The Prevalence of Polycystic Ovaries in Women With Type 2 Diabetes Mellitus

Abstract

Evidence is mounting that insulin resistance and consequent hyperinsulinemia are important in development of polycystic ovary syndrome (PCOS). Type 2 diabetes seems to be more frequent in women with a history of PCOS. This study used ultrasonography to determine the prevalence of polycystic ovaries in 38 premenopausal women (median age, 41 years) with type 2 diabetes, seen at a hospital diabetes clinic, whose condition was managed with diet alone or with oral hypoglycemic drugs. The women were known to have had diabetes for a median time of 3 years. All but 7 of the 38 women (82 percent) had ultrasound evidence of polycystic ovaries; average ovarian volume in the PCOS group was nearly three times greater than that in a non-PCOS reference group. The two groups had similar anthropometric characteristics, reproductive histories, and gonadotropin and testosterone levels. Hirsutism or acne was noted in 35 percent of the PCOS group, and 52 percent of these women had one of these features or disordered menstrual function. Six women (19 percent) had a history of primary or secondary infertility, and 55 percent of the group had had gestational diabetes before type 2 diabetes was diagnosed. Levels of insulin and androstenedione were independently and significantly associated with ovarian volume. Polycystic ovaries are unexpectedly frequent in premenopausal women with type 2 diabetes, although it remains unclear what role insulin plays in the development of polycystic ovaries. It is unlikely that hyperinsulinemia itself is the explanation, because some hyperinsulinemic women with type 2 diabetes have normal-sized ovaries. Clin Endocrinol 2000;52:81–86