My understanding is that no, not everyone with PCOS is insulin resistant. I know how strange that sounds when all the literature you read seems to point to insulin resistance being potentially the cause of PCOS, but from what others have posted on this board, not all of them have tested positive for IR. However, I have read that even some that don't have IR are prescribed metformin and have had success with their PCOS symptoms, even though Metformin is primarily prescribed for IR when it is not prescribed for diabetics. So there must be some other action metformin has that helps many with PCOS.
It makes me wonder if the tests for insulin resistance are necessarily accurate.
If someone tests neg for IR yet the met helps them then there's something wrong with the equation, kwim?
I know a lot of people who are hypoglycemic or borderline for diabetes don't always show IR with some tests but do with others....
I have PCOS and I'm 5'4 and almost 120lbs, so I'm pretty thin. I was worried about being insulin resistant or having diabetes so I just had a blood test done and I do not have either.
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It is difficult to definitively diagnose IR with simple fasting bloodwork or the GTT test unless your insulin levels are out the roof. The best way to test for IR is the Hyperinsulinemic euglycemic clamp which is very expensive and generally only used by researchers. Wiki gives a good explanation of how it is done. http://en.wikipedia.org/wiki/Insulin_resistance
If you google on insulin resistance testing or insulin resistance diagnosis, you will find some interesting theories about the best way to diagnose it using the tests available to medical practitioners. One way is to look at a person's blood pressure, cholesterol and tri-glycerides. If all three of those are even slightly elevated, the person is likely IR.
My doctor tested me for insulin resistance during the GTT, he had them take blood not only to test the blood sugar, but also to test insulin levels and compared the insulin level at certain times during the test. Though my blood sugar stayed normal, the insulin levels were way above normal, so it was pretty obvious and logical to conclude that normal blood sugar - high insulin means insulin resistance. If your blood sugar is normal and your insulin levels are normal then you're not...if your blood sugar is normal or high and your insulin levels are high, you're probably insulin resistant. I'm not sure why they would need all those other fancy tests to conclude something that seems pretty obvious when you compare insulin levels to blood glucose levels.
Has anyone heard of the fasting Glucose to Insulin Ratio (GIR), HOMA, or WICKI for testing for IR. Does anyone know how to calculate these and what the results mean??? Thanks
Are we all insulin resistant? 
