November is National Diabetes Awareness Month

November 18, 2023

November is Diabetes Awareness Month

If you are familiar with Polycystic Ovarian Syndrome aka PCOS, then you also know that at least 70% of people with PCOS have insulin resistance, which is considered a pre-diabetic condition. Various studies show people with PCOS have a 2-3 times increased risk of Type 2 diabetes than those without PCOS. According to the CDC, more than half of people with PCOS will develop type to diabetes by age 40.

Having PCOS does not mean you will have diabetes. There are things you can do to prevent your insulin resistance from getting worse, and stave off diabetes.

How do you know if you have insulin resistance?

The gold standard test for insulin resistance is a 2 hour glucose test. This test is done in a lab or your doctor’s office. You should go after an overnight fast. Your blood glucose will be checked before the test, and then you will be given a 75 mg glucose solution to drink, and after 2 hours, your blood glucose will be checked again. If either value is abnormal, you have insulin resistance.

Other tests include the Hemoglobin A1C. When blood glucose is elevated, some of it binds to hemoglobin molecules. The higher the blood glucose, the higher the percentage of hemoglobin molecules that will be bound to glucose. This can be measured. It reflects how high your blood sugar is over the last 3 months. It is not the most sensitive test for insulin resistance. By the time your Hemoglobin A1C is elevated, you have had insulin resistance for a while.

Another way to test for insulin resistance is to use a continuous glucose monitor for a few weeks. It is a device you wear on your arm to determine if your blood sugar rises higher than normal after a meal. 

And lastly another useful test is a fasting insulin test. If you have had insulin resistance for a while, your body responds by producing more insulin, and therefore your fasting blood insulin level will be elevated.

Once you have established that you have insulin resistance, what can you do to prevent it from turning into diabetes? There are two strategies we use to do this: 1)reduce stimulation of insulin release from the pancreas and 2)improve insulin sensitivity

How can we reduce insulin secretion from the pancreas? The pancreas is an organ in the gastrointestinal system that produces hormones and digestive enzymes. After a meal, the absorbed nutrients pass in the bloodstream to the pancreas. The pancreas is able to sense how much glucose, from digested carbohydrates, is in the blood and it secretes, or releases into the blood, the appropriate amount of insulin. Insulin and glucose travel to your other organs, and insulin signals the cells of your organs to take the glucose inside the cell for energy.

The more glucose the pancreas “sees” the more insulin is produced and released. If there is too much insulin in the blood, cells will develop insulin resistance to prevent the cells of your organs like your muscles,  from taking up more glucose than it needs. So in order to prevent this from happening, we must stop over stimulating the pancreas. 

The following changes to what you eat can have a big impact:

  1. Limit the amount of added sugars: sugar sweetened beverages including coffee beverages, hard and gummy candies are big sources of added sugars. Sugar is the most potent stimulator of pancreatic insulin secretion
  2. Limit refined starches like white flour found in white bread, pasta and rice. If you do consume them, pair them with a fiber rich food like vegetables or beans and add some protein and fat. This will slow down their digestion and small amounts will reach the pancreas over time instead of a big dose all at once.
  3. Choose higher fiber carbohydrate rich foods like quinoa, oats, corn, beans, farro and even potatoes, 

The second strategy to prevent your insulin resistance from turning into diabetes is to make your cells more sensitive to insulin. The following are two ways you can do this:

  1. Exercise. Moving your muscles, even if it is just walking, allows glucose to enter your cells without the need for insulin and in the long run increases your muscle’s sensitivity to insulin.
  2. Use an insulin sensitizer like the supplement inositol or the medication metformin
  3. Ensure that you consume enough Vitamins D, B6, B12 and folate. A daily multivitamin can help. 

In summary, having PCOS with insulin resistance is not a life sentence, and developing type 2 diabetes is not inevitable. You can make some easy life changes that can delay or prevent the development of type 2 diabetes.

For more practical advice about PCOS, check out my other articles here, or follow me on Instagram here 

The PollyPrep Independent Study Course is full of science backed information and advice in order for you to take control of your PCOS and sort through information and misinformation on social media. It is available here