Type 2 Diabetes and PCOS: Understanding the Connection
Experts have long speculated there’s a compelling link between type 2 diabetes and PCOS. Insulin resistance – a common characteristic of PCOS – is thought to be responsible for making women vulnerable to developing type 2 diabetes.
Living with PCOS can compromise your emotional and physical health. But, unsurprisingly, the added burden of type 2 diabetes can make this condition even more taxing and challenging. Despite this, we want to reassure you that, with the correct application and an integrative, holistic approach, you can manage this common symptom of PCOS and support your overall health.
Can PCOS cause diabetes?
While the root cause of PCOS remains fuzzy and inconclusive, there’s tangible evidence pointing to its connection with type 2 diabetes. A recent study suggested women with PCOS were three times more likely to develop this comorbidityi. Experts hypothesize this is the result of insulin resistance, which is often a by-product of PCOSii.
PCOS and insulin resistance
In very simple terms, PCOS triggers a sluggish response to insulin. This means more and more insulin is required before the body utilises glucose for energy. Unfortunately, such high levels of glucose in the body can increase the likelihood of type-2 diabetesiii.
What exacerbates this risk is weight gain, which is another common comorbidity of PCOS. Notably, between 30 and 70% of women with PCOS will experience weight gainiv. It’s not surprising, therefore, that The International Diabetes Federation has officially recognised PCOS as a risk factor in the development of type 2 diabetesv.
Type 2 diabetes takes hold gradually; leading to increased hunger and thirst, a dry mouth, frequent urination, fatigue, blurred vision, and headachesvi.
It’s worth noting that not every woman with PCOS will experience type-2 diabetes. However, it remains important to follow these preventative measures to support your overall health with PCOS.
Obesity is a significant contributing factor in the development of type 2 diabetes. Although PCOS can make weight loss more challenging, losing even a small amount of weight can help to manage symptoms.
As Dr Aled Rees, consultant endocrinologist, states: "Our research indicates that close monitoring of PCOS patients who have difficulty managing their weight could help to catch the development of diabetes early"vii.
Weight loss doesn’t need to be strict or rigorous. Simply making healthy changes to your diet and lifestyle will be enormously beneficial. An integrative approach will support weight loss and will, crucially, restore some harmony to your blood sugar levels, which is essential if you want to minimise the risk of type-2 diabetes.
Add more whole grains
To control hunger cravings, maintain a healthy weight, and above all, keep your glucose levels happy, try adding more on high-fibre, protein-packed whole grains to your diet, instead of their highly processed counterparts.
Build your meals around brown rice, quinoa, rolled oats, pearl barley, buckwheat and millet – all of which have a low glycaemic index (the rate a carbohydrate raises your blood glucose levels).
Beyond this, you should also consider limiting your intake of white rice, pasta and bread. These foods tend to have a high GI profile, causing your blood glucose levels to spike, crash, and leave you craving even more carbohydrates.
Like refined carbohydrates, sugar also causes a rapid increase in your blood sugar levels. To maintain balance, your pancreas releases insulin, but excessive amounts of this hormone can drive sugar into your fat storesviii.
It can be helpful to think about your sugar intake in the same way a car utilises petrol: if your energy requirements are high, the sugar is put to good use, providing fuel to your body’s cells. But when you send sugar to your bloodstream and your body doesn’t need it, you run into problems. This confuses your pancreas, prompting it to release a disproportionate amount of insulin, which is then stored as fat.
Sugar is also dangerously addictive. Try to cut back on sugary snacks, fizzy drinks, and ready meals. Remember, you can enhance meals with spices and citrus fruits as opposed to sugar. Ginger, allspice, cinnamon, nutmeg, lemon and lime all add a healthy, delicious kick to dishes.
Eat more healthy fats
It’s time to dispel the myth about eating fat. While eating unhealthy fats – trans fats or saturated fats – is known to lead to weight gain, healthy fats, like monounsaturated fats, may support weight loss and overall health.
A randomised controlled trial found a Mediterranean diet – one rich in olive oil and nuts – may be extremely useful in weight management.ix Researchers purport monounsaturated fats help to elevate the body’s metabolic rate and encourage it to burn fat more rapidly.
With this in mind, make a conscious effort to add more avocados, oily fish, nuts, chia seeds, and extra virgin olive oil to your diet.
Water doesn’t only promote satiety, but it also increases your caloric burn, thereby supporting weight loss.
In a study of healthy men and women, drinking around 2 glasses of water momentarily elevated the metabolic rate of participants’ by 30 per cent.x The researchers concluded increasing water intake by 6 glasses daily could increase caloric burn by 200 calories.
If water doesn’t appeal, try adding sliced citrus fruits, a sprig of mint or low-sugar cordial.
Exercise is a vital part of any weight loss plan. But your approach to exercise doesn’t have to be rigid and relentless. To reap the benefits, very simply, you can incorporate physical activity into your everyday routine: begin cycling to work; take a brisk walk with your colleagues at lunchtime; use the stairs as much as possible throughout the day.
The notion that smoking is harmful isn’t anything new. There’s an abundance of compelling data illuminating smoking is a risk factor in many medical conditions, including type 2 diabetesxi.
While the exact reasoning behind cigarette smoking and type 2 diabetes remains unclear, existing evidence proposes it may lead to the development of insulin resistancexii.
Smokers are 30-40% more likely to suffer from type 2 diabetes than non-smokers. You can find more advice on smoking cessation here.
A growing body of data suggests alcohol can lead to dangerously fierce spikes in blood sugar and may even result in liver toxicity. A study published in the Annals of Internal Medicine found that heavy consumption of alcohol – defined as 3 or more drinks per day – increased the risk of diabetes by 43 per centxiii.
According to the NHS, women are advised against drinking more than 14 units of alcohol a week on a regular basis. They also encourage you to spread your drinking over 3 days of more if you regularly drink as much as 14 units a week. And if you want to cut down, try to have several drink-free days each week.
Be mindful that 14 units equate to 10 small glasses of low-strength wine and 6 pints of average-strength beer.
Stress is omnipresent in the modern world. Beyond being debilitating, it can have deeper biochemical implications, too, triggering dangerous fluctuations in your blood sugar levels.
When you’re stressed, your body primes itself for ‘fight or flight’ by ensuring there’s a readily available supply of energy, which causes more glucose to flow through your bloodstreamxiv. As aforementioned, excessive spikes in your blood glucose levels are characteristic of type 2 diabetes.
To prevent this, try to carve out some ‘you-time’ every day. Prioritise meditation, mindfulness, visualisation, deep breathing, yoga, or walks in nature – any form of ‘therapy’ to calm your mind in moments of stress.
If you do suffer with PCOS and type 2 diabetes, then in addition to lifestyle measures there are more active ways you can manage both conditions.
With a similar structure to glucose, myo-inositol plays an important role in the body’s communication with cells and may help to manage blood sugar levels.
In a study published by the International Journal of Endocrinology, scientists analysed the metabolic results of taking myo-inositol and d-chiro-inositol (at a ratio of 40:1) in both men and women suffering from type 2 diabetesxv. The inositols were taken twice a day, orally, alongside traditional diabetic treatment drugs, like metformin. The participants also followed a low GI diet. After just 3 months, participants who took the combined inositols saw a marked reduction in their fasting glucose.
To support healthy blood sugar management, we highly recommend taking 4 grams of powdered myo-inositol daily with water or fruit juice.
Traditionally used to alleviate digestive issues, this humble spice has become the focal point of research thanks to its purported blood-sugar balancing properties. Interestingly, data has highlighted cinnamon contains active substances that help regulate blood glucose by imitating insulin in the bodyxvi.
To balance energy reserves between meals, try adding a high-strength 2,500mg cinnamon supplement to your diet.
An essential trace element, chromium is tremendously important in lipid, protein, and carbohydrate metabolism. When the body has insufficient stores, it may lead to glucose intolerance and even insulin resistancexvi.
Chromium is generally found in meat and shellfish. If you fail to eat enough of these food groups, chances are your intake will be poor. We suggest taking a high-strength, well-absorbed chromium supplement that packs 200µg to plug any nutritional gaps.
Metformin for PCOS treatment
Metformin is widely touted as an effective medical intervention for type-2 diabetes. Not only does this medication reduce the amount of glucose (sugar) the liver releases into the body, but it also helps the body’s insulin work more efficiently. In short, metformin improves insulin resistance so that the insulin your body does produce functions better.
If you’re interested in using metformin to manage your symptoms, speak to your GP.
Dealing with a second chronic condition alongside your PCOS can be emotionally and physically taxing. However, as we’ve demonstrated, there are many integrative, holistic approaches you can implement to manage the symptoms of type 2 diabetes and even prevent the onset of the condition in the first place.
Enjoyed reading this article? Please feel free to browse the rest of our hub and discover more ways to manage your PCOS.
Diabetes.co.uk. (2012). Polycystic Ovary Syndrome can raise diabetes risk threefold [ONLINE]. Available online: https://www.diabetes.co.uk/news/2012/Mar/polycystic-ovary-syndrome-can-raise-diabetes-risk-threefold-97794970.html
Dunaif, A. (1997). Insulin resistance and the polycystic ovary syndrome: mechanism and implications for pathogenesis. Endocr Rev. (18): 774–800.
Bremer, A.A., Miller, W.L. (2008). The serine phosphorylation hypothesis of polycystic ovary syndrome: a unifying mechanism for hyperandrogenemia and insulin resistance. Fertil Steril. (89):1039–1048.
Gambineri, A., et al. (2012). Polycystic ovary syndrome is a risk factor for type 2 diabetes: results from a long-term prospective study. Diabetes. (61): 2369–2374.
Alberti, K., et al. (2007). International Diabetes Federation: a consensus on type 2 diabetes prevention. Diabet Med. (24): 451-463.
Dansinger, M. (2017). Symptoms of Type 2 Diabetes [ONLINE]. Web MD. Available: https://www.webmd.com/diabetes/type-2-diabetes-symptoms
Diabetes.co.uk (2012). Polycystic Ovary Syndrome can raise diabetes risk threefold [ONLINE]. Available online: https://www.diabetes.co.uk/news/2012/Mar/polycystic-ovary-syndrome-can-raise-diabetes-risk-threefold-97794970.html
Stanhope, K.L. (2016). Sugar consumption, metabolic diseases and obesity: the state of the controversy. Crit Rev Clin Lab Sci. 53(1): 52–67.
Austel, A., et al. (2015). Weight loss with a modified Mediterranean-type diet using fat modification: a randomized controlled trial. Eur J Clin Nutr. 69 (8): 878-84.
Boschmann, M. (2003). Water-Induced Thermogenesis. The Journal of Clinical Endocrinology & Metabolism. 88 (12): 6015-6019.
Willi, C., et al. (2007). Active Smoking and the Risk of Type 2 Diabetes: A Systematic Review and Meta-analysis. Clinician's Corner. 298 (22): 2654–2664.
Centers for Disease Control and Prevention. (2018). Smoking and Diabetes [ONLINE]. Available online: www.cdc.gov/tobacco/campaign/tips/diseases/diabetes.html#three
Howard, A.A. (2004). Effect of alcohol consumption on diabetes mellitus: a systematic review. The Annals of Internal Medicine. 40(3): 211-9.
Diabetes Education Online. (2007). Blood Sugar and Stress. [ONLINE]. Available online: https://dtc.ucsf.edu/types-of-diabetes/type2/understanding-type-2-diabetes/how-the-body-processes-sugar/blood-sugar-stress/
Pintaudi, B., Di Vieste, G., Bonomo, M. (2016). The Effectiveness of Myo-Inositol and D-Chiro Inositol Treatment in Type 2 Diabetes. Int J Endocrinol.
Ranasinghe, P., et al. (2012 Jul). Efficacy and safety of “true” cinnamon (Cinnamomum zeylanicum) as a pharmaceutical agent in diabetes: a systematic review and meta-analysis. Diabet Med. 29(12):1480–92.
Cefalu, W.T. (1999). Effect of chromium tripicolinate on insulin sensitivity in vivo. J Trace Elem Exp Med. 12:71–83.
Disclaimer: The information presented by Nature's Best is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. Self-treatment is not recommended for life-threatening conditions that require medical treatment under a doctor's care. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications.
Olivia Salter has always been an avid health nut. After graduating from the University of Bristol, she began working for a nutritional consultancy where she discovered her passion for all things wellness-related. There, she executed much of the company’s content marketing strategy and found her niche in health writing, publishing articles in Women’s Health, Mind Body Green, Thrive and Psychologies.