Recently Diagnosed PCOS - Questions about Diabetes
Hi,
I'm 19 and I've had PCOS symptoms (irregular periods, obesity, excess hair other than where it should be, mood swings and constant exhaustion) for over a year (not sure when they started, didn't take much notice to begin with). I had blood tests done earlier this year which showed my hormones were messed up and my doctor told me to have an ultrasound. Last week my ultrasound confirmed PCOS. My doctor told me to have an OGTT done before he prescribed anything, the results of the OGTT are confusing me. My fasting glucose is 101mg/dl (which the doctor who looked at the results, not my regular doctor) said was normal. My 1 hour was 212mg/dl, 2 hour 202mg/dl and 3 hour 109mg/dl. She said it wasn't anything that needed to be treated, that I should diet and it would go away. Is this true? My regular doctor (who I can't see at the moment, he's at the university where I'm studying but it's the summer hols and I'm home right now) said to repeat the test and it was likely I was diabetic. Anyone had similar experiences with 2 doctors saying totally different things? Does anyone know the real ranges the OGTT test should show?
Thanks for the link. My results seem to be high, what do I do next? Is it OK to wait till September when I'm back at uni? Do I need the insulin test? It's not done at the local hospital but I can travel to the larger hospital in the capital for the test..
Welcome! My fasting test was 99, my doctor said that was boarderline and dx me with PCOS IR. I am on 1500 of Met and have not felt this good in years. There are five different types of PCOS .. make sure you get a doctor that will listen to you.
# traditional PCOS -- anovulatory, increased androgens, no insulin resistance
# endocrine syndrome X -- anovulatory, increased androgens, insulin resistance or type 2 diabetes
# non-traditional PCOS --anovulatory, normal androgens, obese, insulin resistant or type 2 diabetes
# non-traditional PCOS -- ovulatory, increased androgens, mild insulin resistance
# idiopathic hirsutism -- ovulatory, increased androgens, no insulin resistance
This disorder is characterized by changes to the ovaries such that multiple follicles accumulate in the ovaries without ovulation. The ovary secretes higher levels of testosterone and estrogens. This results in irregular or no menses, excess body hair growth, occasionally baldness, and often obesity, diabetes and hypertension.
The main concerns of this condition are body changes (hair excess, obesity) and infertility due to anovulation. Because of the anovulation, women with polycystic ovarian syndrome are at risk for irregular and heavy menstrual bleeding problems, endometrial hyperplasia and even endometrial cancer. They are also thought to be at increased risk for premature heart attacks and cardiac disease due to weight and diabetes effects although this has been recently questioned.
Testosterone levels may be normal (20-80 ng/dl, 0.7-2.8 nmol/l) or elevated but usually less than 200 ng/dl. Serum androstenedione and dehydroepiandrosterone sulphate (DHEA -S) are usually normal but may be elevated. FSH and LH levels are normal to high normal, often (25%) with a ratio of LH to FSH of 3.0 or more. Luteinzing hormone - LH - is usually greater than 9 mu/ml (9 U/L) when ovaries appear polycystic on ultrasound.
Adrenogenital syndrome and ovarian androgen secreting tumors can produce this syndrome but the serum testosterone is used to screen for these. If the total serum testosterone is over 150 ng/dl (5 nmol/l) then adrenal or tumor causes should be investigated. TSH and prolactin levels are usually normal but are drawn to rule out pituitary or thyroid causes of the clinical symptoms. Measurement of abnormal glucose tolerance often indicates abnormality in the fasting and 2 hour blood sugar, post 75 gm glucose challenge, or the fasting glucose/insulin ratio or hemoglobin A1c.
Ultrasound findings often include multicystic ovaries with the follicle cysts lining up on the periphery of the ovary but it does not always meet the criteria of ten or more follicle cysts in each ovary. Of women who have classic polycystic ovaries on ultrasound scanning, only 50% have the classic hirsutism and anovulation. Of women who are felt to have polycystic ovarian syndrome on a clinical and laboratory basis but not on ultrasound criteria, 66-82% have the classic ultrasound appearance expected of polycystic ovaries.
High Insulin levels due to insulin resistance may be a primary cause. The insulin levels cause the increased androgen levels. In some cases, the insulin resistance is a genetic abnormality. Some instances of polycystic ovarian syndrome associated with male pattern baldness are thought to be due to an autosomal dominant genetic defect but it is important to note that this does not explain all cases). Since this is a syndrome that likely includes different categories of diseases, it is also likely that some instances are caused by genetic abnormalities while other instances are caused by environmental or as yet unknown conditions.
Restoring ovulation and decreasing the testosterone level are main goals of therapy. Weight loss to decrease the risk for long term early mortality is also a goal. Finally, prevention of endometrial cancer should be a goal of treatment.
Metformin has been used in women with PCOS and insulin resistance (fasting insulin levels over 20 ug/ml) to induce ovulation.
Eatting healthly and getting exercise is good, but those with PCOS are fighting against the wind. PCOS is a double edged sword, it causes the weight gain and if you could only get it off the symptoms may or may not go away. Many of the PCOS's here have found that a low-carb diet does well for them. The gals here are wonderful!
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Hi everyone.. again thanks for the support.
I've just got my results form this mornings OGTT. Fasting 111, 1 Hour 241, 2 hour 281 and 3 hour 171. The doctor who looked at them referred me to an endo but said i wouldn't be given meds. I'm going to get my brother to see my doctor at the uni for me hopefully someone can tell me what's going on with me.. I've looked online and over 200 is listed as diabetic range but the doctor said they would just look at my hormones again..
Hi, just wanted to say to Alison, you are not alone. My RE says my tests came back borderline PCOS but doesn't want to "label" me or give meds. I asked about metformin & he did not think it would help me. I don't know what my actually #'s were.
This is my 1st post too BTW! Lurking through all the messages to see if I can get an idea what I should do. Debating on getting a second opinion on the met. See I am also try to conceive so I need to get this straightened out.
Recently Diagnosed PCOS - Questions about Diabetes 
