Diabetes prevalence and risk factors in polycystic ovary syndrome

Women with PCOS have multiple risk factors for diabetes including obesity, a family history of type 2 diabetes, and abnormalities in insulin action. These may be increased in certain minority groups. There may be independent and additive effects from the presence of hyperandrogenemia, chronic anovulation, and polycystic ovaries. Studies of glucose tolerance in both urban and rural populations have shown rates of glucose intolerance in the range of 30 to 40% in reproductive-aged females with PCOS (both adolescents and adult females). There is poor correlation with fasting glucose levels. These findings justify vigilant screening for these abnormalities with an oral glucose tolerance test (OGTT) and appropriate interventions in a PCOS population. These findings may have substantial clinical relevance because they strongly suggest that women show reproductive abnormalities of androgen excess and irregular menses form a high-risk pool of women for glucose intolerance. Retrospective and preliminary natural history studies suggest that glucose tolerance worsens with age, and therefore periodic repeat OGTT testing is indicated.