PCOS And Diabetes: What's The Link?
Insulin resistance and obesity are common factors in both disorders.
September 13, 2021
Here’s a stat that may stop you in your tracks: More than half of women who develop polycystic ovary syndrome (PCOS) will go on to develop type 2 diabetes by the age of 40, according to The Centers for Disease Control (CDC). If you’ve recently been diagnosed with polycystic ovary syndrome, you probably have questions about PCOS and diabetes, and what you can do to prevent developing another chronic condition.
Read on for more information, including:
- What is PCOS (polycystic ovary syndrome)?
- What are the symptoms of PCOS?
- Does PCOS cause diabetes?
- How are blood sugar and obesity related to PCOS?
What is PCOS (polycystic ovary syndrome)?
If you’ve been trying to get pregnant and are struggling with infertility, you may have come across PCOS. Why? It happens to be the most common cause of female infertility, affecting up to 12% of women during their reproductive years. And while it’s mostly talked about in the context of reproductive health, researchers have found it’s also a risk factor for type 2 diabetes.
PCOS is a hormonal disorder that causes infrequent or longer-than-usual menstrual cycles, as well as increased production of male sex hormones (known as androgens). While doctors don’t yet know what causes PCOS, they have been able to link it to infertility when follicles fail to release an egg during ovulation. When ovulation doesn’t occur, ovaries may develop several small cysts (hence the name “polycystic”) that produce an abundance of androgens that women don’t typically have. This overproduction of androgens can, in turn, mess with your menstrual cycle — making it longer or heavier than a typical one. (Note: You can still have PCOS without the fluid-filled cysts.)
What are the symptoms of PCOS?
Symptoms of PCOS can vary, but there are a few telltale signs. While you may not experience all of these, most women with PCOS experience at least two of the following symptoms:
- Irregular menstrual cycles
- Longer-than-usual menstrual cycles
- Enlarged ovaries or the presence of ovarian cysts
- Excess body hair (thanks to the increased production of those male sex hormones)
- Unexplained weight gain, especially around your middle
- Increased acne or other skin issues (like skin tags)
If you’re experiencing these symptoms, talk to your doctor about the possibility that you may have PCOS. A diagnosis is typically made through a series of exams, which can include a pelvic exam (to examine the health of your reproductive organs), ultrasound (to check for cysts), and blood work (to test for high androgen levels).
Does PCOS cause diabetes?
Now that we have a clear understanding of what polycystic ovary syndrome is, we can bring this back to PCOS and diabetes. A landmark 2017 study in the Journal of Clinical Endocrinology & Metabolism found that women with PCOS were four times more likely to develop diabetes compared to those who did not have PCOS. While this link is compelling, researchers aren’t yet able to pinpoint causality, so we can’t say PCOS causes type 2 diabetes or that type 2 diabetes causes PCOS.
PCOS and diabetes — the obesity factor
What we do know is that there is a connection between PCOS and diabetes, possibly through a common risk factor: obesity.
- Women with PCOS are more likely to be obese, which may be because those excess male hormones can cause weight gain.
- Excess weight and obesity are known risk factors for diabetes. Women with a BMI in the 30s are at 100% greater risk of developing type 2 diabetes than their counterparts with a normal BMI, according to one study.
PCOS is also linked to an increased risk of insulin resistance, a hallmark of diabetes, which occurs when your body is unable to use insulin effectively to move sugar out of the bloodstream.
How are blood sugar and insulin resistance related to PCOS?
To understand the role that blood sugar plays in PCOS, we have to talk a bit more about insulin resistance. Insulin is a hormone released by the pancreas after your body digests carbohydrates, which are broken down into sugars that make their way into your bloodstream. Insulin is produced to get that sugar out of your blood and into your cells for energy or store it in the liver for later use. When your body is constantly bombarded with more sugar than it needs or can handle, your pancreas responds by producing more and more insulin — to the point where your cells simply stop responding well to it. This is called insulin resistance.
The end result is that more sugar stays in your blood than is healthy and you have higher-than-necessary levels of insulin floating around, which causes you to gain weight and have chronically high blood sugar. Over time, this may spur the development of full-blown diabetes.
Insulin resistance happens to be a key attribute of PCOS in women who are overweight and even those who aren’t. While insulin resistance is a symptom of PCOS, it may also be what’s driving the disorder, as high insulin can impair ovulation. This creates a vicious cycle that can be hard to break.
Being proactive if you have PCOS
Women diagnosed with PCOS should be proactive about getting their blood sugar tested, ideally via an A1C test. Lifestyle modifications should be planned and adhered to, including adoption of a healthier diet, regular exercise, stress reduction, and adequate sleep — all aimed at preventing the onset of type 2 diabetes. Similarly, diabetics should concentrate on all aspects of their health, including blood sugar management and weight control, and be cognizant of potential symptoms of PCOS.
There’s enough compelling research to strongly suggest a link between PCOS and diabetes, even if we’re not yet clear on the why. Because we know that the majority of women with PCOS have insulin resistance, which is a common factor in the development of diabetes, if you have either condition, you should be on the lookout for how it may impact the other. For instance, if you have type 2 diabetes and are struggling to get pregnant, talk to your doctor about testing you for PCOS. If you have PCOS but no diagnosis of diabetes, be proactive about taking steps to prevent its development, with the help of a healthcare professional.