Is PCOS a way station on the road to diabetes?
In type 2 diabetes, as well as polycystic ovary syndrome (PCOS), a main component is peripheral insulin resistance,20 although women with PCOS have somewhat better beta cell function than diabetic women, with initial hypersecretion and compensation. Over time, dysfunction develops, leading to inadequate insulin secretion, beta cell exhaustion, fasting hyperglycemia, and frank type 2 diabetes. Just what is insulin resistance? Insulin is the primary anabolic hormone in the body, acting in diverse ways in different tissues. Yet insulin resistance is usually defined as a single action: decreased insulin-mediated glucose uptake by peripheral tissues (largest utilizer: skeletal muscle). Most research tests, such as euglycemic clamp studies, focus on glucose uptake—or its disappearance from the circulation—during dynamic challenge tests. The higher the glucose uptake, the greater the insulin sensitivity and the lower the eventual risk of developing diabetes. Signs of insulin resistance in PCO
