Ovarian Cysts Common in Women With Type 2 Diabetes
March 8, 2000 (Indianapolis) -- Type 2 diabetes mellitus and having multiple
ovarian cysts are both common conditions associated with insulin resistance and
high levels of insulin in the blood. Insulin is a hormone that regulates the
body's ability to burn carbohydrates and fats, especially glucose, a blood
sugar.Insulin therefore helps the body lower its blood glucose
Previous studies have shown that
impaired glucose tolerance -- a condition in which blood sugar levels are
higher than they should be because the body's cells fail to respond to insulin
-- and diabetes are both common in women who have many ovarian cysts and a high
level of male hormones called androgens.
Now another study published in
Clinical Endocrinology adds to the growing body of evidence by reporting
that women with type 2 diabetes are more likely to have multiple ovarian cysts
and high androgen levels -- a condition called polycystic ovary syndrome (PCOS)
-- than similar women in the general population.
"These are both very common
conditions that often coexist together," says Roger A. Lobo, MD, professor
and chairman of obstetrics and gynecology at the Columbia University College of
Physicians and Surgeons in New York City, in an interview with
PCOS affects about 3% to 6% of young
women. Women with this syndrome usually complain of longstanding problems with
ovulation, such as infertility or heavy, irregular, or absent periods. A blood
test will show high levels of androgens, and an ultrasound scan will show the
cysts on the ovaries.
"If you are a diabetic, there is
also a good chance that you have PCOS. In those women who get hair growth,
irregular periods, or other symptoms of the syndrome, they will need to be
addressed in addition to the diabetes," Lobo says.
"There is mounting evidence that
insulin resistance and associated high levels of insulin in the blood play a
central role in the development of PCOS," writes study co-author Gerard S.
Conway, MD, and his colleagues from the Cobbold Laboratories at Middlesex
Hospital in London.
Ann E. Taylor, MD, assistant professor
of medicine at Harvard University Medical School, says this article is relevant
to women with diabetes who also begin to develop menstrual problems.
"The results suggest that certain
therapies for the diabetes might be more likely than others to improve a
woman's overall hormonal balance," she says in an interview with WebMD.
"The insulin-lowering drugs, such as metformin, are more likely to treat
both the diabetes and the hormonal abnormalities of PCOS. So, if a woman has
both type 2 diabetes and PCOS, discussing medications with [her] doctor would
certainly be in order."
Subjects in the study were recruited
from the hospital's Diabetes Clinic. A computer search found 49 premenopausal
women with type 2 diabetes being treated with diet alone or with a pill that
lowers blood sugar by prompting the body to make more insulin. Eighty-two
percent of the 38 women with diabetes who agreed to be studied had an
ultrasound showing PCOS. Of these, 52% had skin changes related to having too
much male hormone and/or had problems with their menstrual cycles.
Although women with type 2 diabetes
have a higher prevalence of PCOS than that reported in the general population,
Conway writes that "not all women with high blood levels of insulin,
however, develop PCOS, suggesting that [high levels of insulin in the blood]
alone is not sufficient for the onset of PCOS."