HbA1C below 5.7% is considered normal.
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It is usually characterized by three main symptoms that are irregular periods, high levels of “male” hormones (androgens) which may cause physical signs such as excess facial or body hair (‘hirsutism’), oily skin or acne, loss of hair loss on the scalp, and a confirmed diagnosis on an ultrasound or MRI scan.
Moreover, PCOS is also associated with several comorbidities like endometrial cancer, diabetes, non-alcohol-related fatty liver disease (NAFLD), and cardiovascular diseases. This crucially necessitates better treatments to further reduce this risk.
Diabetes and PCOS – The Link
PCOS affects 10% of women around the world. The risk of cardiometabolic diseases, such as type 2 diabetes or pre-diabetes (dysglycemia) is almost twice in women with PCOS as per the present study.
In addition, these women also scuffle with excess weight gain and less sensitivity of their body cells to insulin. Consecutively, it results in high levels of blood glucose levels.
To compensate for the increased levels of sugars in the body, the pancreas, in turn, produce more insulin, which ultimately results in elevated production of androgens that further aids in the increased fabrication of insulin levels in the body – thus driving a vicious circle.
How can Contraceptive Pill Help?
Contraceptive pills are birth/fertility control drugs that help in preventing unwanted pregnancies. It is also prescribed in PCOS treatment to regulate the menstrual cycle of women.
The team evaluated 64,051 women with PCOS along with 123,545 controls (without PCOS) from the UK patient GP records – a large population-based cohort study.
The present study “Polycystic ovary syndrome, combined oral contraceptives and the risk of dysglycemia: a population-based cohort study with a nested pharmaco-epidemiological case-control study” was conducted in two sessions – first the risk of type 2 diabetes and pre-diabetes was identified in women with PCOS followed by the effect of contraceptives use in them.
Contraceptive Pill and Diabetes
The combined oral contraceptives (often referred to as ‘the pill’) were evaluated in the study. It was found for the first time that the pill could diminish the risk of type 2 diabetes in almost a quarter of women with polycystic ovary syndrome (PCOS).
Moreover, the study demonstrated that hirsutism among women with PCOS is a substantial risk factor for type 2 diabetes and pre-diabetes.
Second Trial
The team further investigated the effects of the contraceptive pill in type 2 diabetes or pre-diabetes among 4,814 women with PCOS – a case-control study.
It was found that combined oral contraceptives use had abridged the risk of type 2 diabetes and pre-diabetes by 26% in women with PCOS. The study is further set to enter its clinical trial for fetching added evidence to modify global healthcare policies.
Secret behind the Findings
Although existing data point to the prevalence of type 2 diabetes in women with PCOS, the present study lays confirmatory evidence for re-defining the role of combined oral contraceptives in preventing this serious health risk.
The team hypothesizes that the contraceptive pills aid in stifling the androgens’ action for further reducing the risk of diabetes.
The pill encompasses estrogens (female reproductive hormone) that enhance the blood levels of a protein-sex hormone-binding globin (SHBG). The proteins sequentially inactivate the androgens by binding to them, thereby further reducing the number of active androgens.
Because of lower androgens, the impact of this hormone on insulin is further reduced that correspondingly aids in diminishing the diabetes risk.
“Importantly, our data highlight that normal weight women with PCOS were also at increased risk of type 2 diabetes and pre-diabetes. This parallels our previous finding of increased NAFLD risk in normal weight women with PCOS, further challenging the notion that PCOS-related metabolic complications are only relevant in the context of obesity. These data suggest that, rather than obesity in isolation, PCOS-specific factors, including androgen excess, underpin the increased metabolic risk,” says co-senior author Krish Nirantharakumar, Professor in Health Data Science and Public Health at the University of Birmingham’s Institute of Applied Health Research.
Managing Type 2 Diabetes in PCOS
The following methods may help sustain the blood sugar to normal and delay/prevent complications.
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Consume a healthy diet rich in fibers and vegetables - Recapitulate the regular exercise and physical activity
- Losing weight serves as an additional benefit against type 2 diabetes and PCOS
- Have regular diabetes medication or insulin therapy
- Monitor your blood sugar periodically
- Seek your doctor for any queries
Facts on Diabetes and PCOS
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India is ranked as the second-largest diabetic population globally, affecting every 1 in 6 Indians. -
Globally, type 2 diabetes affects 1 in 4 people over the age of 65 and 90-95% of adults. -
This tallies to 26.9 million people diagnosed with type 2 diabetes (including 26.8 million adults) and 7.3 million people (21.4%) being undiagnosed. -
Polycystic ovary syndrome (PCOS) affects every 1 in 10 women. -
It occurs due to hormonal imbalance and metabolism problems that may affect the reproductive health of women – a vital cause of infertility. -
Diabetes risk adds to the burden of PCOS. -
One of the prime disease-modifying recommendations for women with polycystic ovary syndrome (PCOS) is lifestyle modification such as low carbs and dairy diet, losing weight, and physical activity. - Insulin-sensitizing medications, such as metformin are specifically used for treating PCOS although The U.S. Food and Drug Administration (FDA) do not approve them.
- Birth control pills or hormonal contraceptives are recommended for the long-term treatment of PCOS as they help regulate menstrual periods, provided the women do not plan pregnancy.
References:
- Polycystic Ovary Syndrome, Combined Oral Contraceptives, and the Risk of Dysglycemia: A Population-Based Cohort Study With a Nested Pharmacoepidemiological Case-Control Study
– (https://care.diabetesjournals.org/content/early/2021/10/12/dc21-0437) - Type 2 diabetes – (https://www.mayoclinic.org/diseases-conditions/type-2-diabetes/diagnosis-treatment/drc-20351199)
- What is Diabetes?
– (https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes) - Polycystic ovary syndrome
– (https://www.womenshealth.gov/a-z-topics/polycystic-ovary-syndrome)
Source: Medindia
