Insulin resistance affects nearly all women with PCOS. Some experts say 70% while others would argue it affects all women with PCOS to some degree. You can have insulin resistance and not PCOS. Why is this? No one for sure knows why women develop PCOS. Some research indicates there may be a gene that is turned on by environmental factors. Insulin Resistance left untreated will lead to diabetes and higher chances of heart disease. If you missed my first post entitled, Insulin Resistance and PCOS: What You Need To Know, please check it out here.
What is Insulin Resistance?
Insulin resistance is a complex condition in which your body does not respond as it should to insulin, a hormone your pancreas makes that’s essential for regulating blood sugar levels. Several genetic and lifestyle factors can contribute to insulin resistance.
Cleveland Clinic
How?
Constant high blood sugars leads to insulin being unable to open and shut the door with the key. Insulin is the signal to the cells in muscle, liver, and fat to open the door and let glucose or sugar into the cell to be converted to energy.
Because the cells are being told to open the door over and over, they become “resistant” to the signal. The pancreas then releases more insulin to force the door open (hyperinsulinemia). Causing more resistance to open the door, and a vicious cycle occurs.
How is this different from Type 2 Diabetes?
Once the cells are unable to use the glucose, it remains in the bloodstream. The body senses the high glucose and tells the pancreas to secrete more insulin to deal with the excess glucose. Eventually, over years, the pancreas is unable to keep up. The glucose levels remain high in the bloodstream, and diabetes is then diagnosed by a blood test. When someone is diagnosed as diabetic, the pancreas makes little or no insulin because it can not do it anymore. Medications lower the glucose in the blood to allow the cells to use it. Uncontrolled diabetes can wreak havoc on the body and lead to hardened arteries in the heart, eyes, legs, and kidneys. You can refer to my previous post on the causes of insulin resistance.
What Tests Should I Get to Check For Insulin Resistance?
If you have PCOS, then you want to ask your doctor for tests that look at both insulin and glucose levels. These include:
- Fasting glucose or fasting insulin
- HBA1C level
- Oral Glucose Tolerance Test
Fasting Glucose or Insulin
It is more common for your doctor to order a fasting glucose level. Not all offices order a fasting insulin level. Although fasting insulin levels are more accurate. You should fast for about 12 hours before the lab draw.
Normal fasting glucose is below 100. A level over 126 is considered Diabetic.
A normal fasting glucose/insulin ratio of less than 4.5 is diagnostic of insulin resistance. Some would argue it is a better measure than the other tests listed.
HbA1C
This test is a measure of long-term glucose levels in the blood. It is a reflection of what your blood glucose levels have been over the last three months. It is commonly used to monitor diabetics and their response to medications. Your lab value should be less than 5.7 to be normal.
Oral Glucose Tolerance Test
This test is done by having you ingest 75 grams of sugar and then get your blood drawn at each hour for 2 hours, 1st draw when fasting.
Less than 140 mg/dl is normal,
If you are between 140 to 200 mg/dl then you have insulin resistance
If you are greater than 200 mg/dl then you are diabetic.
Metabolic Syndrome and Insulin Resistance
You should also check for metabolic syndrome if you have insulin resistance. Metabolic syndrome is a collection of symptoms that put you at higher risk for chronic diseases such as diabetes, heart disease, and cancer. You have to have 2 of the following criteria to get a diagnosis of metabolic syndrome. The criteria are:
- High blood pressure.
- High abdominal: waist ratio or central obesity of greater than 40 inches.
- HDL or good cholesterol lower than 40mg/dl for men, 50mg/dl for women.
- Triglycerides greater than 150mg/dl.
If you have metabolic syndrome, there is a high chance you are also insulin resistant. So get these labs done yearly as well as a good exam with blood pressure and weight check.
- Cholesterol Panel
- Comprehensive Metabolic Panel
- CBC
- Vitamin B12 and D
