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More than 50% of individuals with PCOS develop Type 2 Diabetes before the age of 40.[1]  Roughly 40% of individuals with PCOS have diabetes compared to 6% in the general population.[2] In this article we explore the link between PCOS and Type 2 diabetes, a condition that results when there is a problem with the way the body regulates and uses sugar as fuel.[3]


PCOS is associated with elevated levels of androgens,[4] sex hormones that are produced in the ovaries, start at puberty and play a key role in reproductive health.[5] 


Find out more about PCOS and Androgen Excess.

  • An Increase in the level of circulating androgens disrupts the way that adipose tissue, the body fat or connective tissue that extends throughout your body,[6] metabolizes glucose;[7]


The adipose tissue produces less adiponectin, a hormone that helps with insulin sensitivity and inflammation,[8] and more leptin,[9] a hormone that causes you to feel hungry in efforts to maintain enough fat stores for long-term health;[10]

  • Reduced adiponectin leads to insulin resistance, whereby the body doesn’t respond as it should to the effects of insulin;[11]

  • In response to insulin resistance, the pancreas produces more insulin, leading to increased levels of insulin in the blood, also known as hyperinsulinemia;[12]

  • In parallel, insulin resistance can result in an imbalance of the types of fat cells or lipids in the blood, also known as dyslipidemia;[13]

  • As a result of dyslipidemia, the liver increases the production of glucose or blood sugar and reduces glucose uptake as a protective measure, leading to the accumulation of triacylglycerols, a type of fat cell[14] within the liver;[15] and

  • Eventually, the pancreas is no longer able to produce enough insulin to maintain healthy levels of blood sugar and the individual develops Type 2 diabetes[16]

  • An accumulation of adipose tissue also contributes to increasing insulin resistance since this tissue is itself a source of circulating androgens.[17]  Insulin resistance affects 95% of individuals with PCOS who are obese compared to 75% of individuals who are lean.[18]


Individuals without PCOS can also develop Type 2 diabetes due to weight gain and accumulation of adipose tissue.[19]  In contrast, Type 1 diabetes, where the pancreas does not produce any insulin, is believed to be an autoimmune condition whereby the body destroys the cells in the pancreas before symptoms appear.[20]


Reviewed by Dr. K, one of Neuraura’s friends and trusted advisors.

 

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Sources
[1] https://www.cdc.gov/diabetes/basics/pcos.html
[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8189332/
[3] https://www.mayoclinic.org/diseases-conditions/type-2-diabetes/symptoms-causes/syc-20351193
[4] https://www.uptodate.com/contents/polycystic-ovary-syndrome-pcos-beyond-the-basics/
[5] https://my.clevelandclinic.org/health/articles/22002-androgens
[6] https://my.clevelandclinic.org/health/body/24052-adipose-tissue-body-fat
[7] https://ovarianresearch.biomedcentral.com/articles/10.1186/s13048-022-01091-0
[8] https://my.clevelandclinic.org/health/articles/22439-adiponectin
[9] https://my.clevelandclinic.org/health/articles/22446-leptin
[10] https://ovarianresearch.biomedcentral.com/articles/10.1186/s13048-022-01091-0
[11] https://www.mayoclinic.org/diseases-conditions/type-2-diabetes/expert-answers/hyperinsulinemia/faq-20058488
[12] https://www.mayoclinic.org/diseases-conditions/type-2-diabetes/expert-answers/hyperinsulinemia/faq-20058488#:~:text=Hyperinsulinemia%20is%20connected%20to%20insulin,of%20insulin%20in%20the%20blood.
[13] https://www.ncbi.nlm.nih.gov/books/NBK560891/
[14] https://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/in-depth/triglycerides/art-20048186
[15] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4836586/
[16] https://www.mayoclinic.org/diseases-conditions/type-2-diabetes/expert-answers/hyperinsulinemia/faq-20058488
[17] https://gremjournal.com/journal/01-2022/the-interplay-between-androgens-and-adipocytes-the-foundation-of-comorbidities-of-polycystic-ovary-syndrome/
[18] https://pubmed.ncbi.nlm.nih.gov/23315061/
[19] https://www.mayoclinic.org/diseases-conditions/type-2-diabetes/symptoms-causes/syc-20351193
[20] https://www.cdc.gov/diabetes/basics/what-is-type-1-diabetes.html

Want to learn more about metabolic health conditions related to PCOS?  Check out the sections on hyperinsulinemia, dyslipidemia and gestational diabetes

Complications – Cardiometabolic

PCOS and Diabetes

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