Insulin Resistance Symptoms and Treatments in Females With PCOS

Risk of diabetes runs high if left untreated

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Polycystic ovary syndrome (PCOS) can put you at risk for insulin resistance. Watch for symptoms of insulin resistance that are common for females with PCOS. These include cravings and frequent urination.

Insulin resistance is an inadequate response to the hormone insulin. People with PCOS are at greater risk of developing insulin resistance because this condition affects how the body uses insulin. If you have PCOS, there are steps you can take to manage insulin resistance before it develops into diabetes.

This article will explain what insulin resistance is, the signs of insulin resistance in PCOS, and which factors put you at risk of developing it. It will also discuss how insulin resistance is diagnosed and treated.

symptoms of insulin resistance
Illustration by Jessica Olah, Verywell

What Is Insulin Resistance?

Insulin is a hormone that is produced by the pancreas, a gland in the abdomen. It is secreted in response to increased amounts of glucose (sugar) in the blood. Insulin helps transport glucose into your muscle, fat, and liver cells where it is converted into glycogen or fat, so it can be stored for later use when your body needs energy.

When you develop resistance to insulin, your pancreas still secretes insulin, but your body stops storing glucose like it normally should. The sluggish response can cause glucose to accumulate in the blood and eventually change the way the body deals with sugar. This results in high blood glucose levels, a condition called hyperglycemia. Worsening insulin resistance can eventually lead to diabetes.

Symptoms of Insulin Resistance

People with insulin resistance often have little, if any, symptoms. When they do, it may be a sign that the condition has progressed to diabetes. If you experience any of these symptoms, you should contact your healthcare provider right away.

Symptoms may include:

  • Cravings for sweets and salty foods
  • Darkening of skin in the groin, armpits, or behind the neck
  • Fatigue
  • Frequent or increased urination
  • Increased hunger or thirst
  • Tingling sensation in the hands of feet

If you are experiencing these symptoms, your healthcare provider will likely order blood tests to see how well your body processes sugar. These include the fasting glucose level, hemoglobin A1C, and glucose tolerance tests.

Risk of Insulin Resistance if You Have PCOS

In females with PCOS, the risk of insulin resistance is higher after age 40, and for those who are overweight, have high blood pressure, live a sedentary lifestyle, or have high cholesterol. You may also be more likely to develop insulin resistance if someone in your family has it too.

By and large, women of Hispanic, African American, or Native American origin are at higher risk of insulin resistance than White or Asian women.

Diagnosing Insulin Resistance

For a fasting glucose level, you would need to suspend eating and drinking at least eight hours before the test. After a blood sample is drawn and sent to the lab, a diagnosis can be made based on the following results:

  • Below 100 milligrams per deciliter (mg/dL) is a normal result.
  • 100 mg/dL to 125 mg/dL is considered prediabetes.
  • Above 125 mg/dL can serve as a diagnosis of diabetes.

The glucose tolerance test also requires an eight-hour fast before the test can be performed. Upon arrival, your healthcare provider will draw blood to use as a baseline reference. You would then be asked to drink 8 ounces of fluid containing 75 grams of sugar. A second blood test would then be taken two hours later.

A diagnosis can be supported based on the following comparative values:

  • Prediabetes is defined as a fasting blood glucose of 100 mg/dL to 125 mg/dL followed by a blood glucose of 140 mg/dL to 199 mg/dL at two hours.
  • Diabetes is defined as a fasting blood glucose of 126 mg/dL or higher followed by a blood glucose of 200 mg/dL or higher at two hours.

Normally, blood sugar will return to normal within three hours. The failure to do so is generally indicative of insulin resistance.

Hemoglobin A1C, also known as the A1C test or HbA1c, is a simple blood test that measures or reflects your average blood sugar over the last three months.

A1C results are interpreted as follows:

  • Normal: Below 5.7%
  • Prediabetes: 5.7% to 6.4%
  • Diabetes: 6.5% or above

Within the prediabetes range, the higher your A1C, the greater your risk is for developing type 2 diabetes.

Treatment

If you are diagnosed with insulin resistance, there is a lot you can do to reverse the condition. In some cases, medications like metformin may be prescribed to help you better control your blood sugar levels.

Lifestyle changes can also help, whether you are prescribed medications or not.

Doing these things can help you reverse insulin resistance:

  • Follow a healthy diet rich in lean meat, high-fiber grains, vegetables, legumes, leafy greens, and fruit (ideally designed in consultation with a nutritionist).
  • Exercise at least 30 minutes per day most days of the week.
  • Get ample rest.
  • Learn to manage stress.
  • Reduce alcohol intake if you consume above the recommended limits.
  • Stop smoking.

A few of the diets that are possibly beneficial for improving insulin resistance include the Mediterranean diet, the Dietary Approaches to Stop Hypertension (DASH) diet, and a diet consisting of foods with low glycemic indexes.

Summary

Polycystic ovary syndrome (PCOS) can change the way your body responds to insulin, resulting in a condition called insulin resistance. Signs of insulin resistance in people with PCOS include cravings for certain foods and an increased need to urinate. If left untreated, insulin resistance can develop into type 2 diabetes.

While you can't control all of the factors that increase your risk of developing insulin resistance, you can control many of them. Following a healthy diet, getting adequate exercise, and managing stress are ways you can treat and even reverse insulin resistance. Talk to a healthcare provider about getting tested if you think have signs of insulin resistance with PCOS.

6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Centers for Disease Control and Prevention. PCOS (polycystic ovary syndrome) and diabetes.

  2. NIH National Institute of Diabetes and Digestive and Kidney Disorders. What is diabetes? Insulin resistance and prediabetes.

  3. Centers for Disease Control and Prevention. Diabetes tests.

  4. American Diabetes Association. Diagnosis.

  5. Centers for Disease Control and Prevention (CDC). All about your A1C

  6. NIH National Institute of Diabetes and Digestive and Kidney Disorders. Your game plan to prevent type 2 diabetes.

By Nicole Galan, RN
Nicole Galan, RN, is a registered nurse and the author of "The Everything Fertility Book."