My 14 year old daughter was diagnosed with type 1 diabetes about 6 months ago; she also is has subclinical hypothyroidism (non medicated at this time). I received a call this week from her endocrinologist with the news that she has blood work consistent with polycystic ovarian syndrome. They want to start her on birth control pills. Is this something that is seen with type one diabetes? I notice in my reading that women with PCOS often become inulin resistant. Is this something I need to be worried about? I have also read that Type 2 medications are prescribed to help regulate hormones. Is this useful for someone with type one? Can you tell me what this might mean for my daughter?

I’m not sure what blood tests your daughter had to indicate polycystic ovary syndrome or why the tests were done. There is no specific blood test for polycystic ovary syndrome, though there are many tests that may or may not be abnormal. This is usually a clinical diagnosis made in a teenager or woman who is often overweight, has irregular periods, and signs of excess androgens (hormones that normally cause pubic hair and acne in females, but when present in excess can cause severe acne, hair on the face or abdomen, and irregular periods.) Often, these hormones are present in normal amounts in the blood, but the woman seems to respond excessively. Often on sonogram, characteristic benign cysts are seen (but don’t have to be seen.) On further hormonal testing, insulin resistance with excessive insulin levels (with normal or high blood sugars) can be seen and type 2 diabetes is often seen.

As far as I know, polycystic ovary syndrome does not occur more frequently in individuals with type 1 diabetes than in the non-diabetic population. In the past several years, it has been shown that medications that improve insulin sensitivity that are used to treat type 2 diabetes, may not only lessen the insulin resistance, but may actually normalize the other features of PCOS.

Sometimes PCOS can occur secondary to untreated hypothyroidism or other rare hormonal abnormalities unrelated to diabetes (adrenal enzyme defects). If your daughter has an underactive thyroid, it is possible that treatment with thyroid medication may also help treat the PCOS without any other medications.

TGL
Additional comments from Dr. Schulga:

It would also be important to note that often women with PCOS are heavy, and the best treatment is a sensible reduction in weight. This will often result in a correction of the hormone imbalances that are found in PCOS.

JS