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Insulin Resistance And Pcos

Pcos: Insulin And Metformin

Pcos: Insulin And Metformin

Young women with PCOS often have elevated insulin levels and are more likely to develop diabetes. Metformin is a medication often prescribed for women with PCOS to help prevent diabetes. A lifestyle that includes healthy nutrition and daily exercise is the most important part of a PCOS treatment plan. What is insulin? Insulin is a hormone made by an organ in the body called the pancreas. The food you eat is broken down into simple sugar (glucose) during digestion. Glucose is absorbed into the blood after you eat. Insulin helps glucose enter the cells of the body to be used as energy. If there’s not enough insulin in the body, or if the body can’t use the insulin, sugar levels in the blood become higher. What is insulin resistance? If your body is resistant to insulin, it means you need high levels of insulin to keep your blood sugar normal. Certain medical conditions such as being overweight or having PCOS can cause insulin resistance. Insulin resistance tends to run in families. What can insulin resistance do to me? High insulin levels can cause thickening and darkening of the skin (acanthosis nigricans) on the back of the neck, axilla (under the arms), and groin area. In young women with PCOS, high insulin levels can cause the ovaries to make more androgen hormones such as testosterone. This can cause increased body hair, acne, and irregular or few periods. Having insulin resistance can increase your risk of developing diabetes. How can I lower my insulin levels? You can help lower your insulin levels naturally by eating fewer starches and sugars, and more foods that are high in fiber and low in refined carbohydrates. Low glycemic foods, on the other hand, don’t raise your blood sugar or insulin levels as much as foods that are high in sugar or refined carbohydr Continue reading >>

Polycystic Ovary Syndrome

Polycystic Ovary Syndrome

The exact cause of polycystic ovary syndrome (PCOS) is unknown, but it's thought to be related to abnormal hormone levels. Resistance to insulin Insulin is a hormone produced by the pancreas to control the amount of sugar in the blood. It helps to move glucose from blood into cells, where it's broken down to produce energy. Insulin resistance means the body's tissues are resistant to the effects of insulin. The body therefore has to produce extra insulin to compensate. High levels of insulin cause the ovaries to produce too much testosterone, which interferes with the development of the follicles (the sacs in the ovaries where eggs develop) and prevents normal ovulation. Insulin resistance can also lead to weight gain, which can make PCOS symptoms worse, because having excess fat causes the body to produce even more insulin. Hormone imbalance Many women with PCOS are found to have an imbalance in certain hormones, including: raised levels of testosterone – a hormone often thought of as a male hormone, although all women usually produce small amounts of it raised levels of luteinising hormone (LH) – this stimulates ovulation, but may have an abnormal effect on the ovaries if levels are too high low levels of sex hormone-binding globulin (SHBG) – a protein in the blood, which binds to testosterone and reduces the effect of testosterone raised levels of prolactin (only in some women with PCOS) – hormone that stimulates the breast glands to produce milk in pregnancy The exact reason why these hormonal changes occur isn't known. It's been suggested that the problem may start in the ovary itself, in other glands that produce these hormones, or in the part of the brain that controls their production. The changes may also be caused by the resistance to insulin. Genetics Continue reading >>

Insulin Sensitivity And Β-cell Function In Women With Polycystic Ovary Syndrome

Insulin Sensitivity And Β-cell Function In Women With Polycystic Ovary Syndrome

OBJECTIVE—To evaluate insulin sensitivity (IS) and β-cell function (βF) in lean and obese women with polycystic ovary syndrome (PCOS), either separately or by using a disposition index (DI). RESEARCH DESIGN AND METHODS—A total of 64 women with PCOS and 20 healthy women were examined by anthropometry, oral glucose tolerance tests (OGTTs), and insulin tolerance tests. Statistical analysis used one-way ANOVA, Kruskal-Wallis, and Mann-Whitney U tests, as appropriate. RESULTS—A significantly higher waist-to-hip ratio (P < 0.0001) was found in both lean and obese women with PCOS. Higher basal blood glucose (P < 0.004) and blood glucose values at 3 h of OGTT (P < 0.008) were found in lean and obese PCOS subjects in comparison with control subjects. Insulin resistance by homeostasis model assessment (P < 0.007) was significantly higher in obese PCOS than in control or lean PCOS subjects. Early-phase insulin secretion (insulinogenic index [ΔI/ΔG30–0, where I is insulin and G is glucose]; P < 0.0007) was significantly higher in both lean and obese PCOS subjects than in healthy women. All tested combinations of parameters of IS and βF (DIs) followed a physiological hyperbolic relationship. Significantly lower values of the fasting state–derived DIs were found (all P < 0.05) in obese PCOS subjects. Significantly higher values of all of these indexes derived from nonfasting values were found in lean PCOS as compared with control and obese PCOS subjects (all P < 10–3). CONCLUSIONS—Increased βF was found even in lean individuals with PCOS. Insulin hypersecretion is thus probably connected to the pathogenesis of PCOS. AUC, area under the curve βF, β-cell function Cp, C-peptide DHEA, dehydroepiandrosterone DHEAS, DHEA sulfate DI, disposition index FGIR, fasting glu Continue reading >>

What You Need To Know About Pcos And Insulin Resistance

What You Need To Know About Pcos And Insulin Resistance

Insulin Resistance PCOS and insulin resistance are frequently found together, which makes it important to understand this common problem. Insulin is a hormone which is produced by the pancreas, a gland in the abdomen with a lot of functions. It is typically secreted in response to a large amount of glucose, or sugar, in the blood. Once produced, insulin causes glucose to be taken into the body cells to be used for energy. Women with PCOS frequently have insulin resistance, meaning their body does not respond as quickly to insulin. The sluggish response will cause larger and larger amounts of insulin to be required before glucose is taken into the body tissues, and eventually a change in the way the body deals with sugar. Consistently high levels of glucose in the blood can lead to diabetes. Insulin is an appetite stimulant, which is perhaps why many women with PCOS report frequent cravings for sweets and other carb rich foods. Elevated insulin levels is also believed to be a contributing factor to inflammation and other metabolic complications associated with PCOS. Pre-Diabtes A condition called pre-diabetes, increases the risk for type 2 diabetes and other metabolic conditions. During this stage, which can last as long as 10 to 12 years, the body is no longer as sensitive to insulin as it may have been before. This leads to high blood sugars after eating that do not quickly lower. Because PCOS is now recognized as a risk factor for developing diabetes, it is recommended that women with the disease be routinely screened so that insulin resistance can be found early, and treatment can be initiated earlier. Screening As many as 30% to 40% of women may experience insulin resistance and eventually develop type 2 diabetes. Because of the associated risk of cardiovascular dis Continue reading >>

Hypothyroidism, Insulin Resistance Risk Due To Polycystic Ovary Syndrome (pcos)

Hypothyroidism, Insulin Resistance Risk Due To Polycystic Ovary Syndrome (pcos)

Hypothyroidism increases the risk of insulin resistance due to polycystic ovary syndrome (PCOS). PCOS is a common hyperandrogenic disorder affecting women. PCOS increases the risk of obesity, infertility, metabolic syndromes and insulin resistance. It’s reported that 50 to 70 percent of those with PCOS have insulin resistance – a condition where the body does not use insulin properly. Being insulin resistant increases the risk of cardiovascular disease as well as diabetes. Hypothyroidism as well has been shown to cause changes in the metabolism, which can contribute to insulin resistance. Thyroid hormones have been shown to increase glucose hepatic output. Research in women with PCOS revealed that having subclinical hypothyroidism can aggravate insulin resistance. Hypothyroidism and PCOS PCOS is often mistaken for a thyroid disorder, making it difficult to diagnose. Additionally, abnormalities in thyroid hormones can contribute to PCOS, which is influenced by insulin resistance. PCOS is caused by a hormonal imbalance. PCOS is associated with female reproduction but can also interfere with the thyroid. A hormone imbalance in one part of the body can trigger a hormone imbalance in another, thus PCOS can very well contribute to a thyroid condition. When levels of the male hormone androgens are too high it can cause PCOS. Androgens can disturb the female reproductive system and cause an imbalance of the female hormones estrogen and progesterone. Symptoms of PCOS include: Infertility Polycystic ovaries Hirsutism Hair loss Weight gain and obesity Sporadic or missed menstrual cycles Anovulation Skin conditions High cholesterol High blood pressure Sleep apnea PCOS and insulin resistance Insulin is produced in the pancreas and released into the blood stream. Insulin allows f Continue reading >>

All Women With Pcos Should Be Treated For Insulin Resistance

All Women With Pcos Should Be Treated For Insulin Resistance

Polycystic ovarian syndrome (PCOS) while clinically heterogeneous, commonly exhibits hyperandrogenism, ovulatory dysfunction and is associated with obesity, insulin resistance, and subfertility (1, 2). Overall, insulin resistance and the compensatory hyperinsulinemia affects some 65–70% of women with PCOS (3,4), with 70–80% of obese (BMI >30) and 20–25% of lean (BMI<25) women exhibiting these characteristics. Part of the insulin resistance appears to be independent of obesity and related specifically to PCOS, with abnormalities of cellular mechanisms of insulin action and insulin receptor function having been documented (5,6). The hyperinsulinemia appears to be an important factor in maintaining hyperandrogenemia, acting directly to induce excess androgen production by theca cells and also as a co-gonadotropin, augmenting the effect of the increased LH stimulus seen in a majority of women with PCOS (7). The elevated insulin may exert other actions having been implicated in the central actions of androgen in impairing progesterone inhibition of the GnRH pulse generator (9,10). In vitro, insulin increased mRNAs for adrenal steroidogenic enzymes (11) and acutely enhanced adrenal secretory responses to ACTH (12). In accord with the high prevalence of insulin resistance and obesity, glucose intolerance, type 2 diabetes, dyslipidemia and increased evidence of inflammation are more common in women with PCOS (4). Similarly many women demonstrate features consistent with the metabolic syndrome and elevated triglycerides, LDL and decreased HDL are well recognized (14). The above outlines the importance of insulin resistance, compensatory hyperinsulinemia and its consequences, the majority of which have negative effects on both metabolic and reproductive health. Options for Continue reading >>

Insulin Resistance And The Polycystic Ovary Syndrome: Mechanism And Implications For Pathogenesis

Insulin Resistance And The Polycystic Ovary Syndrome: Mechanism And Implications For Pathogenesis

POLYCYSTIC ovary syndrome (PCOS) is an exceptionally common disorder of premenopausal women characterized by hyperandrogenism and chronic anovulation ( 1 , 2 ). Its etiology remains unknown. Although there have been no specific population-based studies, a 510% prevalence of this disorder in women of reproductive age is probably a reasonable conservative estimate. This is based as an upper limit on studies of the prevalence of polycystic ovaries, which found that 20% of self-selected normal women had polycystic ovary morphology on ovarian ultrasound ( 3 ). Many of these women had subtle endocrine abnormalities ( 3 ). The lower estimate is based on the reported 3% prevalence rate of secondary amenorrhea for 3 or more months ( 4 ) and the fact that up to 75% of women with secondary amenorrhea will fulfill diagnostic criteria for PCOS ( 5 ). PCOS women can also have less profound disturbances in menstrual function ( 1 , 3 , 6 ). Since the report by Burghen et al. ( 7 ) in 1980 that PCOS was associated with hyperinsulinemia, it has become clear that the syndrome has major metabolic as well as reproductive morbidities. The recognition of this association has also instigated extensive investigation of the relationship between insulin and gonadal function ( 1 , 8 11 ). This review will summarize our current understanding of insulin action in PCOS, address areas of controversy, and propose several hypotheses for this association. Abnormalities of steroidogenesis and gonadotropin release will not be discussed in detail; these changes have been reviewed recently by Erhmann and colleagues ( 12 ) and by Crowley ( 13 ), respectively. The association between a disorder of carbohydrate metabolism and hyperandrogenism was first described in 1921 by Achard and Thiers ( 14 ) and was call Continue reading >>

Diet For Pcos And Insulin Resistance

Diet For Pcos And Insulin Resistance

Polycystic ovary syndrome, or PCOS, affects 5 to 10 percent of all women of reproductive age and is associated with infertility, irregular menstrual cycles, cardiovascular risks, insulin resistance and risk of diabetes, according to the Office on Women's Health. Many women who have PCOS also struggle with obesity, which can further complicate PCOS symptoms. Modifying your lifestyle by eating healthy and exercising can improve your body’s sensitivity to insulin, lower your blood sugar levels and normalize your hormone levels. Losing even 10 percent of your body weight can regulate your menstrual cycle. Video of the Day Fat is a critical part of a balanced diet, but where your fat comes from is important. Fats, particularly omega-3 and omega-6 fatty acids, should make up between 20 and 25 percent of your daily calories. Omega-3 fatty acids are found in fish, walnuts and flaxseed. Diets high in monounsaturated fats are associated with greater weight loss for women who have PCOS. If you have PCOS, eating a high-protein, low-carb diet may aid in weight loss and improve blood sugar levels. Aim to eat between two and five servings of protein per day. Adding complex carbohydrates to your diet can help with insulin resistance associated with PCOS. Most complex carbs, such as whole-grain breads and cereals, legumes, and starchy vegetables, are converted into blood sugar much more slowly than simple carbohydrates. This produces a weaker insulin response. Complex carbohydrates also tend to be high in fiber, which slows digestion, and helps you to feel full. Aim to get 30 to 50 grams of fiber per day. Fruits and vegetables are good sources of antioxidants, vitamins, minerals and phytochemicals. By increasing your fruit and vegetable intake, you can improve some symptoms of PCOS by Continue reading >>

Insulin Resistance And Polycystic Ovary Syndrome.

Insulin Resistance And Polycystic Ovary Syndrome.

Abstract BACKGROUND: Insulin resistance and the associated compensatory hyperinsulinemia are common findings in women with PCOS, and may play a key role in this condition. METHODS: In this article, we focused on the significance of insulin resistance in PCOS, reviewing the available literature on epidemiology, pathogenesis, pathophysiology and treatment of this condition. RESULTS: It has been estimated that approximately 70% of these women are insulin resistant, but this figure is affected by frequent referral bias. In addition, there is metabolic heterogeneity between clinical phenotypes of PCOS. A fundamental issue is the role that hyperinsulinemia plays in androgen overproduction, which is enhanced by bidirectional links between insulin resistance and hyperandrogenism. Available data suggest that women with PCOS may have insulin action alterations of heterogeneous origins, which induce specific abnormalities in these subjects due to the presence of intrinsic defects. Obesity is a common finding in these patients and contributes to the association between PCOS and insulin resistance, combining with the effect of PCOS per se. Insulin sensitization shows several beneficial effects in the treatment of this condition. However, clinical response is heterogeneous. CONCLUSION: Insulin resistance is a common feature of women with PCOS, although it is not universal and differ between clinical phenotypes of PCOS. Insulin resistance and hyperandrogenism appear to be interrelated key factors in the pathogenesis of PCOS. We hypothesize that PCOS might represent a common end-stage clinical phenotype of different processes, in which there are impaired insulin action and hyperandrogenism, probably favoured by specific, intrinsic abnormalities of these women. Continue reading >>

Molecular Mechanisms Of Insulin Resistance In Polycystic Ovary Syndrome

Molecular Mechanisms Of Insulin Resistance In Polycystic Ovary Syndrome

Polycystic ovary syndrome (PCOS) is a common endocrinopathy of unknown aetiology that affects women of reproductive age. During the past ten years, defective insulin activity in PCOS has been demonstrated in target tissues and causes insulin resistance and hyperinsulinaemia. Furthermore, presence of insulin receptors in the ovarian tissue and overproduction of androgens by theca cells leads to characteristic hyperandrogenaemia. Recent data suggest a divergence in post-receptor signalling pathways for insulin in its target tissues (muscle, adipocytes and ovarian tissue), where the metabolic pathway of insulin activity is defective, whereas the activation of steroidogenesis is maintained. Investigators are still searching for clues to understand the cause of this enigmatic syndrome, despite great advances in molecular medicine and genetics. Continue reading >>

Selected Cytokines Are Associated With Markers Of Insulin Resistance In Polycystic Ovary Syndrome

Selected Cytokines Are Associated With Markers Of Insulin Resistance In Polycystic Ovary Syndrome

The polycystic ovary syndrome (PCOS) is associated with features of the insulin resistance syndrome and altered glucose homeostasis. Factors that play an important role in these processes are still emerging. Pro-inflammatory cytokines may be involved in development of insulin resistance in PCOS. The purpose of this study was to determine if a relationship exists between interleukin-6 (IL-6), interleukin-8 (IL-8), monocyte chemoattractant protein-1 (MCP-1), hepatocyte growth factor (HGF), nerve growth factor (NGF), tumor necrosis factor alpha (TNF alpha), fibroblast growth factor-21 (FGF-21) and insulin resistance indices in PCOS. Methods: Fasting insulin, glucose, C-peptide, lipid profile, follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin, testosterone, sex hormone binding globulin (SHBG), 17-hydroxyprogesterone, IL-6, IL-8, MCP-1, HGF, NGF, TNF alpha, FGF-21 serum concentrations were analyzed in 19 women with PCOS and 15 age- and weight- matched healthy controls. Homeostasis model assessment insulin resistance (HOMA-IR) was calculated. Statistics: Mann Whitney test and partial correlations adjusted for BMI. Results: Fasting insulin and C-peptide were significantly higher in women with PCOS than in control group (P<0.05 for both), HOMA-IR tended to be higher in PCOS (P<0.06). IL-6, MCP-1, HGF, NGF, TNF alpha, FGF-21 levels did not differ between groups. In women with PCOS, after BMI adjustment: (1) MCP-1 and HGF serum concentrations significantly positively correlated with fasting insulin (P<0.01 for both) and HOMA-IR (P<0.05 and P=0.001, resp.), (2) IL-6 and IL-8 serum concentrations significantly negatively correlated with HDL cholesterol (P<0.01 and P<0.05, resp.), (3) IL-6 positively correlated with triglyceride concentrations (P<0.01), (4) FGF Continue reading >>

Polycystic Ovarian Syndrome And Insulin Resistance

Polycystic Ovarian Syndrome And Insulin Resistance

Introduction Polycystic Ovarian Syndrome (PCOS) is the most common endocrine abnormality in reproductive aged women affecting approximately 5-10% of this population. (NEJM 1995;333:853) The classic triad of this syndrome consists of chronic anovulation, hirsutism, and obesity. PCOS was first discovered by Stein and Leventhal (Am J Obstet Gynecol 1935;29:181) and its management has confused clinicians ever since. The exciting news recently involves understanding the contribution of insulin resistance to the etiology and treatment of PCOS. This newsletter will review the endocrinopathy and medical consequences of PCOS as well as examine the current understanding of insulin resistance and the use of insulin sensitizing agents. PCOS PCOS involves a ‘vicious cycle’ of hormonal imbalance that may begin with a hypersensitivity of the pituitary to GnRH. The pituitary responds with an increase in LH secretion resulting in increased ovarian androgen production by the ovarian thecal cells. This tonic elevation in LH has also been implicated in the well documented, but not well understood increased risk of miscarriage in PCOS patients. The ovarian ‘androgen excess’ of androstenedione and testosterone has several effects: a) inhibiting follicle development and estradiol production; b) increasing the production of dihydrotestosterone (DHT) thereby stimulating excess terminal hair production (hirsutism) and c) increasing peripheral conversion of estradiol to estrone by aromatase. Estrone, although a weaker estrogen, in large amounts has the ability to act on target tissues with similar efficacy as estradiol. Consequently, FSH production is inhibited thereby further preventing follicle development and ovulation. Additionally, estrone proliferates the endometrium unopposed and i Continue reading >>

The Role Of Insulin Resistance In Pcos

The Role Of Insulin Resistance In Pcos

Polycystic ovary syndrome (PCOS) phenotype can be structured into three components: anovulation, hyperandrogenism and the metabolic syndrome (of which hyperinsulinemia, secondary to insulin resistance, is the central abnormality)(1). It is the most common endocrinologic disease seen in Gynecologic clinic. The follicular excess in polycystic ovaries and the failure of selection of one dominant follicle contribute to the anovulation of PCOS. The infertile PCOS female usually suffered from difficult ovulation induction and high risk of ovarian hyperstimulation syndrome because of extensive stimulation. PCOS is the main androgen disorder in women and has been suggested to be associated with a high risk of developing cardiovascular disease and type-2 diabetes. In many PCOS patients, overweight or central obesity is generally associated with increases in fasting insulin levels, insulin resistance, and glucose intolerance, and has been identified as a target for new therapeutic strategy, including early change in lifestyle. Insulin resistance, defined as decreased insulin-mediated glucose utilization, is commonly (10-25%) found in the normal population. In women with PCOS, insulin resistance appears even more common (up to 50%), in both obese and non-obese women.Hyperinsulinemia appears to play a key pathogenic role in the ovarian androgen overproduction, because of the stimulatory effect of insulin on ovarian steroid production. Show Detailed Description Study Type : Observational Estimated Enrollment : 500 participants Observational Model: Case Control Observational Model: Natural History Time Perspective: Longitudinal Time Perspective: Prospective Official Title: The Role of Insulin Resistance and Adiponectin in the Pathogenesis of Polycystic Ovary Syndrome Study Start Date Continue reading >>

Polycystic Ovary Syndrome

Polycystic Ovary Syndrome

Polycystic ovary syndrome (PCOS) is common. It can cause period problems, reduced fertility, acne and excess hair growth. Many women with PCOS are also overweight. Treatment includes weight loss (if you are overweight) and lifestyle changes in addition to treating the individual symptoms. There are some long-term health problems which are more likely in women with PCOS, so a healthy lifestyle is particularly important to lower the chance of these problems. Understanding ovaries and ovulation The ovaries are a pair of glands that lie on either side of the womb (uterus). Each ovary is about the size of a large marble. The ovaries make eggs (ova) and various hormones. Hormones are chemicals that are made in one part of the body, pass into the bloodstream and have an effect on other parts of the body. Ovulation normally occurs once a month when you release an egg (ovum) into a Fallopian tube. The tube takes the egg into the uterus. Before an ovum is released at ovulation, it develops within a little swelling of the ovary, called a follicle. (A follicle is like a tiny cyst.) Each month several follicles start to develop but normally just one fully develops and goes on to ovulate. The main hormones that are made in the ovaries are oestrogen and progesterone - the main female hormones. These hormones help with the development of breasts and are the main controllers of the menstrual cycle. The ovaries also normally make small amounts of male hormones (androgens) such as testosterone. On the Forums I was thinking of maybe starting to take the contraceptive pill since me and my bf have decided we're not ready to start having children yet and was wondering if it has any negative effects on... What is polycystic ovary syndrome (PCOS)? PCOS, formerly known as the Stein-Leventhal syn Continue reading >>

Insulin Resistance

Insulin Resistance

What medical conditions are associated with insulin resistance? While the metabolic syndrome links insulin resistance with abdominal obesity, elevated cholesterol, and high blood pressure; several other medical other conditions are specifically associated with insulin resistance. Insulin resistance may contribute to the following conditions: Type 2 Diabetes: Overt diabetes may be the first sign insulin resistance is present. Insulin resistance can be noted long before type 2 diabetes develops. Individuals reluctant or unable to see a health-care professional often seek medical attention when they have already developed type 2 diabetes and insulin resistance. Fatty liver: Fatty liver is strongly associated with insulin resistance. Accumulation of fat in the liver is a manifestation of the disordered control of lipids that occurs with insulin resistance. Fatty liver associated with insulin resistance may be mild or severe. Newer evidence suggests fatty liver may even lead to cirrhosis of the liver and, possibly, liver cancer. Arteriosclerosis: Arteriosclerosis (also known as atherosclerosis) is a process of progressive thickening and hardening of the walls of medium-sized and large arteries. Arteriosclerosis is responsible for: Other risk factors for arteriosclerosis include: High levels of "bad" (LDL) cholesterol Diabetes mellitus from any cause Family history of arteriosclerosis Skin Lesions: Skin lesions include increased skin tags and a condition called acanthosis nigerians (AN). Acanthosis nigricans is a darkening and thickening of the skin, especially in folds such as the neck, under the arms, and in the groin. This condition is directly related to the insulin resistance, though the exact mechanism is not clear. Acanthosis nigricans is a cosmetic condition strongly Continue reading >>

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