• Mar 2024

What should I know about glucose and PCOS?

What should I know about glucose and PCOS?
  • PCOS is a group of symptoms related to having high androgen (hormone) levels that affects nearly 1 in 10 women. (1)
  • Symptoms of PCOS result from problems with insulin, the hormone that regulates glucose in the body.
  • Adopting a low-carbohydrate diet and managing glucose levels is one way to minimise PCOS symptoms and related issues.

What is PCOS?

Polycystic ovarian syndrome (PCOS) is a common diagnosis that affects nearly one out of every ten women. (1) It’s a group of symptoms related to having a higher-than-normal level of androgens (male hormones) thought to be caused by a combination of genetic and environmental factors. (2)

Women are at higher risk for PCOS if they have a mom or sister with PCOS, or if they have obesity. (2) Any discussion regarding a diagnosis is only between you and your medical provider. Here is some general information on what the science says about PCOS and glucose.

How are insulin resistance and PCOS connected?

The main symptom of PCOS is menstrual cycle irregularities such as cycles lasting longer than 28 days, many days of bleeding, and anovulation (not releasing an egg during the menstrual cycle), but it’s more than just a period problem.

Other symptoms of PCOS result from problems with insulin, the hormone that moves glucose from the bloodstream into cells to be used for energy. When cells become resistant to insulin, the glucose level in the blood rises, which causes the body to produce more insulin to act on glucose. Too much insulin drives up the production of androgens, causing symptoms of PCOS. (2) Women can experience excess facial and body hair, acne, hair loss, weight gain, and infertility. 

It is estimated that between 50-80% of women with PCOS have insulin resistance, independent of BMI and body fat distribution. (3) Having insulin resistance increases risk for gestational diabetes, type 2 diabetes, and heart disease. (3) A hallmark feature of insulin resistance is impaired glucose levels. (4) 

How glucose management can benefit women with PCOS

Diet plays a crucial role in managing PCOS, because controlling carbohydrate intake can improve insulin sensitivity and help manage symptoms, ultimately leading to better quality of life and chronic disease risk reduction. (5)

Research shows high -glycaemic index (GI) and high-glycaemic load (GL) diets are linked to higher BMI, waist circumference, insulin resistance, chronic inflammation, cardiovascular problems, and other metabolic abnormalities in women with PCOS. (6) Conversely, research suggests adopting a long-term low-carbohydrate diet can be beneficial for women with PCOS by improving insulin resistance, promoting weight loss, supporting normal hormone levels, and enhancing fertility. (7) 

Lifestyle Tips for PCOS

  1. Eat low-carb: You don’t have to cut out carbs completely. Reducing carbs to less than 45% of total calories (or around 130 grams per day) can help manage symptoms and reduce disease risk (5). A sample day of ~130 grams of carbs may look like: 

    Breakfast:
    Eggs with 60 g slice sourdough toast (30 g)
    Lunch: Chicken salad with 55 g roasted chickpeas (30 g carbs)     
    Snack/post workout: Greek yoghurt mixed with protein powder and half a banana (30 g carbs)
    Dinner: Stir-fry veggies and beef with 100 g brown rice (30 g carbs) 

  2. Steady glucose: Managing glucose helps insulin work properly. Keep levels steady after meals by:

    Prioritising protein:
    Build each meal around 30 g of protein. Eggs, chicken, beef, fish, tofu, and tempeh are good options.
    Go with green: Deeply coloured vegetables like leafy greens, bell peppers, and berries (yes, a fruit) provide filling fibre as well as inflammation-fighting antioxidants.
    Savoury not sweet: Reach for foods that are high in protein and fat and low in added sugars and carbs whenever you can. A simple swap: top a piece of toast with smoked salmon instead of honey or jam. 
    Fuel with healthy fats: Fats from plant oil, nuts, seeds, eggs, fatty fish are all great options to add flavour without spiking glucose  

  3. Exercise: Both aerobic exercise and resistance training can improve insulin sensitivity and androgen levels in women with PCOS. (8) Here are some exact protocols from studies that yielded results:

    Cycling for 30 min three days per week at 60–70% VO2max
    (moderate intensity where you’re breathing a bit harder, but still able to carry on a conversation) decreased fasting insulin after just 3 months.
    Walking, cycling, or any other aerobic exercise at a self-selected pace (where heart rate is ≥120 beats/min) for 30 min at least three days per week decreased androgens in 4 months.
    Any exercise routine of choice that burns 14-23 kcal/kg/week (this is about 150-250 calories burned daily for an 80 kg individual) showed promising trend towards improved insulin response after 8 months.

A final note from Lingo

While there is no cure for PCOS, managing symptoms is attainable through intentional nutrition and exercise strategies. Continuous glucose monitors (CGMs) like Lingo are not medical devices nor used to diagnose or treat any medical condition. However, CGMs are a tool that can be used to help provide insights into how your lifestyle choices are impacting your glucose, which can be of great value for women managing PCOS.

References

  1. Deswal R, et al. The Prevalence of Polycystic Ovary Syndrome: A Brief Systematic Review. J Hum Reprod Sci. 2020 Oct-Dec;13(4):261-271. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7879843

  2. https://www.nichd.nih.gov/health/topics/pcos/conditioninfo/causes

  3. Amisi CA. Markers of insulin resistance in Polycystic ovary syndrome women: An update. World J Diabetes. 2022 Mar 15;13(3):129-149. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8984569

  4. Tao M, et al. Continuous glucose monitoring reveals abnormal features of postprandial glycemic excursions in women with polycystic ovarian syndrome. Postgrad Med. 2011 Mar;123(2):185-90. https://pubmed.ncbi.nlm.nih.gov/21474907

  5. Zhang X, et al. The Effect of Low Carbohydrate Diet on Polycystic Ovary Syndrome: A Meta-Analysis of Randomized Controlled Trials. Int J Endocrinol. 2019 Nov 26;2019:4386401. https://pubmed.ncbi.nlm.nih.gov/31885557

  6. Manta A, et al. Glycemic Index and Glycemic Load Estimates in the Dietary Approach of Polycystic Ovary Syndrome. Nutrients. 2023 Aug 7;15(15):3483. https://pubmed.ncbi.nlm.nih.gov/37571420

  7. Mavropoulos JC, et al. The effects of a low-carbohydrate, ketogenic diet on the polycystic ovary syndrome: a pilot study. Nutr Metab (Lond). 2005 Dec 16;2:35. https://pubmed.ncbi.nlm.nih.gov/16359551

  8. Shele G, et al. A Systematic Review of the Effects of Exercise on Hormones in Women with Polycystic Ovary Syndrome. J Funct Morphol Kinesiol. 2020 May 31;5(2):35. https://pubmed.ncbi.nlm.nih.gov/33467251

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