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PCOS and Diabetes: What Women Need to Know


Amy Rushlow

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Woman Talking to Doctor

Flip a coin. Heads or tails? If you’re a woman living with polycystic ovarian syndrome (PCOS), your odds of developing diabetes may be about the same as a coin flip. More than half of women with PCOS will develop prediabetes or diabetes by age 40.

What Is PCOS?

A woman’s ovaries have small sacs called follicles. Normally, they hold eggs and release them when the eggs are mature. But with PCOS, these follicles bunch together, creating cysts. Eggs develop, but they aren’t let go.

Making healthy lifestyle choices is key to managing type 2 diabetes, but it can be hard to stay on track. Dr. Anthony Cardillo explains that focusing on diet, exercise and stress reduction can help you maintain control of your diabetes.

Medical Reviewer: William C. Lloyd III, MD, FACS Last Review Date: Aug 13, 2015

2017 Healthgrades Operating Company, Inc. All rights reserved. May not be reproduced or reprinted without permission from Healthgrades Operating Company, Inc. Use of this information is governed by the Healthgrades User Agreement.

In women with PCOS, the ovaries make too many androgens (male hormones such as testosterone). The androgens affect normal egg development and release.

PCOS affects between 5% and 10% of women of childbearing age. Experts don’t know what causes it, but they suspect genetics may be involved.

PCOS Symptoms and Diagnosis

PCOS is the most common cause of infertility in women. Common symptoms include:

  • Anxiety

  • Dandruff

  • Thinning hair or hair loss

  • Obesity or weight gain

  • Unusual hair growth on the face, toes, thumbs, belly, chest, or back

  • Depression

  • Heavy, sustained bleeding during periods

  • Irregular or infrequent periods, or missing periods

  • Lack of ovulation, leading to infertility

  • Painful periods

  • Oily skin or acne

  • Pain in the pelvic area

  • Sleep apnea, a condition in which breathing stops during sleep

To diagnose PCOS, your health care provider will look at your medical history and do a physical exam. He or she will also do a pelvic exam or vaginal ultrasound to check your ovaries. You may have a blood test to check your hormones, insulin, and blood glucose.

The Link Between PCOS and Diabetes

Several published large studies clarify the relationship between PCOS and diabetes. One study published in Diabetes followed 225 Italian women with PCOS for up to 17 years. By the end of the study, nearly 40% developed diabetes. Only about 6% of healthy Italian women of the same age have diabetes.

In another study, Swedish researchers looked at 87 women without PCOS and 84 with PCOS. After 14 years, 21% of PCOS patients developed diabetes, compared to 4.5% of those without the condition.

Overall, women with PCOS have a 3- to 7-fold higher diabetes risk. PCOS patients who are obese, or have a large waist circumference, are especially at risk Why is diabetes so common in women with PCOS? Some evidence suggests that high androgen hormones may be a result of an underlying metabolic problem. The same metabolic problem could be related to diabetes.

High androgens might also cause insulin resistance, which can lead to diabetes. Research shows that giving androgens to healthy women leads to insulin resistance. On the other hand, blocking androgens improves insulin sensitivity.

Do You Need a Diabetes Test?

You should be screened for diabetes if you have PCOS and one of the following:

  • A family history of type 2 diabetes

  • Acanthosis nigricans, a skin condition that causes darker, thicker skin on some areas of your body

  • High levels of androgen hormones and no ovulation

  • Obesity (a BMI greater than 30)

The guidelines above are general recommendations from the American Society for Reproductive Medicine. Your health care provider may suggest a different plan.

Treating Diabetes and PCOS

The primary treatment for women with diabetes and PCOS is a healthy diet and lifestyle. Eat plenty of lean meats, fruits, vegetables, and whole grains. Limit sugars and processed foods. A healthy eating plan lowers blood glucose levels and helps your body use insulin.

Was this helpful? (7)
Medical Reviewers: William C. Lloyd III, MD, FACS Last Review Date: Mar 25, 2016

© 2016 Healthgrades Operating Company, Inc. All rights reserved. May not be reproduced or reprinted without permission from Healthgrades Operating Company, Inc. Use of this information is governed by the Healthgrades User Agreement.

View Sources

Medical References

  1. Fauser BC, et al. Consensus on Women’s Health Aspects of Polycystic Ovary Syndrome (PCOS): The Amsterdam ESHRE/ASRM-Sponsored 3rd PCOS Consensus Workshop Group. Fertility and Sterility. 2012;97(1):28-38.e25.
  2. American Diabetes Association. Standards of Medical Care in Diabetes—2013. Diabetes Care. 2013; 36(Suppl 1): S11–S66. 
  3. Gamberini A, et al. Polycystic Ovary Syndrome Is a Risk Factor for Type 2 Diabetes. Diabetes. 2012;61(8):2369-74. 
  4. Hudecova M, et al. Diabetes and Impaired Glucose Tolerance in Patients with Polycystic Ovary Syndrome—A Long Term Follow-Up. Human Reproduction. 2011;26(6): 1462-68. 
  5. Acanthosis nigricans. American Academy of Dermatology.
  6. Infertility FAQs. Centers for Disease Control and Prevention.
  7. Weight Loss. American Diabetes Association.
  8. Polycystic Ovarian Syndrome (PCOS). American Diabetes Association.
  9. Wang ET, et al. Polycystic Ovary Syndrome and Risk for Long-Term Diabetes and Dyslipidemia. Obstetrics and Gynecology. 2011;117(1):6-13. 
  10. Metformin.  MedlinePlus, U.S. National Library of Medicine.
  11. Polycystic ovary syndrome (PCOS) fact sheet. U.S. Department of Health and Human Services, Office Of Women’s Health.

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