Polycystic Ovary Syndrome (PCOS) is a condition often associated with insulin resistance. A significant majority of women, whether overweight, obese, or of normal weight, who display fat accumulation around the waist (male-type fat distribution) are found to have insulin resistance. This situation leads to the appearance of insulin resistance symptoms, which are linked to waist circumference thickness. This type of fat accumulation, seen in both thin and overweight women, is one of the indicators of insulin resistance. Progression of insulin resistance leads to impaired glucose tolerance and the development of type 2 diabetes.
In women with PCOS, insulin resistance often progresses rapidly from adolescence. Therefore, impaired sugar tolerance and diabetes may manifest at younger ages. Changes in dietary habits can further accelerate this process. Nowadays, the shift from protein-heavy diets to carbohydrate-heavy ones along with adopting a sedentary lifestyle increases the risk of insulin resistance.
In individuals with insulin resistance, the pancreas produces more insulin to balance this condition, leading to elevated circulating insulin levels (hyperinsulinemia). Insulin resistance can be widespread across all subgroups of PCOS, standing out as an important factor affecting the course of the disease.
Accurately assessing insulin resistance in women diagnosed with Polycystic Ovary Syndrome (PCOS) is critically important for managing and treating the disease. In some cases, incorrect diagnoses can be made based on fasting blood sugar and insulin measurements, causing unnecessary worry and panic by being told "you have insulin resistance" to individuals who do not have it.
For the most accurate evaluation of insulin resistance in women with PCOS, alongside fasting measurements, post-75 gram glucose loading test or postprandial 120th-minute blood sugar and insulin level measurements can provide more reliable results.
Polycystic Ovary Syndrome (PCOS) is not just a reproductive health issue but also a disease with significant impacts on overall health. The strong relationship between insulin resistance and PCOS indicates that this condition also brings an increased risk of cardiovascular disease and type 2 diabetes. Thus, treatment of PCOS should not only target anovulation and hyperandrogenism but also focus on managing the metabolic syndrome.
Patients with PCOS, even if they are young, should be thoroughly evaluated for components of the metabolic syndrome. This comprehensive clinical assessment should include parameters such as blood pressure measurement, waist circumference measurement, body mass index (BMI) calculation, fasting lipid profile, and a 2-hour oral glucose tolerance test. Advanced investigations, such as C-Reactive Protein (CRP) and homocysteine levels, should also be considered to explore cardiovascular risk factors.
Coping with Insulin Resistance: The Role of Lifestyle Changes
In the treatment of Polycystic Ovary Syndrome (PCOS), lifestyle changes targeting insulin resistance are of great significance. A healthy diet and regular physical activity increase insulin sensitivity, ensuring hormonal balance and contributing to relieving PCOS symptoms. Opting for foods with a low glycemic index prevents sudden fluctuations in blood sugar, reducing the risk of hyperinsulinemia.
Exercise is a natural method that reduces insulin resistance by increasing the muscles' insulin usage capacity. At least 150 minutes of moderate-intensity exercise per week helps women with PCOS maintain their metabolic health. Additionally, achieving an ideal body weight or keeping weight under control is a fundamental step in combating insulin resistance.
Drugs that increase insulin sensitivity, such as Metformin, are widely used in PCOS treatment and help regulate glucose metabolism.
Considering the link between Polycystic Ovary Syndrome and insulin resistance, it becomes necessary to evaluate these two conditions together. A treatment approach that considers not only reproductive health but also long-term cardiovascular and metabolic risks should be adopted.
Frequently Asked Questions
What are the consequences if insulin resistance in PCOS is not treated?
Untreated insulin resistance increases the risk of type 2 diabetes, hypertension, cholesterol imbalances, and cardiovascular diseases over time. Ovulation disorders related to PCOS may intensify, and symptoms such as hirsutism and acne can worsen. These metabolic disorders can lead to serious health problems at an early age.
Can thin women develop insulin resistance?
Yes, thin women can also have insulin resistance. If there is male-type fat accumulation around the abdomen, this could be an indicator of insulin resistance. Therefore, not just weight, but also body fat distribution should be carefully assessed.
Does everyone diagnosed with PCOS have insulin resistance?
Not every PCOS patient may have insulin resistance, although it is generally seen in a significant majority. Hence, individual-specific evaluations should be conducted, supporting the diagnosis with detailed tests such as fasting and postprandial insulin levels. Tests should be conducted under the supervision of an expert doctor to prevent unnecessary diagnoses.
What is the link between PCOS and insulin resistance?
PCOS involves metabolic imbalances along with hormonal disorders. Insulin resistance causes more insulin to be produced in the body, which in turn increases androgen production in the ovaries, exacerbating the symptoms of PCOS. This mutual interaction can complicate the disease's progression. Management of PCOS requires a multifaceted approach that considers insulin resistance.