Do women with PCOS have a higher diabetes risk?

Question

Hi doctor,

I am a 40-year-old woman who is currently overweight and was recently diagnosed with type 2 diabetes. My latest labs show an A1C of 8.2 percent and a fasting glucose of around 160 mg/dL. I also have PCOS and experience acne.

I am curious to know if women with PCOS are at a higher risk of developing diabetes. Additionally, I would like guidance on which diabetes medications are considered safe and effective if I am planning to conceive in the next few years.

Thank you for your time and advice.

Answer 1

Hi,

Welcome to icliniq.com.

I understand your concern.

Women with PCOS are more likely to acquire type 2 diabetes since insulin resistance is frequent in both illnesses. Your HbA1C of 8.2 percent and fasting glucose of 160 mg/dL suggest that your blood sugar is currently not under control, which is especially essential if you plan to conceive in the future.

Metformin is commonly used as the first-line treatment for women with PCOS and type 2 diabetes. It increases insulin sensitivity, regulates menstrual cycles, and promotes ovulation, making it very beneficial for women attempting to conceive. Metformin is also deemed safe in early pregnancy and may minimize the risk of miscarriage in women with PCOS.

If blood sugar levels remain above target after taking Metformin alone, additional drugs such as GLP-1 receptor agonists (e.g., Semaglutide) can be investigated, though these are generally not indicated during pregnancy or when trying to conceive. In some circumstances, insulin therapy may be required, especially if glucose levels remain elevated or during pregnancy.

I hope this information was helpful.

We appreciate your comments and use them to make patient care better.

Thanks.