Metabolic Health
Reviewed by

Shifa Fathima

What is the link between PCOS and Insulin Resistance?

One type of diabetes can occur due to a condition called insulin resistance. Insulin resistance can often be the cause and the consequence of diabetes. Type 1 and type 2 diabetes come with an array of symptoms, causes, and issues, and that can affect a person in several different ways. Effective management of diabetes and its symptoms is critical because it is known to create havoc among multiple body organs in the later stages, especially if proper care is not taken in the early stages. The heart, lungs, kidneys, feet, eyes, and many other parts of the body can deteriorate as a result of diabetes. Frequent bouts of high blood sugar levels and several episodes of lows can suck the life and energy out of the body parts resulting in issues. 

Another area that commonly witnesses a problem as a result of the mismanagement of the symptoms of diabetes would be related to hormones. Thyroid, PCOS, etc are some of the hormonal disorders that are commonly seen with diabetes. Since insulin is a hormone, if there is insulin resistance, it is likely that other hormonal aspects in the body might also be affected. PCOS and insulin resistance may have a much stronger link than expected.

The link between insulin resistance – PCOS is a reciprocal one. This means that irrespective of which condition comes first, the other one would have a very high likelihood of occurrence. For example, people with PCOS reportedly have insulin resistance and people have a low tolerance to insulin might also have an underlying PCOS-related issue. 

Reports and studies have shown that approximately 30-40% of the women who have been diagnosed with polycystic ovary syndrome or PCOS also have insulin resistance. In other words, this means that they would also have higher blood sugar levels that would be much more likely to develop prediabetes or type 2 diabetes. Insulin resistance is often known to be at the root of PCOS. It plays a major role in causing the condition and can also impact and aggravate the symptoms of PCOS. 

Many doctors and gynecologists do not acknowledge the role that insulin as a hormone plays in the development and sustenance of the symptoms of PCOS. Every woman who has been diagnosed with PCOS must be screened for insulin resistance to understand its role and to be able to effectively manage and mitigate the symptoms of both the conditions. 

What is Insulin Resistance?

To understand how insulin resistance - PCOS may impact each other, it would first be necessary to look at them separately. In a person with good levels of insulin sensitivity, the secretion of the hormone (insulin) happens after eating. The liver and the muscles are then stimulated to take up the sugar and glucose from the blood to convert them into energy. This results in the optimal maintenance of blood sugar levels and also insulin levels.

Insulin resistance is a condition wherein the body does not respond and react to using insulin as effectively or quickly as it should. Even if insulin is produced in the body, it will not be used to the optimal level leaving the overall blood sugars much higher than they should be. This particular phenomenon also leaves the person feeling drained and low in energy along with the high blood sugar levels in the body. In case this goes undiagnosed or untreated, as time passes, more and more amounts of insulin would be required in the body to deal with the glucose molecules that are present in the bloodstream. The body then begins to deal with sugar in a different manner and the constant high levels might lead to the diagnosis of diabetes. The excessive production of insulin by the pancreas due to the resistance will lead to inflammation and weight gain. 

PCOS and Insulin Resistance

PCOS is a completely endocrine condition and metabolic disorder. It not only affects the ovaries and ovulation but also plays an important role in the maintenance of proper levels of hormones in the body and the overall endocrine functioning. PCOS and insulin resistance are highly interconnected as the latter is often known to be the underlying physiological driver of PCOS. It is a key feature that may result in the different types of PCOS – obese and lean. Statistics reveal that insulin resistance occurs in around 70-95% of people with obese PCOS and in around 30-75% of the women with lean PCOS. 

The relationship between the two is correlated as high levels of insulin might not just be a symptom of PCOS but might also be the cause and driving factor. How this works is that high insulin levels might impair the process of ovulation and can result in the ovaries producing extra testosterone. The question ‘can PCOS cause diabetes?’ can also be answered here - due to the higher levels of insulin, an individual might be more likely to develop type 2 diabetes. PCOS is also related to an increase in body weight and fat, and eventually obesity. 

Book a Free Session

Insulin Resistance & PCOS treatment

Both these conditions first need to be tested to see how they are interconnected and how they might be affecting one another. Essentially, the diagnosis of PCOS would result in several follow-up tests to understand the level of insulin resistance present in the individual. This will help determine the course of action and proper steps can be taken to deal with both the conditions depending on the severity. Precautionary and preventive measures can also be taken after proper testing and that would play an important role in the treatment. 

Conventional treatment would involve making some drastic but important changes in lifestyle. The insulin resistance PCOS treatment would primarily include exercise and dietary changes.

Exercise and physical activity to promote weight loss is one of the first things suggested by any doctor to deal with these conditions. Any form of aerobic exercise, cardio, yoga, etc would be recommended

Medication – Meds to improve insulin sensitivity can be another common course of treatment that is seen with these conditions. Oral contraceptives are also, at times, prescribed as a treatment for PCOS. However, these can hinder the regulation of sugar in the body and can cause insulin resistance. 

Diet changes – This is recommended for PCOS, but is a much more important factor to maintain the blood sugar levels in the body and keep the insulin levels in check. To not let insulin resistance develop into diabetes would be primary.

Role of Fructose in Insulin Resistance?

PCOS and type 2 diabetes might be highly connected. Here, the role of fructose comes into play. Therefore, one of the first things to incorporate as a form of dietary restriction would be to limit the intake of fructose. Dieticians advise against the consumption of high amounts of fructose. For example, lower levels of fructose that one can get from fruits in the form of natural sugars might not be a problem and might also be beneficial. However, consumption of desserts, cakes, sugary drinks, etc has a very different effect on the body. High doses of fructose can overwhelm the processing pathways in the small intestine. This fructose, upon reaching the liver, can cause inflammation and impair insulin sensitivity.

Nutritional Supplements for IR and PCOS

To deal with these conditions better, there are different supplements that can be taken under the advice of a doctor. 

Inositol – This is an intracellular messenger that is involved in insulin signaling and can be eaten as a nutritional supplement. It is known to improve insulin resistance and can also regulate menstrual cycles in women. It is known to play a role in enhancing the process of ovulation and can induce metabolic changes in PCOS. This would work well for treating insulin resistance PCOS. 

Magnesium – It works to correct and improve the deficiency of magnesium in the body that may be contributing to increased insulin resistance and heart disease. Magnesium, zinc, calcium, and vitamin D improve insulin metabolism in people with PCOS.

Bottomline

Conditions that affect the hormones like PCOS and insulin resistance are comorbidities that often appear together. If one is diagnosed, it would be potent to test for the other for effective management. The link between these is pretty strong and treatment of both would prevent the full-blown occurrence of diabetes. Diet, exercise, weight management, and nutritional supplements would be important in the effective treatment and alleviation of symptoms.

References

  • https://helloclue.com/articles/cycle-a-z/the-link-between-pcos-and-insulin-resistance

Was this post helpful?

+91 -
Book Free Consultation