Potential Diabetes and PCOS: Symptoms and Management

Suspected diabetes / polycystic ovary syndrome (PCOS) issues?

Hello, Doctor.
I apologize for the lengthy explanation, and I appreciate your patience.
About mid-last year, I consulted an endocrinologist because I felt that my weight loss efforts were ineffective, and I suspected it might be an endocrine issue.
At that time, I underwent tests in both the endocrinology and obstetrics departments, but I did not receive a definitive diagnosis.
The endocrinologist suspected I had polycystic ovary syndrome (PCOS) and referred me to the obstetrics department for further evaluation.

The blood test results from the obstetrics department indicated that my blood sugar did not decrease two hours after consuming a sugary drink.
When I asked if this meant I had diabetes, the doctor mentioned that if left untreated, it could potentially develop into diabetes in 20 years.
Subsequently, the doctor prescribed Metformin for me, to be taken twice a day.

I later consulted two or three different obstetricians, all of whom noted symptoms consistent with PCOS (obesity, hirsutism, and irregular ovulation after menstruation).
The only symptom that did not align was that my menstrual cycle has always been regular in terms of timing, volume, and frequency.
Recently, during a health check-up, my postprandial blood sugar was normal, but during my follow-up appointment, the doctor did not request a repeat blood test for confirmation.
Should I schedule another appointment to clarify whether my blood sugar levels are indeed normal?
Since there is no definitive diagnosis, I am unsure how to proceed with monitoring my condition.
Additionally, I have another question: Is it acceptable for me to consume food between meals, such as boiled eggs or unsweetened soy milk? Will this affect insulin secretion?

Lin, 20~29 year old female. Ask Date: 2020/10/28

Dr. Lin Jianliang reply Internal Medicine

You can discuss your condition and how to monitor it with your physician.
Most doctors are willing to engage in a collaborative discussion with you, but please clearly communicate your concerns.
You may eat between meals, but it is important to avoid foods that could affect your blood sugar levels.
If the food contains carbohydrates, it may potentially impact insulin secretion.

Reply Date: 2020/10/28

More Info

Understanding potential diabetes and polycystic ovary syndrome (PCOS) is crucial for effective management and improving overall health. Based on your description, it seems that you have been experiencing symptoms that may be related to insulin resistance, which is often associated with both diabetes and PCOS.

Symptoms and Diagnosis
PCOS is characterized by a combination of symptoms, including irregular menstrual cycles, excessive hair growth (hirsutism), weight gain, and sometimes acne. While you mentioned that your menstrual cycle is regular, the presence of obesity and other symptoms such as excessive hair growth could still indicate PCOS. The fact that your blood sugar levels did not decrease after consuming sugar suggests that you may have insulin resistance, which is a common precursor to type 2 diabetes.

Your healthcare provider's warning that you could develop diabetes in the future if left unmanaged is significant. Insulin resistance can lead to higher blood sugar levels over time, increasing the risk of developing type 2 diabetes. It is essential to monitor your blood sugar levels regularly and follow your doctor's recommendations.

Management Strategies
1. Medication: You mentioned being prescribed metformin (安胰敏), which is commonly used to improve insulin sensitivity and help with weight management in individuals with PCOS. It is crucial to take this medication as directed and discuss any side effects or concerns with your healthcare provider.

2. Dietary Changes: Nutrition plays a vital role in managing both PCOS and blood sugar levels. A balanced diet that focuses on whole foods, including vegetables, lean proteins, whole grains, and healthy fats, can help regulate blood sugar levels.
- Snacking: Regarding your question about snacking between meals, consuming foods like boiled eggs or unsweetened soy milk (無糖豆漿) can be beneficial. These foods are low in carbohydrates and high in protein, which can help stabilize blood sugar levels and may not significantly impact insulin secretion. However, it is essential to monitor how your body responds to different foods and adjust accordingly.

3. Regular Monitoring: Since your blood sugar levels were normal during your recent check-up, it would be prudent to follow up with your healthcare provider to confirm this result. Regular monitoring of your blood sugar levels can help you and your doctor make informed decisions about your management plan.

4. Physical Activity: Incorporating regular physical activity into your routine can improve insulin sensitivity and aid in weight management. Aim for at least 150 minutes of moderate-intensity exercise each week, such as brisk walking, cycling, or swimming.

5. Weight Management: If you are overweight, even a modest weight loss of 5-10% of your body weight can significantly improve insulin sensitivity and reduce the risk of developing diabetes.

6. Follow-Up Care: Since you have seen multiple specialists, it may be beneficial to establish a primary care provider who can coordinate your care and help you navigate your symptoms. They can also assist in monitoring your condition and making necessary referrals.

Conclusion
In summary, managing potential diabetes and PCOS involves a multifaceted approach that includes medication, dietary changes, regular monitoring, and physical activity. It is essential to maintain open communication with your healthcare providers and advocate for your health by seeking clarification on any concerns you have regarding your condition. If you feel uncertain about your diagnosis or management plan, do not hesitate to ask for further testing or a second opinion. Your health is a priority, and proactive management can lead to better outcomes in the long run.

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