If you have been diagnosed with PCOS, you may already know that it increases your risk to obesity, Type 2 Diabetes, and cardiovascular disease. But even if you don’t have clinical diabetes just yet, you should know about the connection between PCOS and pre-diabetes.
Pre-diabetes is a condition where blood sugar is already higher-than-normal levels. Pre-diabetes is accompanied by insulin resistance, increasing the risk factor for full-blown diabetes and related health complications. You have pre-diabetes if your fasting blood sugar level is 100-125 mg/dl, or a hemoglobin A1C level of 5.7-6.4%.
Pre-diabetes, or impaired fasting glucose (IFG), is rather common in women diagnosed with PCOS. That means PCOS is not something you should take lightly. At all. But how are PCOS, Pre-Diabetes and Diabetes Type 2 related? The answer – Insulin Resistance.
Studies have found that approximately 50-70% of all women with PCOS (Polycystic Ovarian Syndrome) may have some degree of insulin resistance. This insensitivity to insulin very likely contributes to excess male-sex hormones, which are responsible for the symptoms and signs of PCOS. In short, insulin resistance, PCOS and prediabetes are linked.
Insulin resistance happens when the body does produce insulin (unlike patients of Diabetes Type 1) which is necessary to turn sugars into energy, but this insulin is not efficiently used by the body. As a result, the extra sugars circulating in the blood lead to increased blood glucose levels. To cope with this, the body pumps out more and more insulin in an effort to normalize blood glucose levels, leading to hyperinsulinemia. Now this process triggers the ovaries produce more androgens like testosterone. These excess androgens then cause hormonal imbalance, which is what leads to PCOS.
It’s difficult to pinpoint the exact cause of insulin resistance, but it is closely linked with chronic inflammation. Low-grade chronic inflammation, hyperinsulinemia and PCOS are all inter-related.
Wondering what is the distinction between Insulin Resistance and Pre-Diabetes? If your body produces sufficient insulin, but the cells in your body lack adequate receptor sites for absorption of insulin, you have insulin resistance. However, when your body is no longer producing adequate insulin or loses its ability to process it, this leads to pre-diabetes. When left unchecked, pre-diabetes leads to Diabetes Type 2.
Most women diagnosed with PCOS, though not all, have insulin resistance. Your doctor would’ve most likely recommended blood tests to measure fasting glucose levels as well as a lipid panel. If your fasting glucose levels are above 100 mg/dl, you probably have insulin resistance and are also pre-diabetic.
Doctors across the globe don’t yet agree on what ideal fasting insulin levels should actually be. Dr. Joseph Mercola, a natural health expert, believes that fasting insulin levels should be less than 5mIU/ml. Other doctors may consider 10-20mIU/ml to be within the normal range. However, most experts consider a fasting insulin level of 8.4mIU/ml as normal.
A study conducted in Arizona supports the views of Dr. Mercola. The study found that women with the fasting insulin level of around 8.0mIU/ml were two times more at risk of prediabetes when compared to those with fasting insulin level of around 5.0mIU/ml. Women who had fasting insulin level of around 25.0mIU/ml were five times more at risk of prediabetes.
Left unchecked, insulin resistance makes your cells less sensitive to insulin over time, leading to Type 2 Diabetes. This is why doctors commonly prescribe Metformin and other diabetes-drugs to women diagnosed with PCOS.
Other factors that are linked to PCOS also play a role in the development of prediabetes. For example – your lipid profile may reveal high LDL “bad” blood cholesterol, low levels of HDL “good” cholesterol, higher-than-normal levels of triglycerides, excessive abdominal fat, and hypertension.
But here’s some good news for you. Pre-diabetes (and insulin resistance) can be reversed with the right diet and lifestyle changes, without the need for medication. This will also bring about a positive impact on your other PCOS symptoms like lethargy, hunger pangs, weight gain and brain fog.
Now the question is – what can you do to reverse PCOS and pre-diabetes? Simple, daily lifestyle changes like a balanced diet and regular exercise that help you lose weight go a long way towards reversing these two conditions.
To lower your insulin levels, the best method is to adopt a diet that helps lower glucose levels. The right pre-diabetes diet plan that focuses on cutting back sugars and processed grains is an excellent starting point. We highly recommend a LCHF or Low Carb-High Fat diet to reverse prediabetes and insulin resistance. Be wary of allopathic medicines as they come with a plethora of side effects. Studies have found that a low glycemic index (GI) diet can be particularly helpful in the management of PCOS. The right diet plan will not only help manage insulin levels but also alleviate chronic inflammation, which lies at the heart of PCOS and insulin resistance.
Regular exercise improves insulin sensitivity, according to research. An exercise of any kind will be helpful – be it walking, cycling, swimming or yoga. Do know that muscle and weight training workouts are particularly helpful. Because these workouts build lean muscle mass, which increases insulin sensitivity. Since overweight and obese women are most at risk for PCOS as well as pre-diabetes, focus on an exercise routine that is designed for weight-loss.
There are a variety of supplements for increasing insulin sensitivity and reducing inflammation. We really like omega-3 rich Cod Liver Oil supplements. They help in reducing serum concentrations of testosterone and regulate menstrual cycle. They also fight against chronic inflammation and improve insulin sensitivity. Another supplement we recommend is Inositol that helps reduce insulin resistance and improve ovulatory function. Inositol or D-Chiro Inositol also helps in reducing obesity by regulating glucose uptake and glycogen synthesis.
Researchers have found that oxidative stress may contribute to a pro-inflammatory state that induces insulin resistance and excess male hormones in women with PCOS. So, it’s imperative to learn coping techniques to keep stress of everyday life at bay, and to also improve your sleep routine. We highly recommend practicing yoga and meditation, which are wonderful stress relievers.
Know that the earlier you take action, the better are your chances of naturally reversing insulin resistance and PCOS. Work closely with your doctor to keep a close eye on your blood glucose levels and insulin levels so you can chart your progress. This will keep you motivated and also help you figure out what works for you and what doesn’t.
Frequency of prediabetes in women with polycystic ovary syndrome – https://www.ncbi.nlm.nih.gov/pubmed/24520755
Clinical update on screening, diagnosis and management of metabolic disorders and cardiovascular risk factors associated with polycystic ovary syndrome – http://journals.lww.com/co-endocrinology/Abstract/2012/12000/Clinical_update_on_screening,_diagnosis_and.12.aspx
Polycystic Ovary Syndrome as a Paradigm for Prehypertension, Prediabetes, and Preobesity – https://link.springer.com/article/10.1007/s11906-014-0500-6
Hyperinsulinism and polycystic ovary syndrome (PCOS): role of insulin clearance – https://link.springer.com/article/10.1007/s40618-015-0372-x
Low Grade Chronic Inflammation in Women with Polycystic Ovarian Syndrome – https://academic.oup.com/jcem/article/86/6/2453/2848804/Low-Grade-Chronic-Inflammation-in-Women-with
Identifying prediabetes using fasting insulin levels – https://www.ncbi.nlm.nih.gov/pubmed/19789156
Exercise and insulin sensitivity: a review – https://www.ncbi.nlm.nih.gov/pubmed/10683091
Reactive Oxygen Species-Induced Oxidative Stress in the Development of Insulin Resistance and Hyperandrogenism in Polycystic Ovary Syndrome – https://academic.oup.com/jcem/article/91/1/336/2843549/Reactive-Oxygen-Species-Induced-Oxidative-Stress