What is PCOS and how is it related to Type 2 diabetes?

Polycystic ovary syndrome, also known as PCOS, is an endocrine-metabolic disorder that is reported to occur in about 5-12% of women* of reproductive age. It is characterized by multiple features, including accumulation of immature follicles developing in the ovary, hyperandrogenism (excessive level of androgen), irregular or missed menstruation, and obesity. PCOS is especially concerning for women as it has been reported to be a risk factor for infertility and pregnancy complications.

Throughout the past years, studies have found that women with PCOS have an increased risk for developing Type 2 diabetes mellitus (T2DM) later in life. While many experts posit insulin resistance to play a key role, the mechanism of action and the details of how PCOS is linked to the development of T2DM has yet to be established.

Among recent research, a study published in 2020 suggested obesity and high abdominal fat distribution in PCOS patients to be highly associated with development of T2DM later in life. This longitudinal study conducted a clinical evaluation across women of reproductive age and assessed their BMI, waist circumference, waist-hip ratio, and serum testosterone correspondingly at baseline, then 24 years later at follow-up. Hyperandrogenism, on the other hand, showed no statistical significance between women with PCOS who had developed T2DM at follow-up and those who had not. It must be noted that this work studied relatively small sample size of women with PCOS (n = 27) compared to that of controls (n = 94).