“During routine blood work, I started noticing that my fasting blood sugar was rising. My dad also has type 2, and for a long time, I was naïve and didn’t want to admit that I had it,” she says. RELATED: What to Know About Your Type 2 Diabetes Risk if a Parent Has the Disease Even without a family history, having PCOS dramatically raises your risk of type 2 diabetes. One study published in October 2017 in The Journal of Clinical Endocrinology & Metabolism found women with PCOS had four times higher odds of developing the disease, and were diagnosed with type 2 diabetes at an earlier age than those women without PCOS. Now 40, Elkins says that looking back on her PCOS diagnosis, she was never told that type 2 diabetes was something that should be on her radar. “Back when I was diagnosed, the message was, you have this thing called PCOS, but we really don’t know what comes from it,” she says. It’s a sentiment echoed by doctors, too. “In the past, PCOS was thought of as a reproductive disorder related to fertility. In the last few years, people are becoming aware that it’s a metabolic condition,” says Fiona McCulloch, ND, founder and owner of White Lotus Integrative Medicine in Toronto, Canada. Dr. McCulloch explains that women with PCOS experience problems with insulin, which can range from mild to severe. “These women secrete more insulin than other women, especially after eating, which prompts the body to store fat and is associated with inflammation. Over time, this can cause problems with pancreatic function,” she says. PCOS is also linked to obesity, particularly with gaining fat around the waistline, another factor that can up risk for type 2. Slim women can still have PCOS, but McCulloch says “as a general rule, these women are much less likely to develop type 2,” she says. Still, that doesn’t mean you’re immune. For her part, Boston-area health coach Amy Medling, who specializes in PCOS diagnoses and runs the website PCOS Diva, points out that “PCOS is a syndrome, so it doesn’t affect every woman in the same way,” she says. (Medling also has PCOS.) “For instance, I’m a lean person, but I’ve definitely had hypoglycemia and noticed that my blood sugar wasn’t controlled all the time,” she says. RELATED: How to Spot the Signs of High and Low Blood Sugar
The Importance of Getting Screened for Type 2 Diabetes if You Have PCOS
In the years after being diagnosed with PCOS, you may see that all of your blood sugar markers look really normal, says McCulloch. The validated tests to screen for diabetes in PCOS include fasting glucose, A1C, or oral glucose tolerance test (OGTT). Ask your doctor what tests they recommend for you, keeping in mind that you may have to broach the subject if your doctor doesn’t have diabetes on their radar. For example, Medling had to ask her doctor to prescribe a glucometer so that she could test her blood sugar before and after meals, something that “helped me finally start connecting the dots on why I was dealing with fatigue, nausea, and cravings for sugar,” she says. Early detection is key. “If you can intervene early, you can prevent type 2 diabetes,” says McCulloch. You can also then work to prevent the complications of diabetes, and protect your arteries, eyes, and kidneys in the process. For Elkins, despite taking medication and a once-a-week injection, she says keeping her blood sugar in check is still a struggle. “The diagnosis hit me pretty hard. I know I need to get this under control. I don’t want to be sick and end up having complications in my later years,” she says.
How to Help Prevent Type 2 Diabetes if You Receive a PCOS Diagnosis
Watch for warning signs and symptoms of type 2 diabetes. Potential signs and symptoms of type 2 diabetes include skin discoloration (called acanthosis nigricans), skin tags, frequent urination, increased thirst, and foot pain or numbness. Keep your weight in check. Staying leaner and more active can help prevent a lot of the early insulin resistance, the hallmark of type 2 that’s hard to reverse, says McCulloch. Elkins discovered that PCOS made managing diabetes more difficult. “Once you put on weight, it’s extremely difficult to get off,” she says. If you have prediabetes, losing just 5 to 7 percent of your body weight can help prevent progression of the disease into full-blown type 2 diabetes, the Centers for Disease Control and Prevention (CDC) notes. Think about your diet. An anti-inflammatory diet may be your best bet for preventing diabetes if you have PCOS, says McCulloch. That means “avoiding sugars and processed foods, and focusing on lean proteins, healthy fats, and lots of veggies,” she says. The vegetables will provide you with the fiber you need to help stabilize blood sugars, while avoiding highly processed foods will keep out those that stimulate insulin release. RELATED: 10 High-Fiber Foods to Add to Your Diet Build your plate. Beyond what foods to eat, Medling generally recommends that her clients with PCOS who are looking to control their blood sugar follow her plate rule: One-half should be nonstarchy veggies, one-quarter is a starchy veggie or gluten-free grain, and the other quarter is a protein. On top, add a generous dollop of healthy fat. “However, there’s no one-sized-fits-all approach, so you need to pay attention to how your body feels and adjust the ratios accordingly,” she says. Lift a little. Strength training will help build lean muscle mass. “Gaining more muscle will make you more insulin sensitive,” says McCulloch. One way to do that is through high-intensity interval training. A study published in July 2017 in the journal Frontiers in Physiology found that 10 weeks of high-intensity interval training (HIIT) can help women at risk for type 2 diabetes improve measures of blood pressure, and blood glucose — and it helped them lose weight. Zen out and conk out. Having strategies at the ready to curtail stress — such as going for a walk, taking a few calming breaths, or calling a friend — and carving out the seven to eight hours a night most adults require for sleep can be a big player in weight management, says McCulloch. RELATED: 10 Surprising Causes of Blood Sugar Swings You Probably Didn’t Know Consider supplements. It’s important to work with your medical provider regarding supplements you’re thinking of taking to ensure they won’t interfere with any current medication. Medling often suggests berberine, an herbal supplement that has been shown to improve insulin resistance in people with metabolic syndrome, according to research published in March 2012 in the World Journal of Cardiology. Also, a trial is currently underway to show how effective it may be for treating insulin resistance in women with PCOS.
