Diabetic Polycystic Ovarian Syndrome
When PCOS and Diabetes Combine

Diabetic polycystic ovarian syndrome is a combination of two hormonal disorders, and they will make a woman's life miserable. It is much worse if you have no clue what is causing your misery.

Diabetes is a disease, and PCOS is a syndrome. What is the difference?

If you have all of the symptoms you have a disease. If you have some symptoms but not all, you have the syndrome.

You may only have two out of three of the markers for polycystic ovarian syndrome, but it means you have the hormone disorder that causes it.

And diabetic polycystic ovarian syndrome is a combination of two problems with an inflammatory root. If you have PCOS you may also be prediabetic.

What is PCOS?

PCOS was discovered in 1935 and its discoverers gave it their names. It was called Stein-Leventhal syndrome for a while, but today we know it as polycystic ovarian syndrome. When it joins with prediabetes it becomes diabetic polycystic ovarian syndrome.

The name is misleading, giving you the idea that this is a gynecological disorder. But it is not. Just like type 1 and type 2 diabetes, PCOS is a hormone or endocrine disorder that needs to be treated by an endocrinologist.

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Doctors know the name confuses us, and they tried to think of something else to call it, but the name PCOS has stuck.

It also confuses women that many of them are diagnosed with polycystic ovarian syndrome when they have normal ovaries on ultrasound. But this is a syndrome and abnormal ovaries are only one symptom.

The cause of polycystic ovaries seems to be that hormones are not letting the eggs go when it is time. The cysts are cavities in the ovary where an egg is stuck.

Those eggs were supposed to be released, but in PCOS the hormones are not doing their job.

So more and more of these cysts form around the outside of the ovary, giving it a bumpy appearance on an ultrasound. But removing ovaries does not cure PCOS or make it better.

This is an endocrine disorder, and cysts on your ovaries are only one symptom. But diabetic polycystic ovarian syndrome is a leading cause of infertility in women, affecting 5% to 10% of us because eggs do not fall into the uterus.

As a result you may have irregular or absent menses (periods), very heavy periods or prolonged ones that require a D&C, or just regular periods with spotting from a thickened lining of the uterus that bleeds a little.

Other Symptoms of PCOS

Women with diabetic polycystic ovarian syndrome often have terrible PMS (premenstrual syndrome) with back pain, carbohydrate cravings, mood swings, depression and sleep disturbance.

Having your hormones out of whack can lead to other things as well. You may grow extra body hair and develop acne as well as male pattern baldness on the top of your head.

The cysts on your ovaries may cause you no physical pain, but if sudden fever and pain do occur, you must go to your gynecologist quickly.

A cyst may have ruptured, or the ovary became twisted. This is a life-threatening situation.

But most women don't have symptoms to let them know they have diabetic polycystic ovarian syndrome. That is, until they have infertility problems. Or they may miscarry one or more pregnancies.

There is a high rate of this because of lowered progesterone levels. Progesterone is needed especially in the first trimester of pregnancy.

How PCOS and Type 2 Diabetes Connect

Diabetic polycystic ovarian syndrome connects at the metabolic syndrome and hyperinsulinemia.

Women with PCOS often test positive for hyperinsulinemia even if they have a normal blood glucose level. So getting your insulin levels checked can help to diagnose both PCOS and prediabetes.

Women with polycystic ovarian syndrome have carbohydrate sensitivity, leading to weight gain. Some women gain huge amounts very quickly.

The PCOS diet and diabetes diet resemble each other in many ways. For diabetic polycystic ovarian syndrome you should eat fewer high glycemic carbohydrates but eat lots of fiber, plenty of antioxidants and good protein.

Thyroid Problems

Another similarity is that both diabetics and PCOS sufferers tend to have thyroid problems. That's not surprising because the thyroid is a hormone regulator.

Hashimoto's thyroiditis is four times more likely to appear in women with PCOS. This particular thyroid problem is an autoimmune disorder where white blood cells attack the thyroid.

So doctors look for the antibodies that are present in Hashimoto's to diagnose it. Thyroid malfunction is also seen in type 1 and type 2 diabetics.

Signs of low thyroid include sleep disorders like insomnia and sleep apnea, hair loss, weight gain, ridged nails and dry skin. Low thyroid leads to dermatitis, depression and mental confusion.

But Hashimoto's is different from low thyroid in that you might have lows and then sudden high thyroid as the destruction of the thyroid progresses.

Treating Hashimoto's helps some of the symptoms of diabetic polycystic ovarian syndrome, but it does not address the metabolic syndrome, insulin resistance or hyperinsulinemia. So the progression from PCOS to type 2 diabetes can happen anyway.

Other Similarities

Sadly, there are other complications of PCOS besides type 2 diabetes. One is endometrial cancer that may be caused by the lack of progresterone to balance out estrogen.

Then there are infertility, miscarriage and a tendency for eating disorders. The list also includes high blood pressure, high triglycerides and heart disease.

If those last three sound familiar, it's because they are all complications of type 2 diabetes as well.

What Causes Diabetic Polycystic Ovarian Syndrome?

As with other autoimmune disorders, inflammation is the source, although at this time no one knows what causes the rampant autoimmunity that leads to diabetic polycystic ovarian syndrome.

Some factors are excess insulin, low grade inflammation and white blood cells interfering with normal organs, what many think is the underlying cause of insulin resistance.

Heredity is another factor. There are genetic markers for PCOS, and either parent can pass them to a daughter.

If there is a family history of thyroid disease and insulin resistance the chances of PCOS are higher. And if you have PCOS, your sisters have more than a 50% chance of having it too.

Some research is showing that exposure to excessive androgen while you are in the womb can lead to "gene expression," changes that make you more likely to have abdominal fat, insulin resistance and low grade inflammation.

But instead of looking at how it may have happened, perhaps you would rather know what can be done about it.

Diagnosing Diabetic Polycystic Ovarian Syndrome

Endocrine doctors look at your history first. Are there menstrual problems, miscarriages or polycystic ovaries in your family history or your personal history?

Do you struggle with obesity? Half of women with PCOS do. Do you have skin tags or velvety brown discoloration in skin folds or on your neck?

An ultrasound and blood tests will help, but you will need an endocrinologist for treatment because this is an endocrine disorder. Your doctor will rule out other endocrine problems, because PCOS is a "diagnosis of exclusion."

If there are no other causes and you have some of the symptoms you will be diagnosed with PCOS whether you have multiple cysts on your ovaries or not.

Next comes the treatment, and it does not include gynecological intervention. A hysterectomy won't fix PCOS.

Treating PCOS

For diabetic polycystic ovarian syndrome, you will be asked to change some things. There is a PCOS diet that is much like a diabetic one, because it avoids high glycemic carbohydrates. This will lower hyperinsulinemia.

You will need to control your weight and manage your stress. As with type 2 diabetes, exercise will help with weight, stress, and insulin problems.

Even if you do not have insulin resistance you might be started on metformin (Glucophage). This diabetic medication has been shown to help women become fertile, especially if it accompanies weight loss.

The combination of metformin, a low glycemic diet and exercise have led to an 85% improvement in menstrual cycles and ovulation. That makes them worth doing.

As with diabetes there is no true cure for PCOS, just things that have been found to help manage the symptoms.

All inflammatory syndromes are helped the most by a diet that avoids AGEs. We know that AGEs not only start autoimmune reactions but fuel their progression.

The same antioxidant rich diets and exercise help diabetics and PCOS sufferers alike. If you have PCOS and type 2 diabetes, it helps to know there are forums with exercise ideas, recipes and personal stories that will encourage you.

Please watch out for depression and self-pity. They are our worst enemies.

A woman facing PCOS has a lot to deal with, and if you are a type 2 diabetic as well, the challenge may be overwhelming. If you have diabetic polycystic ovarian syndrome, it might help to remember this. The only ones who fail are the ones who stop trying.

  • "What would men be without women? Scarce, sir, mighty scarce." ~ Mark Twain

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