March 3, 2004
Diagnosis and Symptoms, Type 2
Question from Brockport, New York, USA:
I am a 28 year old female, who went to my doctor in May complaining of being tired and not being able to lose weight. I was also suffering from menstrual irregularities. My doctor took blood via a finger prick test to determine my blood sugar level. It was 210 mg/dl [11.7 mmol/L]. She told me I had diabetes and put me on Glucophage, 500mg once a day with my evening meal. She told me to monitor my sugar levels using a hand held machine. That night, I took my medicine, then checked my blood sugar two hours later and it was 185 mg/dl [10.3 mmol/L]. Within three days, my fasting sugar levels were under 110 mg/dl [6.1 mmol/L]. Since May, I have lost 52 pounds and my sugars run between 80-87 mg/dl [4.4-4.8 mmol/L] in the morning, and mid 90s [about 5.3 mmol/L] after meals. I am exercising and following a low carbohydrate diet.
After I was told I had diabetes, my gynecologist, a month in a half later, told me I had PCOS. She said that could have contributed to my high sugar levels, giving me insulin resistance. Is insulin resistance the same as diabetes? I had blood work done two months after I was diagnosed with diabetes to confirm PCOS. My gynecologist tested my A1c level and she said it was 5.2. Can I be considered a diabetic without having any test done besides an in office finger prick? Or, is it more likely I have insulin resistance? I know losing weight has made my energy soar and my periods normal. I am 30 pounds away from having a BMI under 25. My sugar levels are all normal now no matter what time of day I check them. My doctor wants me to stay on the Glucophage until I reach my goal weight. Should I continue to take it? Do I have diabetes or insulin resistance? If I had insulin resistance could it have been reversed by diet, exercise, and weight loss?
Insulin resistance is one of the factors with type 2 diabetes mellitus. However, others who have been diagnosed with PCOS or polycystic ovarian syndrome also manifest insulin resistance at times. The fact that you were overweight and had elevated blood glucoses indicated type 2 diabetes mellitus. You have lost the weight and have improved your control. You still should be concerned with diabetes, but you are now diet controlled.
PCOS is an overall term that has many etiologies. One of these, is the production of testosterone from the adrenal glands. There is a block in the enzyme synthesis and an overproduction of testosterone occurs. Insulin resistance is also a key feature of this adult form of testosterone overproduction. Glucophage is one of the treatments. I would discuss this with your physician but it appears that the treatment regimen has been effective.