Here's yet another consequence of America's childhood obesity epidemic: New research shows that girls with type 2 diabetes can set themselves up for developing a condition known as polycystic ovary syndrome (PCOS).
What is PCOS?
PCOS occurs when a woman's ovaries or adrenal glands produce more male hormones than normal, and its many symptoms include:
- Painful cysts on the ovaries
- Irregular periods
- Excessive hair growth
- Acne
- Weight gain
- Infertility
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What is the link between diabetes and PCOS?
Exactly how type 2 diabetes and PCOS are linked isn't fully understood yet.
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"There's more work to be done to explore the genetic, epigenetic and environmental factors that can explain this association," says study author Dr. M. Constantine Samaan. He's an associate professor of pediatrics at McMaster University and McMaster Children's Hospital in Hamilton, Ontario, Canada.
Insulin resistance likely plays a central role in both conditions, Samaan shares. When the body doesn't respond well to insulin, blood sugar can build up in your bloodstream, eventually leading to type 2 diabetes. Many women with polycystic ovary syndrome are also insulin-resistant.
Samaan and his colleagues conducted a review to get a better handle on the risk of PCOS in girls with type 2 diabetes. Just shy of 20% of 470 girls with type 2 diabetes from six studies conducted across several countries had polycystic ovary syndrome. That rate is at least twice as high as it is in the general adolescent population, he notes.
"Previously, we knew that some girls with type 2 diabetes can develop PCOS, and our paper defines the specific global prevalence of PCOS in type 2 diabetes in girls," Samaan adds.
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Awareness of PCOS risk is the key, he shares. "Girls with type 2 diabetes need to be counseled about the risk of PCOS, and patients need to share information with their providers about irregular periods, acne or excessive hair growth, to allow appropriate investigations and treatments to be implemented," Samaan notes.
What are the risks?
The exact cause of PCOS is unknown, however, many factors might play a role:
- Excess insulin. As mentioned before, if your cells become resistant to the action of insulin, your blood sugar levels can rise and your body might produce more insulin. Excess insulin can increase androgen production, and cause you to have difficulty with ovulation.
- Low-grade inflammation. This term is used to describe white blood cells' production of substances to fight infection. According to research, women with PCOS have a type of low-grade inflammation that stimulates polycystic ovaries to produce androgens. This can lead to heart and blood vessel problems.
- Heredity. Research also shows that certain genes might be linked to PCOS.
- Excess androgen. When the ovaries abnormally produce high levels of androgen, it results in hirsutism and acne.
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The importance of screening
Dr. Laurie Cohen, chief of the Division of Pediatric Endocrinology and Diabetes at the Children's Hospital at Montefiore in New York City, points out that it's a two-way street when it comes to type 2 diabetes and polycystic ovary syndrome.
"Individuals with PCOS are at increased risk for metabolic syndrome and type 2 diabetes, so [they] should be screened for these conditions, and individuals with obesity or type 2 diabetes mellitus should be screened for PCOS," she says.
Getting treatment
Treating PCOS can ease many of its symptoms, Cohen adds.
In adolescents, the first line of treatment for PCOS is usually a combined oral contraceptive pill, she shares. "If the excessive hair growth doesn't improve, an anti-androgen medication may be added."
When a child with PCOS is also overweight or obese, lifestyle modifications such as diet and exercise are recommended. "Sometimes a medication called metformin is used if there is prediabetes or type 2 diabetes," Cohen explains.
When to see a doctor
You should see your doctor if you have concerns or are experiencing problems with your menstrual periods, infertility or if you have signs of excess androgen such as worsening hirsutism, acne and male-pattern baldness.
