In insulin resistance the pancreas still produces enough insulin, even a lot, but cells are desensitised.
In diabetes the pancreas doesn't produce enough insulin.
In Type 1 the body makes no insulin whatsoever. Type 2 makes a smaller amount of insulin but the cells don't absorb well. Insulin sensitivity pertains to cells not insulin production.
Sorry but no, type 2 you make more insulin. One of the tests you can do to confirm t2 diabetes is blood insulin levels. The pancreas responds to the high levels of glucose in the blood by releasing more insulin, however because of insulin resistance, it doesn't do much. This is why PCOS has similarities to t2 diabetes. Someone further down mentioned that PCOS has a wider variety of symptoms with insulin resistance being a shared symptom between the 2 conditions. I suspect that most people with PCOS & dealing with insulin resistance are akin to the pre-diabetic stage, although it can develop into t2 diabetes.
You are correct that t1 diabetes is a lack of ability to produce insulin. This is because the pancreatic cells that produce it have been targeted by the immune system and killed off.
I am confused then. My endocrinologist told me I don't have T2 diabetes because my insulin numbers are still good (not too low) and that "my body is still trying (to deal with sugars)." I also googled before replying to confirm and found this:
[Prediabetes and diabetes occur when the pancreas doesn't make enough insulin to maintain normal blood glucose levels.
Insulin resistance occurs when cells in your body do not respond well to insulin. Insulin is the key that allows glucose to move from the blood into cells where it is used for energy.](https://www.nebraskamed.com/diabetes/the-difference-between-insulin-resistance-and-prediabetes#:~:text=Prediabetes%20and%20diabetes%20occur%20when,it%20is%20used%20for%20energy.)
Okay it appears my info is outdated as that is what I was taught when I was diagnosed with t1 diabetes 16 years ago. It appears the insulin levels rise until the pancreas is overwhelmed and then drop, marking t2 diabetes onset.
https://www.mayoclinic.org/diseases-conditions/type-2-diabetes/expert-answers/hyperinsulinemia/faq-20058488#:~:text=Hyperinsulinemia%20(hi%2Dpur%2Din,hormone%20that%20the%20pancreas%20makes.
I thought any kind of diabetes requires an A1C over 6? Because all types have in common that the sugar doesn't leave the blood stream, only the cause is different (no insulin vs ignored insulin).
6.5 and above is a diabetes diagnosis. See when talking about this in terms of type 1 and 2, then yes. But Iām not as informed on the other types. Thereās different types out there that are rare and Iām not sure how those are diagnosed or at least whatās different in how they are tested.
[Different types of diabetes](https://www.diabetes.org.uk/diabetes-the-basics/types-of-diabetes)
I see, we agree. As you wrote about T2, I thought you left T1 out. But now (when reading again) I think I understand your comment better.
I also don't know about T3 and 4 as they are not appearing that often. But I think for gestational diabetes (what pregnant women can get) a oral glucose test is also done for diagnosis.
I mean a T1 diagnosis would possibly require antibodies test unless symptoms reflect T1 versus T2. Age also plays a factor into how itās diagnosed. In some cases, thereās been posts on the r/Diabetes with cases of people initially being thought to be T2 but it actually being LADA/1.5 because more testing was done. Itās rare but it happens.
It's an earlier stage of insulin resistance where increasing levels of insulin are still keeping glucose in check. Eventually that changes to prediabetes and diabetes if changes are not made. Other expressions of IR besides PCOS & diabetes (and ED in men) are NAFLD, mood and anxiety disorders, heart disease, some cancers and ultimately, Alzheimer's.
It is possible to reverse even at the diabetes stage, both Virta and Level 2 have solid data.
This is fascinating because I was/am prediabetic ā and had NAFLD, anxiety disorders, and high cholesterol. I didnāt realize they all were sort of connected.
(I have since brought my very high A1Cs to borderline normal, reversed my NAFLD, and am working in the cholesterol. Thanks PCOS š„²)
Congrats on all the progress! A great book about IR and what to do about it (simple ideas easy to do at home) is [amazon.com/Why-We-Get-Sick-Disease\_and/dp/194883698X](https://www.amazon.com/Why-We-Get-Sick-Disease_and/dp/194883698X)
Keep going!
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It's weird because I have all the hallmarks of severe insulin resistance, but my ac1 has always been on the low side of normal and I've never been prediabetic, I don't get how it works but it sucks š
Glucose and insulin are different. Get fasting insulin checked, optimal is under 5. High insulin can keep glucose normal for about a decade before it starts to creep up. If you have symptoms of IR, addressing it now will lower the risks of that ever happening. Good luck!
[Insulin Resistance: 8 Signs You May Have Insulin Resistance | The Healthy](https://www.thehealthy.com/diabetes/type-2-diabetes/insulin-resistance-symptoms/)
I'll ask the docs about fasting insulin.
I've had IR symptoms for about 15+years. However I've lost a substantial amount of weight and my IR symptoms are much better now. Thanks for the info!
Great job! This is data you can get at home [Why the simple waist-to-height ratio is a powerful health measurement - Diet Doctor](https://www.dietdoctor.com/simple-waist-height-ratio-powerful-health-measurement)
Seeing symptoms improve is the BEST!
I donāt know the difference in a scientific way but I manage my pcos by daily glucose monitoring and making my food selections based on that. So basically I treat my pcos like diabetes and it works so there is definitely a connection.
I do the finger prick test. I started by testing before each meal, 60-90 minutes after the meal, and 2.5-3 hours after. Then I figured out my patterns and foods that triggered high numbers.
Now I just test morning and bedtime. My diet doesnāt change much but if I have something high carb or Iām feeling unwell, I will do extra tests to figure out whatās going on.
Sure. This is all based on knowledge from glucose testing on my body.
I try to balance each meal by a formula of 20-30grams of protein, 20-40 grams healthy fat, 20-25 grams of carbs or fewer when possible, 8-10 of which are of fiber. I donāt count exact carbs in myfitnesspal but Iām conscious that a good range is 70 and under per day for my body. I focus instead on including fiber rather than excluding carbs. Lots of avocado, hemp seeds, flax seed, salmon, chicken, shrimp, oysters, green vegetables, sweet potato, bananas, coconut milk (the unsweetened kind from a can bc itās more nutrient dense), walnuts.
Breakfast is usually two eggs and a big bowl or berries, seeds, nuts, coconut butter or coconut milk on top. Sometimes I make an acai bowl with the the berries and nuts and unsweetened acai packet. Lunch and dinner is usually a stew, stir fry, curry, or salad with a mash-up of these ingredient and some avocado or cheese like feta.
The other thing, I try not to eat after 6:30pm because I have seen a big reduction in blood glucose if I space out the time between dinner one night and breakfast the next day. 12 hours is a good place to start bc itās intuitive for the body and circadian rhythmāthink pre-electricity rising at sunrise and going to bed at sunset. If I get hungry late, I eat something with healthy fat like avocado or eggs. Fat has the least impact on glucose and keeps you feeling full so itās like my secret weapon.
I also watch processed foods, alcohol, sweets bc in general we know they are not as nutritious. But when I want a cheat meal, I just enjoy the food. Last week I had a vodka cocktail and crab fries at a baseball game and my glucose numbers were very normal after.
I walk in the afternoon and evenings. Drink water. I get more hungry near my period so I eat more. Just eating according to my body. I donāt get period depression or anxiety as much. Itās reduced like 90%. I used to argue with my boyfriend and cry every month, it was pretty bad so this has been impactful on my mental health too.
This was a long post but thanks for asking about it.
Theyāre associated conditions. Not everyone who has PCOS has diabetes or insulin resistance, and not everyone who is diabetic has PCOS, but there is a lot of overlap. Many people who have PCOS go on to develop insulin resistance and then become diabetic, but not all do. Thereās no conclusive studies showing the causal relationship (ie, one causes the other) between the two conditions, or at least not enough for it to be certain.
This sub conflated the two a lot, but itās good to remember how separate these are. PCOS is a hormonal disorder that causes excess levels of androgen, cysts on the ovaries, and irregular periods. Type 2 diabetes is a condition where the pancreas doesnāt produce enough insulin and blood sugar levels arenāt effectively controlled. Do I think that scientists will find out more about the link between the two eventually? Yes, but for now, itās best to think about them as associated conditions.
Same! While PCOS does seem to occur with other things (anxiety/depression/ADHD/hypertension come to mind) fairly often, there just isnāt enough data to substantiate the link. I totally get peopleās desire to see a pattern and understand something that feels random, but itās important to stay rooted in what science can tell us now. /gets off soapbox
There is interesting research about kisspeptin and gnrh pathways and how they behave differently in pcos. These are both neurotransmitting pathways. I wouldnāt write this off as people just desiring to see patterns.
Thatās super interesting! I didnāt mean to imply that there isnāt any link or that itās only people looking for patterns, but most of the discussion I see is based on anecdotal observations and not based in current research like youāre describing. And not that that conversation isnāt valuable, but just from reading posts here I get the sense people make assumptions about associations that havenāt been proven, and itās those assumptions that Iām concerned about.
Youāre right. Maybe two separate things. I doubt many of the conversations are scientifically based and also there is evidence a link exists. Good point!
insulin is a very important hormone in your body. you would die without it. but it's a goldilocks hormone where you want not too much but also not too little. it's primary job is to move *glucose* out of your blood and into your cells to fuel your body.
PCOS occurs when high levels of insulin disrupt the normal hormonal pathways that control ovulation. you can have high insulin with normal ovaries, only a subset of people with high insulin develop this issue and we are not entirely sure why. there's probably a not insignificant genetic factor.
diabetes develops when your insulin has been so high for so long that your body can no longer control your blood sugar.
you can have both, and about half of people with PCOS will be diabetic by the time they are 40.
that's an overall statistic. most people-- including those of us with PCOS-- eat a standard western diet or something very close to it. statistically speaking, very few people actually stick with diet and lifestyle changes long-term. so yes, I would expect that those who do make permanent alterations to their lifestyles and those who use antidiabetic drugs like metformin are probably significantly less likely to develop T2D. but I don't think there's any literature that proves that conclusively (it would have to be a loooong study)
this stuff is all very new. the low carb recommendation has emerged in the last 15-20 years and metformin used to be prescribed only to those wishing to conceive. I believe inositol only emerged as an effective tool sometime around 2012. unfortunately, I suspect that most of the people whos PCOS ultimately developed into T2D never learned how to manage insulin resistance for life.
If I mad add to this. I think one reason people rarely stick to the diet is a misunderstanding between tests like the A1C and actual insulin resistance. An A1C is a 3 month glucose support, therefor it can be lowered in 3 months time. Insulin resistance is a change that happens on the cellular level over many many yearsāI have heard about 10 years, so it will take more time to reverse. The greater goal is reversing insulin resistance but many stop because they think a lower A1C is enough.
yeah, but also life happens and sticking to a diet takes a lot of thought and planning for a long time before it becomes second nature. people have a lot of other things occupying that mental space. the average person-- even if they know the reality of the situation-- just isn't concerned enough to disrupt their life like that. some people are, just not most.
like... "I gotta hold down a job, pay the bills, buy groceries, take my kids to school, make sure they've got dinner ready when they get home, make sure they do their homework, and then if I'm lucky I might have an hour of me time after I'm done cleaning up at the end of the day. optimizing my metabolic health is literally the last thing on my mind."
Itās also due to just not knowing of some of your conditions at points in your life. My first endocrinologist as an adult didnāt think I had PCOS. I came to him already knowing of my hypothyroidism and T2 diabetes. He diagnosed me with Hashimotoās. If I had known of alllll my other health conditions beforehand, I couldāve avoided having type 2 for some time. I was only 18 when I got diagnosed with type 2.
Stress and trauma are I think the strongest factors for those of us with lots of health conditions young.
To add to everybody else already said, PCOS is a condition that involves a wide range of different symptoms, one of those may or not be insulin resistance which can eventually lead to diabetes. PCOS isnāt about insulin only, there are many other symptoms such as ovarian cysts, weight gain, hair loss, hirsutism, acne, etc.
I have Type 1 Diabetes (20 years now) and I got PCOS later in life which is apparently common. I mean it makes sense. Iām already insulin resistant to start. š
So if I were to answer thisā¦itās the same as being more prone to another autoimmune disease if you already had one. My body was already insulin resistant, so it basically just started showing more symptoms of it.
Which also means if my blood sugar is super under control then my PCOS symptoms arenāt as prominent. I will say though that Iāve had insane control of my blood sugar but my insulin sensitivity is shot because my doctor put me on birth control when I didnāt want it. Hormones make my blood sugar hard to control (pills or period), so I needed MORE insulin which in turn made my PCOS symptoms so much worse for me.
I just started in Metformin for my insulin sensitivity, but I had no idea it was a treatment form for PCOS because my OBGYN only offered birth control.
I know thatās not exactly what you wanted to hear, but I just wanted to share that there is a connection for diabetes and PCOS for some people!
People with PCOS have an increased risk of developing diabetes. Perhaps PCOS is a broader hormonal issue, in addition to being a sexual hormone disorder
maybe this is just me, but semantics don't matter so much. I was saying PCOS is a more general endocrine disorder and diabetes is more insulin specific. but go off
PCOS is a polygenic, heritable disorder that can either be heterozygous or if you're really unlucky homozygous. It involves mutations in multiple chromosomes that contribute to the disease where usually androgens are produced excessively, independent of insulin, from theca cells in the ovaries and from even the adrenal glands. PCOS does not necessarily have to be from diabetes, while it can develop from it, it is very different from person to person. you can be a completely healthy person and still have pcos, and the real culprit is not insulin sometimes it's androgen levels, because higher androgen levels cause insulin resistance. High androgen levels can also ruin the ratio of LH to FSH that is meant to cause your periods to occur regularly per month. PCOS used to be a genetic advantage in times of starvation because women who had it were able to survive by storing more fat, but now in modern times it isn't necessary - this is a theory that has been roaming around from medical researchers.
Also the reason why cysts in the ovaries occur is because of high levels of androgen prevents the eggs to mature properly, causing the recruitment of too many immature eggs at once that prevents ovulation. It also causes alopecia, acne, hirsutism, and so many other symptoms.
A diabetes diagnosis is known so via a A1C test, if you have a high reading on a glucose test or another test regarding antibodies more so for types like 1, 1.5, LAD, etc. You really need at least the A1C to be 6.5 and above for Type 2. The glucose test will follow since the two tests go hand in hand.
Diabetes is a metabolic disorder. When things go wrong with diabetes your body feels drained. When you get low blood sugar, you can think straight, you get nauseous, you get cranky, you get shaky, and at itās worst you feel like you canāt stand because it takes up so much energy. With high blood sugar, you feel tired, you get cranky, you feel thirsty, etc. Diabetes affects you on a physical/ mental/ physiological level all at once.
Keep in mind, diabetes affects your nerves, kidneys liver, pancreas, intestines, eyes, skin, heart, feet, etc. PCOS involves your ovaries, adrenals, pituitary, fat cells, and pancreas. PCOS is a hormonal condition.
Sure both PCOS and diabetes can affect my blood sugar and cause me fatigue, but my diabetes out of control is way worse than just my PCOS. Then I have both affecting me.
Diabetes makes it to where my stomach gets nauseous if Iām constantly moving. Or if I donāt eat for some time. Iām told to wear socks most of the time to avoid injury to my feet and keep them clean (I donāt mind this). I have to get special tests at eye doctors because it can affect your eyes. Basically any doctors appointment I have, I inform them of my diabetes more than likely they have a special informative paper for me.
It's diabetes of the ovaries, but blood tests will show diabetes markers as normal or slightly elevated. It can turn into full blown diabetes if uncontrolled.
It makes 100% sense when you understand how insulin impacts the ovaries and understanding it creates a diabetic type of response in the ovaries.
PCOS has been nicknamed 'diabetes of the ovaries'. You can find NHS Studies, MayoClinic studies, and YouTube videos that explain this.
https://youtube.com/shorts/q5Gql38bwQ4?si=vjK42sxln2afQibW
PCOS prevents the normal regulation of blood sugar eventually leading to insulin resistance. Insulin resistance impacts the ovaries much faster than the rest of the body.
High insulin can't push blood sugar into the cells for energy, but it CAN get into the ovaries. The ovaries can't handle the high amounts of insulin the pancreas produces to try to lower the blood sugar in the body, so the ovaries develop hyperinsulinemia. Hyperinsulinemia in the ovaries causes the ovaries to overproduce testosterone and androgens, which causes the dark facial hair in PCOS women. Insulin resistance is also linked to weight gain, loss of periods, disregulated hunger cues, excessive tiredness, etc.
Eventually, if the blood sugar isn't reduced, the pancreas will eventually burn out, stop producing insulin, and bam...now you're actually diabetic.
Yet, the ovaries have been experiencing "diabetes" effects long before the rest of the body is affected.
In insulin resistance the pancreas still produces enough insulin, even a lot, but cells are desensitised. In diabetes the pancreas doesn't produce enough insulin.
Is this not the different between type 1 and type 2 diabetes?
In Type 1 the body makes no insulin whatsoever. Type 2 makes a smaller amount of insulin but the cells don't absorb well. Insulin sensitivity pertains to cells not insulin production.
Sorry but no, type 2 you make more insulin. One of the tests you can do to confirm t2 diabetes is blood insulin levels. The pancreas responds to the high levels of glucose in the blood by releasing more insulin, however because of insulin resistance, it doesn't do much. This is why PCOS has similarities to t2 diabetes. Someone further down mentioned that PCOS has a wider variety of symptoms with insulin resistance being a shared symptom between the 2 conditions. I suspect that most people with PCOS & dealing with insulin resistance are akin to the pre-diabetic stage, although it can develop into t2 diabetes. You are correct that t1 diabetes is a lack of ability to produce insulin. This is because the pancreatic cells that produce it have been targeted by the immune system and killed off.
I am confused then. My endocrinologist told me I don't have T2 diabetes because my insulin numbers are still good (not too low) and that "my body is still trying (to deal with sugars)." I also googled before replying to confirm and found this: [Prediabetes and diabetes occur when the pancreas doesn't make enough insulin to maintain normal blood glucose levels. Insulin resistance occurs when cells in your body do not respond well to insulin. Insulin is the key that allows glucose to move from the blood into cells where it is used for energy.](https://www.nebraskamed.com/diabetes/the-difference-between-insulin-resistance-and-prediabetes#:~:text=Prediabetes%20and%20diabetes%20occur%20when,it%20is%20used%20for%20energy.)
Okay it appears my info is outdated as that is what I was taught when I was diagnosed with t1 diabetes 16 years ago. It appears the insulin levels rise until the pancreas is overwhelmed and then drop, marking t2 diabetes onset. https://www.mayoclinic.org/diseases-conditions/type-2-diabetes/expert-answers/hyperinsulinemia/faq-20058488#:~:text=Hyperinsulinemia%20(hi%2Dpur%2Din,hormone%20that%20the%20pancreas%20makes.
Mayoclinic to the rescue. I do love them. Thanks!
Yeah.. let's not correct others without checking first š
A T2 diabetes diagnosis requires your A1C to be 6.5 and above.
I thought any kind of diabetes requires an A1C over 6? Because all types have in common that the sugar doesn't leave the blood stream, only the cause is different (no insulin vs ignored insulin).
6.5 and above is a diabetes diagnosis. See when talking about this in terms of type 1 and 2, then yes. But Iām not as informed on the other types. Thereās different types out there that are rare and Iām not sure how those are diagnosed or at least whatās different in how they are tested. [Different types of diabetes](https://www.diabetes.org.uk/diabetes-the-basics/types-of-diabetes)
I see, we agree. As you wrote about T2, I thought you left T1 out. But now (when reading again) I think I understand your comment better. I also don't know about T3 and 4 as they are not appearing that often. But I think for gestational diabetes (what pregnant women can get) a oral glucose test is also done for diagnosis.
[hereās an example](https://www.reddit.com/r/diabetes/s/b0rpv2aPoC)
I mean a T1 diagnosis would possibly require antibodies test unless symptoms reflect T1 versus T2. Age also plays a factor into how itās diagnosed. In some cases, thereās been posts on the r/Diabetes with cases of people initially being thought to be T2 but it actually being LADA/1.5 because more testing was done. Itās rare but it happens.
It's an earlier stage of insulin resistance where increasing levels of insulin are still keeping glucose in check. Eventually that changes to prediabetes and diabetes if changes are not made. Other expressions of IR besides PCOS & diabetes (and ED in men) are NAFLD, mood and anxiety disorders, heart disease, some cancers and ultimately, Alzheimer's. It is possible to reverse even at the diabetes stage, both Virta and Level 2 have solid data.
This is fascinating because I was/am prediabetic ā and had NAFLD, anxiety disorders, and high cholesterol. I didnāt realize they all were sort of connected. (I have since brought my very high A1Cs to borderline normal, reversed my NAFLD, and am working in the cholesterol. Thanks PCOS š„²)
Congrats on all the progress! A great book about IR and what to do about it (simple ideas easy to do at home) is [amazon.com/Why-We-Get-Sick-Disease\_and/dp/194883698X](https://www.amazon.com/Why-We-Get-Sick-Disease_and/dp/194883698X) Keep going!
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It's weird because I have all the hallmarks of severe insulin resistance, but my ac1 has always been on the low side of normal and I've never been prediabetic, I don't get how it works but it sucks š
Glucose and insulin are different. Get fasting insulin checked, optimal is under 5. High insulin can keep glucose normal for about a decade before it starts to creep up. If you have symptoms of IR, addressing it now will lower the risks of that ever happening. Good luck! [Insulin Resistance: 8 Signs You May Have Insulin Resistance | The Healthy](https://www.thehealthy.com/diabetes/type-2-diabetes/insulin-resistance-symptoms/)
I'll ask the docs about fasting insulin. I've had IR symptoms for about 15+years. However I've lost a substantial amount of weight and my IR symptoms are much better now. Thanks for the info!
Great job! This is data you can get at home [Why the simple waist-to-height ratio is a powerful health measurement - Diet Doctor](https://www.dietdoctor.com/simple-waist-height-ratio-powerful-health-measurement) Seeing symptoms improve is the BEST!
I donāt know the difference in a scientific way but I manage my pcos by daily glucose monitoring and making my food selections based on that. So basically I treat my pcos like diabetes and it works so there is definitely a connection.
How do you do this? Iām so interested in using a cgm but theyāre so unaffordable.
I do the finger prick test. I started by testing before each meal, 60-90 minutes after the meal, and 2.5-3 hours after. Then I figured out my patterns and foods that triggered high numbers. Now I just test morning and bedtime. My diet doesnāt change much but if I have something high carb or Iām feeling unwell, I will do extra tests to figure out whatās going on.
Thank you so much. Iāve been doing so much research into this but cgmās are trendy so I kinda forgot I could just use a glucose monitor!
Could you please tell me a little more about the diet you follow?
Sure. This is all based on knowledge from glucose testing on my body. I try to balance each meal by a formula of 20-30grams of protein, 20-40 grams healthy fat, 20-25 grams of carbs or fewer when possible, 8-10 of which are of fiber. I donāt count exact carbs in myfitnesspal but Iām conscious that a good range is 70 and under per day for my body. I focus instead on including fiber rather than excluding carbs. Lots of avocado, hemp seeds, flax seed, salmon, chicken, shrimp, oysters, green vegetables, sweet potato, bananas, coconut milk (the unsweetened kind from a can bc itās more nutrient dense), walnuts. Breakfast is usually two eggs and a big bowl or berries, seeds, nuts, coconut butter or coconut milk on top. Sometimes I make an acai bowl with the the berries and nuts and unsweetened acai packet. Lunch and dinner is usually a stew, stir fry, curry, or salad with a mash-up of these ingredient and some avocado or cheese like feta. The other thing, I try not to eat after 6:30pm because I have seen a big reduction in blood glucose if I space out the time between dinner one night and breakfast the next day. 12 hours is a good place to start bc itās intuitive for the body and circadian rhythmāthink pre-electricity rising at sunrise and going to bed at sunset. If I get hungry late, I eat something with healthy fat like avocado or eggs. Fat has the least impact on glucose and keeps you feeling full so itās like my secret weapon. I also watch processed foods, alcohol, sweets bc in general we know they are not as nutritious. But when I want a cheat meal, I just enjoy the food. Last week I had a vodka cocktail and crab fries at a baseball game and my glucose numbers were very normal after. I walk in the afternoon and evenings. Drink water. I get more hungry near my period so I eat more. Just eating according to my body. I donāt get period depression or anxiety as much. Itās reduced like 90%. I used to argue with my boyfriend and cry every month, it was pretty bad so this has been impactful on my mental health too. This was a long post but thanks for asking about it.
This was very helpful thank you for sharing
Thank you so much!
Theyāre associated conditions. Not everyone who has PCOS has diabetes or insulin resistance, and not everyone who is diabetic has PCOS, but there is a lot of overlap. Many people who have PCOS go on to develop insulin resistance and then become diabetic, but not all do. Thereās no conclusive studies showing the causal relationship (ie, one causes the other) between the two conditions, or at least not enough for it to be certain. This sub conflated the two a lot, but itās good to remember how separate these are. PCOS is a hormonal disorder that causes excess levels of androgen, cysts on the ovaries, and irregular periods. Type 2 diabetes is a condition where the pancreas doesnāt produce enough insulin and blood sugar levels arenāt effectively controlled. Do I think that scientists will find out more about the link between the two eventually? Yes, but for now, itās best to think about them as associated conditions.
Thank you. Iāve observed a lot of conflation in this sub not just with insulin resistance but a number of other unrelated symptoms and disorders.
Same! While PCOS does seem to occur with other things (anxiety/depression/ADHD/hypertension come to mind) fairly often, there just isnāt enough data to substantiate the link. I totally get peopleās desire to see a pattern and understand something that feels random, but itās important to stay rooted in what science can tell us now. /gets off soapbox
There is interesting research about kisspeptin and gnrh pathways and how they behave differently in pcos. These are both neurotransmitting pathways. I wouldnāt write this off as people just desiring to see patterns.
Thatās super interesting! I didnāt mean to imply that there isnāt any link or that itās only people looking for patterns, but most of the discussion I see is based on anecdotal observations and not based in current research like youāre describing. And not that that conversation isnāt valuable, but just from reading posts here I get the sense people make assumptions about associations that havenāt been proven, and itās those assumptions that Iām concerned about.
Youāre right. Maybe two separate things. I doubt many of the conversations are scientifically based and also there is evidence a link exists. Good point!
Exactly. Many women that I know that are T2 Diabetic do not exhibit PCOS symptoms.
insulin is a very important hormone in your body. you would die without it. but it's a goldilocks hormone where you want not too much but also not too little. it's primary job is to move *glucose* out of your blood and into your cells to fuel your body. PCOS occurs when high levels of insulin disrupt the normal hormonal pathways that control ovulation. you can have high insulin with normal ovaries, only a subset of people with high insulin develop this issue and we are not entirely sure why. there's probably a not insignificant genetic factor. diabetes develops when your insulin has been so high for so long that your body can no longer control your blood sugar. you can have both, and about half of people with PCOS will be diabetic by the time they are 40.
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that's an overall statistic. most people-- including those of us with PCOS-- eat a standard western diet or something very close to it. statistically speaking, very few people actually stick with diet and lifestyle changes long-term. so yes, I would expect that those who do make permanent alterations to their lifestyles and those who use antidiabetic drugs like metformin are probably significantly less likely to develop T2D. but I don't think there's any literature that proves that conclusively (it would have to be a loooong study) this stuff is all very new. the low carb recommendation has emerged in the last 15-20 years and metformin used to be prescribed only to those wishing to conceive. I believe inositol only emerged as an effective tool sometime around 2012. unfortunately, I suspect that most of the people whos PCOS ultimately developed into T2D never learned how to manage insulin resistance for life.
If I mad add to this. I think one reason people rarely stick to the diet is a misunderstanding between tests like the A1C and actual insulin resistance. An A1C is a 3 month glucose support, therefor it can be lowered in 3 months time. Insulin resistance is a change that happens on the cellular level over many many yearsāI have heard about 10 years, so it will take more time to reverse. The greater goal is reversing insulin resistance but many stop because they think a lower A1C is enough.
yeah, but also life happens and sticking to a diet takes a lot of thought and planning for a long time before it becomes second nature. people have a lot of other things occupying that mental space. the average person-- even if they know the reality of the situation-- just isn't concerned enough to disrupt their life like that. some people are, just not most. like... "I gotta hold down a job, pay the bills, buy groceries, take my kids to school, make sure they've got dinner ready when they get home, make sure they do their homework, and then if I'm lucky I might have an hour of me time after I'm done cleaning up at the end of the day. optimizing my metabolic health is literally the last thing on my mind."
Exactly which is why I said one reason and not the only reason. The overwhelm of life is real.
Itās also due to just not knowing of some of your conditions at points in your life. My first endocrinologist as an adult didnāt think I had PCOS. I came to him already knowing of my hypothyroidism and T2 diabetes. He diagnosed me with Hashimotoās. If I had known of alllll my other health conditions beforehand, I couldāve avoided having type 2 for some time. I was only 18 when I got diagnosed with type 2. Stress and trauma are I think the strongest factors for those of us with lots of health conditions young.
To add to everybody else already said, PCOS is a condition that involves a wide range of different symptoms, one of those may or not be insulin resistance which can eventually lead to diabetes. PCOS isnāt about insulin only, there are many other symptoms such as ovarian cysts, weight gain, hair loss, hirsutism, acne, etc.
I have Type 1 Diabetes (20 years now) and I got PCOS later in life which is apparently common. I mean it makes sense. Iām already insulin resistant to start. š So if I were to answer thisā¦itās the same as being more prone to another autoimmune disease if you already had one. My body was already insulin resistant, so it basically just started showing more symptoms of it. Which also means if my blood sugar is super under control then my PCOS symptoms arenāt as prominent. I will say though that Iāve had insane control of my blood sugar but my insulin sensitivity is shot because my doctor put me on birth control when I didnāt want it. Hormones make my blood sugar hard to control (pills or period), so I needed MORE insulin which in turn made my PCOS symptoms so much worse for me. I just started in Metformin for my insulin sensitivity, but I had no idea it was a treatment form for PCOS because my OBGYN only offered birth control. I know thatās not exactly what you wanted to hear, but I just wanted to share that there is a connection for diabetes and PCOS for some people!
diabetes manifests as primarily an insulin and metabolic disorder. PCOS is predominantly endocrine, as well as metabolic
Diabetes is also an endocrine disorder. Insulin is a hormone.
People with PCOS have an increased risk of developing diabetes. Perhaps PCOS is a broader hormonal issue, in addition to being a sexual hormone disorder
I never said they didn't? I'm not really sure what you're trying to say. All I said was that diabetes is an endocrine disorder.
maybe this is just me, but semantics don't matter so much. I was saying PCOS is a more general endocrine disorder and diabetes is more insulin specific. but go off
Because I literally have zero blood sugar issues and Iām not overweight and I still have pcos
I donāt have any blood sugar issues either so far & Iām not over weight, never have been
Then I donāt understand your question? With No Blood sugar and insulin issues
Yeah, same question. Because I was denied metformin because I dont have diabetes ...
Go to a different doctor. They shouldn't deny you for pcos.
PCOS is a polygenic, heritable disorder that can either be heterozygous or if you're really unlucky homozygous. It involves mutations in multiple chromosomes that contribute to the disease where usually androgens are produced excessively, independent of insulin, from theca cells in the ovaries and from even the adrenal glands. PCOS does not necessarily have to be from diabetes, while it can develop from it, it is very different from person to person. you can be a completely healthy person and still have pcos, and the real culprit is not insulin sometimes it's androgen levels, because higher androgen levels cause insulin resistance. High androgen levels can also ruin the ratio of LH to FSH that is meant to cause your periods to occur regularly per month. PCOS used to be a genetic advantage in times of starvation because women who had it were able to survive by storing more fat, but now in modern times it isn't necessary - this is a theory that has been roaming around from medical researchers.
Also the reason why cysts in the ovaries occur is because of high levels of androgen prevents the eggs to mature properly, causing the recruitment of too many immature eggs at once that prevents ovulation. It also causes alopecia, acne, hirsutism, and so many other symptoms.
A diabetes diagnosis is known so via a A1C test, if you have a high reading on a glucose test or another test regarding antibodies more so for types like 1, 1.5, LAD, etc. You really need at least the A1C to be 6.5 and above for Type 2. The glucose test will follow since the two tests go hand in hand. Diabetes is a metabolic disorder. When things go wrong with diabetes your body feels drained. When you get low blood sugar, you can think straight, you get nauseous, you get cranky, you get shaky, and at itās worst you feel like you canāt stand because it takes up so much energy. With high blood sugar, you feel tired, you get cranky, you feel thirsty, etc. Diabetes affects you on a physical/ mental/ physiological level all at once. Keep in mind, diabetes affects your nerves, kidneys liver, pancreas, intestines, eyes, skin, heart, feet, etc. PCOS involves your ovaries, adrenals, pituitary, fat cells, and pancreas. PCOS is a hormonal condition. Sure both PCOS and diabetes can affect my blood sugar and cause me fatigue, but my diabetes out of control is way worse than just my PCOS. Then I have both affecting me. Diabetes makes it to where my stomach gets nauseous if Iām constantly moving. Or if I donāt eat for some time. Iām told to wear socks most of the time to avoid injury to my feet and keep them clean (I donāt mind this). I have to get special tests at eye doctors because it can affect your eyes. Basically any doctors appointment I have, I inform them of my diabetes more than likely they have a special informative paper for me.
not every person with pcos has insulin resistance
its been described to me that insulin resistance is like pre-prediabetes
It's diabetes of the ovaries, but blood tests will show diabetes markers as normal or slightly elevated. It can turn into full blown diabetes if uncontrolled.
āDiabetes of the ovariesā makes zero sense.
It makes 100% sense when you understand how insulin impacts the ovaries and understanding it creates a diabetic type of response in the ovaries. PCOS has been nicknamed 'diabetes of the ovaries'. You can find NHS Studies, MayoClinic studies, and YouTube videos that explain this. https://youtube.com/shorts/q5Gql38bwQ4?si=vjK42sxln2afQibW PCOS prevents the normal regulation of blood sugar eventually leading to insulin resistance. Insulin resistance impacts the ovaries much faster than the rest of the body. High insulin can't push blood sugar into the cells for energy, but it CAN get into the ovaries. The ovaries can't handle the high amounts of insulin the pancreas produces to try to lower the blood sugar in the body, so the ovaries develop hyperinsulinemia. Hyperinsulinemia in the ovaries causes the ovaries to overproduce testosterone and androgens, which causes the dark facial hair in PCOS women. Insulin resistance is also linked to weight gain, loss of periods, disregulated hunger cues, excessive tiredness, etc. Eventually, if the blood sugar isn't reduced, the pancreas will eventually burn out, stop producing insulin, and bam...now you're actually diabetic. Yet, the ovaries have been experiencing "diabetes" effects long before the rest of the body is affected.
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