Why Does Polycystic Ovary Syndrome Affect Glucose?

Why Does Polycystic Ovary Syndrome Affect Glucose?

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Polycystic ovary syndrome may increase a woman's risk for type 2 diabetes.

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Polycystic ovary syndrome is a disease with many faces. In its classic and full-blown form, it is characterized by menstrual irregularities, abdominal obesity, infertility, high male hormone levels and multiple ovarian cysts. However, other forms of PCOS have been described in which ovarian cysts are not present, menstruation is more regular, body weight is normal or hormonal imbalances are not as severe. In women with PCOS, other metabolic abnormalities, such as elevated blood glucose, are also common.

Insulin Resistance

Sixty to 80 percent of all women with PCOS are insulin resistant, although the reasons for this are not clear. Insulin is a hormone produced by your pancreas whenever your blood glucose rises. Its primary function is to drive the glucose from your bloodstream into your cells, where it can be metabolized for energy. If your cells don't respond to insulin as they should, your blood glucose edges upward and your pancreas must release more insulin to keep your glucose at a normal level. Insulin resistance is a risk factor for type 2 diabetes and heart disease.

Obesity May Contribute

Insulin resistance is not exclusive to women with PCOS. Metabolic syndrome -- a pre-diabetic condition -- type 2 diabetes and obesity are characterized by insulin resistance, as well. While the obesity that is often associated with PCOS may contribute to insulin resistance, many women who have PCOS but who are not obese are still insulin resistant. Thus, insulin resistance in PCOS is at least partly due to other factors that may be specific to women who are affected by this disorder.

Disabled Muscular Absorption

Your liver, muscles, brain and fat tissue are metabolically active and require high levels of glucose to accomplish their functions. Normally, glucose uptake in these tissues is facilitated by high concentrations of cellular receptors and signaling molecules. A study published in the March 2009 issue of the “Biochemical Journal” demonstrated a defect in one of three important signaling molecules in the muscles of women with PCOS. This cellular defect reduces your muscles' ability to respond to insulin, impairs glucose uptake and increases your blood glucose level. It is not clear why insulin signaling molecules are altered in women with PCOS, nor is it yet clear if this same defect is present in other tissues and organs of affected women.

Improving Insulin Sensitivity

Infertility, irregular menstrual cycles and a heightened risk for type 2 diabetes and cardiovascular disease are among the issues faced by women with PCOS. Insulin resistance and elevated blood glucose contribute to these problems by triggering inflammation in tissues throughout your body. Insulin sensitivity can be improved with exercise, which increases muscular uptake of glucose. However, exercise alone may not be sufficient for addressing insulin resistance in women with PCOS. Metformin (Glucophage), a medication that decreases glucose production in your liver and improves insulin sensitivity in other tissues, is frequently prescribed for women who have PCOS. Metformin has been shown to reduce blood glucose levels, regulate menstrual cycles, improve fertility and help maintain pregnancies in some women with PCOS. Your doctor will determine if metformin is appropriate for you.


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