Polycystic ovary syndrome: PCOS increases risk of type 2 diabetes

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Stubborn obesity, increased body hair, thinning head hair and acne – polycystic ovary syndrome (PCOS) may be behind these symptoms. It is the most common hormone disorder in women of childbearing age. The condition also poses a completely different problem: it significantly increases the risk of developing type 2 diabetes.

“One in seven women of childbearing age suffers from PCOS,” Dr. Susanne Reger-Tan introduced her presentation at the joint online press conference of the German Diabetes Society (DDG) and the German Society for Endocrinology (DGE). The clinical picture is characterized by a slight excess of male hormones. “The excess is only marginal, but sufficient to bring about significant changes,” explained the head of the Diabetes Center Diabetologikum at Essen University Hospital.

These changes are expressed not only externally by a “masculinization”, but also internally, as the imbalance of sex hormones can lead to cycle disorders, less frequent ovulation and consequently an unfulfilled desire to have children. The patients’ level of suffering is often very high, says Reger-Tan. In addition, the metabolism is also affected, because another characteristic of PCOS is insulin resistance.

As a result, women often suffer from severe persistent obesity. “Since the body’s cells respond sluggishly to insulin, the pancreas secretes more insulin and hyperinsulinemia occurs,” the doctor explained. The excess of insulin in the blood, in turn, stimulates further weight gain and also increases the excess of male hormones. “PCOS aggravates with insulin resistance in a vicious cycle.” But she also dispelled a prejudice: “There are also slim women with PCOS.”

Metabolic sequelae

Affected women are at risk of metabolic disease as a consequence. According to Reger-Tan, the risk of type 2 diabetes is four times higher than in healthy women of the same age. The risk for gestational diabetes is twice as high, he said. The risk for other pregnancy complications, such as gestational hypertension or preeclampsia, is also increased, she said.

“We need to be aware of this risk as physicians. Because women usually come to us with other complaints. Part of the initial diagnosis is a consistent diabetes diagnosis. As the years go by, we should reevaluate the risk,” Reger-Tan emphasized.

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