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Ovarian Cysts Common in Women With Type 2 Diabetes

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WebMD Health News

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 level.

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 WebMD.

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."

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