Insulin resistance and Polycystic ovarian syndrome- Demystified

22 Jul Insulin resistance and Polycystic ovarian syndrome- Demystified

Polycystic ovarian syndrome is a relatively new gynecological disease which is now reaching alarming proportions affecting as much as 20 percent women .

It is a complex metabolic disease which is part of a bigger patholgy called Metabolic Syndrome .  Even though it is a metabolic problem, it usually first manifests in women with gynecologic symptoms  like irregular periods, infertility, abnormal hair growth on the body and resistant weight gain. However the basic  pathology of PCOS is complex and multifactorial with “Insulin resistance” as the primary cause.

So what is insulin resistance?

Insulin is a hormone which is released by pancreas in response to the high blood sugars in the blood after a meal. The hormone insulin sends a signal to the tissues like muscle and liver to pick up sugars for their use. This action of insulin feeds the tissue with glucose and also helps to maintain normal glucose levels in the blood all the time. But in some cases, the tissues become immune or dumb to the command of insulin and refuse to pick up glucose leading to abnormally high blood sugar levels. This is called Insulin resistance. The pancreas then overproduces insulin to compensate for the lack of this action and the insulin levels rise leading to what is medically called Hyperinsulinemia.  Hyperinsulinemia is dangerous, signaling lot of problems like cellular inflammation leading to atherosclerosis, hypertension, cardiovascular problems etc. High insulin levels further increase the insulin resistance by stunting the action of insulin, creating a vicious loop. Hyperinsulinemia also causes increased cell growth ( insulin like growth factor- ILGF1) leading to resistant weight gain . It also stimulates the ovary to produce abnormal androgenic hormones causing acne, increased body hair, scalp hair loss ,abnormal pigmentation on the body etc.

So what causes insulin resistance.

• Lipid overload- High fat diet or inefficient fat burning- accumulation of intracellular lipids causes oxidative stress, mitochondrial damage, formation of free radicles and cellular inflammation  leading to IR. The culprits are animal meat diets, excessive dairy consumption, hydrogenated refined oils
• intake of refined, processed and packaged food , so called fake carbohydrates
• inadequate exercise
• central obesity ( waist size of >31.5inches in females and >35.5 inches in men  predisposes them to IR )
• chronic stress
• lack of  good quality sleep- Disruption of circadian rhythm  (shift workers, airline pilots,medical staff), abnormal eating patterns, wrong food choices due to lack of sleep add ti insulin resistance
• smoking
• age
• ethnicity
• Genetics

How do we diagnose IR

Body weight, BMI, BP, lipid profile,

02 hrs insulin GTT

treatment

• Healthy  plant based , unrefined, un processed  diet, rich in dietary fibre
• Good exercise, Get Going
• Adequate sleep , in accordance with the circadian rhythm
• No smoking
• Minimum use of electronic gagdets
• Maintain healthy weight
• Avoid stress and worry