Individuals with PCOS are 1.8-2.8x more likely to have intermediate hyperglycemia or high blood sugar, defined as impaired glucose tolerance (IGT) or impaired fasting glucose (IFT).[1]

In this article we explore the link between PCOS and hyperglycemia.

PCOS is associated with elevated levels of androgens[2], sex hormones that are produced in the ovaries, start at puberty and play a key role in reproductive health.[3] 

• 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,[4] metabolizes glucose;[5]

• The adipose tissue produces less adiponectin, a hormone that helps with insulin sensitivity and inflammation;[6],[7]

• The adipose tissue also produces more leptin,[8] a hormone that causes you to feel hungry in efforts to maintain enough fat stores for long-term health;[9]

• Reduced adiponectin leads to insulin resistance, whereby the body doesn’t respond as it should to the effects of insulin;[10] 

• Insulin resistance leads to elevated production of insulin in the pancreas as a compensatory measure, leading to elevated levels in insulin in the blood or hyperinsulinemia;[11] and

• Eventually, the pancreas is no longer able to produce enough insulin to maintain healthy levels of blood sugar and the individual develops hyperglycemia, or high blood sugar.

The symptoms of high blood sugar include:[12],[13]

• Increased thirst and/or hunger;

• Frequent urination;

• Blurred vision and headaches;

• Vaginal yeast infections and skin infections;

• Fatigue;

• Weight loss; and

• Slow-healing cuts and sores.

Hyperglycemia can lead to additional health complications, including pre-diabetes and Type 2 diabetes (T2D).[14]

If hyperglycemia is untreated it can develop into diabetes-related ketoacidosis (DKA), where the high volume of ketones, acids that your body makes when it’s using fat instead of glucose as energy,[15] in the blood causes it to become acidic.[16]  DKA is an emergency medical situation that is more commonly associated in patients with Type 1 Diabetes and can lead to coma and death; symptoms include:[17],[18]

• Nausea, vomiting and diarrhea;

• Dehydration and feeling thirsty;

• Stomach pain;

• Breath that smells fruity (like pears or nail polish remover);

• Deep labored breathing or hyperventilation;

• Rapid heartbeat;

• Confusion and disorientation;

• Blurred vision; and

• Loss of consciousness.

Risk factors, other than PCOS, for hyperglycemia include:[19]

• Obesity;

• Family history of Type 2 Diabetes;

• Personal history of gestational diabetes; and

• Prediabetes (elevated blood sugar but not high enough to be diagnosed as diabetic).

Hyperglycemia is diagnosed via blood tests for fasting plasma glucose (FPG) or glucose tolerance test (GTT).

Hyperglycemia treatment may include a combination of:[20]

• Lifestyle modifications such as improved diet and increased exercise;

• Glucose monitoring; and

• Medications to lower glucose such as metformin.

Reviewed by Riya Ganguly PhD., MBA, ICD.D, expert on technology transfer, new venture development and research facilitation

PARTNER SPOTLIGHT

RxSugar® is a health and wellness company disguised as a food company, focused on solving for sugar. RxSugar® products are specifically formulated for blood sugar control and satiety using Allulose, the rare natural sugar with proven metabolic health benefits.

Sources

[1] https://pmc.ncbi.nlm.nih.gov/articles/PMC8771268/

[2] https://www.uptodate.com/contents/polycystic-ovary-syndrome-pcos-beyond-the-basics/

[3] https://my.clevelandclinic.org/health/articles/22002-androgens

[4] https://my.clevelandclinic.org/health/body/24052-adipose-tissue-body-fat

[5] https://ovarianresearch.biomedcentral.com/articles/10.1186/s13048-022-01091-0

[6] https://my.clevelandclinic.org/health/articles/22439-adiponectin

[7] https://diabetesjournals.org/diabetes/article/51/9/2734/34499/Androgens-Decrease-Plasma-Adiponectin-an-Insulin

[8] https://my.clevelandclinic.org/health/articles/22446-leptin

[9] https://ovarianresearch.biomedcentral.com/articles/10.1186/s13048-022-01091-0

[10] https://www.mayoclinic.org/diseases-conditions/type-2-diabetes/expert-answers/hyperinsulinemia/faq-20058488

[11] https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes/prediabetes-insulin-resistance

[12] https://my.clevelandclinic.org/health/diseases/22206-insulin-resistance

[13] https://my.clevelandclinic.org/health/diseases/9815-hyperglycemia-high-blood-sugar

[14] https://my.clevelandclinic.org/health/diseases/24178-hyperinsulinemia

[15] https://my.clevelandclinic.org/health/body/25177-ketones

[16] https://my.clevelandclinic.org/health/diseases/9815-hyperglycemia-high-blood-sugar

[17] https://www.ncbi.nlm.nih.gov/books/NBK560723/

[18] https://my.clevelandclinic.org/health/diseases/9815-hyperglycemia-high-blood-sugar

[19] https://www.yalemedicine.org/conditions/hyperglycemia-symptoms-causes-treatments

[20] https://www.yalemedicine.org/conditions/hyperglycemia-symptoms-causes-treatments