Around 50% of women with polycystic ovarian syndrome (PCOS) will develop pre-diabetes or type-2 diabetes before the age of 40. People with PCOS are also at a much higher risk of developing gestational diabetes (high blood sugar levels that develop during pregnancy).

Although this can be a pretty daunting statistic, it’s important to know that this is preventable and there are plenty of lifestyle changes you can make to reduce your chances of developing pre-diabetes, diabetes, and gestational diabetes.

So, how are diabetes and PCOS related?

Although we’re not 100% sure of the reason for this increased risk, it is believed that insulin resistance has a role to play. People with PCOS are 27% less sensitive to insulin, this means that their bodies don’t respond to insulin as well as they should.

You may have heard the lock and key analogy where insulin acts as a key opening up the cells to let glucose in and provide the body with energy. When we have reduced sensitivity to insulin this lock and key mechanism is not as effective as it should be, leaving glucose in the bloodstream and causing the body to produce more insulin. Over time this build-up of glucose causes damage to cells and tissues which may then result in diabetes.

Pre-diabetes and type-2 diabetes can often go undiagnosed, therefore it’s important to know what the symptoms are and to get checked regularly.

Can you have PCOS and not have diabetes?

Yes. Whilst many people with PCOS do experience insulin resistance, it’s less common that type 2 diabetes will develop. Nevertheless, it is a risk that should be monitored.

Symptoms of diabetes:

• Increased thirst
• Increased urination (getting up in the night to use the loo)
• Unexplained weight loss
• Feeling tired (because your body is not able to get the glucose it needs for energy)
• Increased hunger
• Feeling lightheaded or dizzy
• Sores or blisters that take a while to heal
• Blurred vision
• Numbness or tingling of hands and feet

What should you do if you think you might have diabetes?

If you are currently experiencing any of the symptoms above, then it’s a good idea to flag these with your GP and ask them to run some tests. If you are pregnant then make sure you let your midwife know that you have PCOS, and they will make sure that you are tested for gestational diabetes around week 24 of your pregnancy (this may differ slightly by area). 

To help reduce your risks of developing type-2 diabetes or gestational diabetes why not try making some of the following lifestyle changes:

1. Try to move your body regularly

Exercise increases the body’s sensitivity to insulin which means more of those cell doors open, letting glucose get to where it needs and taking it out of the bloodstream where it could cause harm. Remember that exercise comes in various forms and doesn’t have to be a certain duration or intensity to make it worthwhile. If a 10-minute walk around the block is all you can manage, then do it – this will make a difference.

2. Don’t stop eating fruit

Yes, fruit contains sugar, but it also contains lots of fibre and really important vitamins and minerals. fibre helps slow down digestion and therefore the release of glucose. Aim to have your five portions of fruits and vegetables a day and choose carbohydrate sources that are high in fibre, think wholegrain!

3. Prioritise sleep

I know it’s easier said than done but try to aim for 8 hours of sleep most nights. Studies have shown that sleep disturbances are associated with an increased risk of developing type-2 diabetes. Don’t worry about the occasional late night, but if you’re regularly staying up late or battling insomnia then you might want to start working on sleep hygiene. Some quick wins could be avoiding screens for an hour before bedtime, creating a relaxing bedtime routine to help you unwind every night, or crawling into bed with a good book to calm a busy mind.

4. Support yourself with supplements

Inositol is a nutrient that is naturally occurring in nuts, grains, fruits, and beans and is produced by the body. Studies have shown that supplementing with inositol improves insulin sensitivity in women with PCOS and reduces the risk of diabetes and gestational diabetes.

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5. Make sure you’re eating enough

When we follow strict diets or restrict certain foods, we are more likely to binge or overeat at some point. Have you ever noticed that when you leave long gaps between your meals it takes a lot more food to satisfy your hunger when you do eventually eat? Eating enough and eating regularly helps control blood glucose and hunger levels.

In conclusion

The message that we hope is loud and clear is that although women with PCOS are at an increased risk of developing type 2 diabetes, this does not mean you will. Lifestyle changes are an effective way to decrease that risk and they can be implemented straight away.

If you feel that you could benefit from making all of the changes recommended above then don’t overwhelm yourself, start with one change and then add to this when you feel ready. 

This piece was written by Jodie Relf, Registered Dietician, @Jodie_Relf 

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