
Increased Androgen: This may lead to excess hair growth on the face and body. This issue is called hirsutism. Sometimes, severe acne and baldness may be observed.
Polycystic Ovaries: In such ovaries, follicles may be present. Ovaries do not work as they should.
The symptoms of PCOS, especially among obese women, may be severe.
Healthy ovaries tend to release eggs every month. When the problem is related to the ovary, like in PCOS, it may affect fertility and the normal menstrual cycle. PCOS is considered the main cause of ovulatory infertility in women.
The cause of PCOS is not known. Family history, diet, physical inactivity, and environmental toxins may be contributing factors to the development of PCOS. This condition may be associated with other health issues such as obesity, insulin resistance, high cholesterol, and high blood pressure.
What Is Insulin Resistance?
Insulin resistance is caused by insulin. Insulin is a hormone secreted by the pancreas. This hormone is responsible for the regulation of blood glucose levels. After consuming food, it is broken down to form glucose. Insulin helps the glucose in the bloodstream enter the cells. In the cells, the glucose gets converted into energy to power the body's functions.
Insulin resistance can be observed when insulin production is normal but cannot be used effectively. This leads to increased glucose levels in the blood compared to normal. This state causes the pancreas to secrete more insulin (hyperinsulinemia). If the pancreas cannot secrete more insulin to manage this type of situation, it may lead to type 2 diabetes.
According to an estimation, it was found that 44 % - 70 % of individuals with PCOS suffer from insulin resistance. A study found that enlarged fat cells, decreased serum adiponectin, and central abdominal weight are mainly responsible for insulin resistance among women with PCOS.
It was noted that increased weight in the belly area may increase insulin resistance risk. Adiponectin, which is a protein hormone produced by fat tissue, is found to help regulate insulin sensitivity and blood glucose levels.
What Are the Symptoms of Insulin Resistance Among Women With PCOS?
Women with PCOS may have insulin resistance, but symptoms may not be felt. They may have warning signs. These include,
Acanthosis Nigricans: In this condition, dark pigmentation and thickening of the skin occur, especially in the folds of the skin around the neck, groin, and armpits.
Hunger: Excessive hunger may be felt due to the rise of insulin levels.
Weight Gain: Insulin stores glucose in the liver and muscles. These glucose act as a fuel for the body to function. Extra glucose is stored as fat. This may lead to weight gain.
Symptoms of insulin resistance are the same for those with PCOS or without the condition.
These include,
Change in Appetite: Insulin is considered to stimulate the appetite. Hence, women with PCOS tend to eat and crave sweets and other carbohydrates. This may further lead to increased weight and cause other complications like cardiovascular diseases, obesity, osteoarthritis, and diabetes.
Prediabetes or Diabetes: Prediabetes may cause the risk of development of type 2 diabetes and other metabolic conditions. This prediabetic stage may last for long periods. Further, it may lead to increased thirst, frequent urination, and decreased energy. Diabetes may lead to reduced energy, vision loss, neuropathy, and vascular diseases.
What Is the Link Between Insulin Resistance and PCOS?
The condition PCOS is considered to be responsible for the development of diabetes among women with PCOS. Though the symptoms of PCOS appear earlier than the symptoms of insulin resistance, it is thought that insulin resistance plays a major role in the development of PCOS.
Increased insulin resistance may affect different individuals differently. This applies to women, even. All women with insulin resistance may not develop PCOS. Researchers have noticed that obesity, linked to insulin resistance, changes the function of the hypothalamus and the pituitary gland in the brain. This causes increased production of androgenic hormones, leading to PCOS. Increased levels of androgenic hormones are considered to be responsible for female infertility and ovarian dysfunction. This factor may or may not be related to PCOS.
Insulin resistance and PCOS both individually contribute to female infertility. Among individuals with PCOS, hormonal imbalance may result in anovulation. This means these women may not be able to produce or release eggs. The secondary cause may be the problem with the implantation of the embryo. Insulin resistance can result in miscarriage due to insufficient nutrition and support for the embryo.
PCOS may make the pregnancy more difficult. This may increase the risk of gestational diabetes and hypertension during pregnancy.
How to Diagnose Insulin Resistance Among Women With PCOS?
Lab tests do not diagnose insulin resistance. Since the procedure is invasive, it is done for research.
Some tests that are done during high blood glucose levels include,
Fasting Plasma Glucose (FPG): In this test, the blood is drawn during fasting (usually early in the morning before eating). FPG is considered normal when the blood glucose measured is 100 mg/dL. The FPG measured is 100-125 mg/dL; it is considered to be prediabetes. This state is at risk of developing type 2 diabetes. If FPG is above 126 mg/dL, then that condition is considered to be diabetes.
A1C: A1C is also called glycated hemoglobin (HbA1C). This test provides an average blood glucose level for 3 months. This test is done to know about prediabetes or diabetes. If the A1C is between 5.7 to 6.4 %, then it is considered to be prediabetes, and if it is above 6.5 %, it may be diagnosed as diabetes.
Oral Glucose Tolerance Test: In this test, if the blood glucose levels are between 140-199 mg/dL, it is considered prediabetes, and if the blood glucose levels are above 200 mg/dL, then it is considered diabetes.
Fasting and 2-Hour Insulin Levels: Increased insulin levels in this test suggest insulin resistance.
HOMA - IR (Homeostatic Model Assessment for Insulin Resistance): This can be calculated based on fasting glucose and insulin levels. If the values are above 2, it is considered insulin resistance. The reference range varies.
What Is the Treatment for Insulin Resistance in PCOS?
PCOS is not curable, but it can be treated. Insulin resistance should be treated to improve the symptoms of PCOS and prevent the condition called diabetes. A healthy lifestyle, dietary modifications, and physical activity improve insulin resistance.
Conclusion:
PCOS is a condition caused by hormonal imbalance. This may further cause insulin resistance among those women affected by PCOS. Hence, it becomes important to know the connection between PCOS and insulin resistance. Knowing about it helps in identifying the disease at the earliest. Early diagnosis always leads to effective treatment. This provides a good quality of life.
