Diabetes

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Women with Polycystic Ovary Syndrome Often Have Cardiovascular Disease Risk Factors, Too

Thursday, October 10th, 2013

A study published in the Journal of Clinical Endocrinology and Metabolism highlighted the relationship between polycystic ovary syndrome (PCOS) and cardiovascular disease (CVD). Researchers noted that women with PCOS were more likely to have risk factors for CVD. They carried out a study in which evidence-based reviews were provided of studies that examined the risk relationship and to develop guidelines for lessening the risk of CVD.

The study included only other studies where PCOS patients were compared with control patients, and excluded any articles that included unclear PCOS diagnoses or unclear controls. The conclusion of the study was that women with PCOS who are also obese, smoke, or have high blood pressure or impaired glucose tolerance are at risk for CVD. Women who have PCOS and type 2 diabetes are at high risk for CVD.

PCOS is common, affecting 6-10% of women of childbearing age, and is characterized by hyperandrogenism, ovulatory dysfunction, and polycystic ovaries. Other symptoms that women may notice to varying degrees include irregular menstrual periods, hirsutism, acne or other skin problems, weight gain (especially around the waist), thinning hair, pelvis pain, sleep apnea, and anxiety or depression. In young women with PCOS, there may be multiple risk factors for CVD, such as metabolic syndrome, type 2 diabetes, abdominal obesity, and high blood pressure. For these women, taking measures to prevent future CVD is an absolute necessity.

If you feel you may have PCOS, talk to your doctor about it. Your doctor will take some steps to see if you really do have PCOS or if another condition is causing your symptoms. Expect your doctor to ask you about your medical history, including your menstrual cycle and any weight changes; perform a physical exam, including blood pressure, waist size, and areas of increased hair growth; a pelvic exam, to check your ovaries for enlargement; a vaginal ultrasound, to further examine your ovaries; and blood tests to check for androgen and glucose levels in your blood.

If you do find out you have PCOS, even though there is no known cure, there are effective treatments that can help you manage your symptoms and prevent further problems. The right treatment for you will depend on your individual symptoms and whether or not you may become pregnant. Goals of treatment include lowering your risk for CVD and relieving your symptoms. A combination of treatments is the most effective route for most women.

The first line of defense against PCOS is losing weight. Eating healthfully and exercising can help you manage your symptoms with great success. Limiting sugars and processed foods will lower your blood glucose levels, improve the way your body uses insulin, and help normalize androgen levels. Even losing 10% of your body weight can make a big difference in irregular periods. If you don’t want to become pregnant, birth control pills can regulate your menstrual cycle, reduce your levels of male hormones, and help clear up your skin.

If you have diabetes, metformin is a drug your doctor may prescribe. It affects the way insulin is processed in your body and lowers male hormone production; it can also relieve many PCOS symptoms such as excessive hair growth, lowering cholesterol levels, and assisting with weight loss. It is important to note that metformin has not been approved by the FDA for treating PCOS, but it is approved and effective at treating diabetes, and studies show that it does, indeed, help with many common symptoms of PCOS.

– Yvonne S. Thornton, M. D., M. P. H.

Sleep Yourself Thin

Thursday, May 31st, 2012

When you are a parent, you do not always get a lot of opportunity for sleeping.  You do not get a lot of time for yourself in general really.  You have work to take care of, children to manage, and somewhere in there, a body to consider.  The fact is though, with our busy American lifestyles, the health of our bodies simply seems to take a back seat.  Unfortunately, this has caused many of us to become overweight, or even worse, obese and diabetic.  A recent study shows though, that if we could all just find enough regular time to sleep, we might be able to stay slimmer and healthier in general.

Right now, nearly two-thirds of Americans are overweight or obese.  Even more concerning is how many of these people are progressing into diabetes.  The CDC cites diabetes as a health issue for 8.3% of Americans and a whopping 79 million show signs of prediabetes.  While poor diet and little to no exercise are obvious causes for such an epidemic, stress and sleep schedules also play a role.   A recent study by researchers at the Brigham and Women’s Hospital and the Harvard Medical School in Boston found that “lack of sleep or disrupted sleep patterns…may lead to an increased risk of diabetes and obesity.”  The study involved tracking the effects of disrupted sleep routines in participants by shifting their sleeping time from 10 hours a night, to just 5.6 hours per 24 hour period.  This sleep restriction and pattern disruption caused 32% of participants to have decreased insulin secretion when they ate and lower metabolic rates, which led to high blood sugar levels bordering on pre-diabetic.  If they had continued the study for a year, they estimated that these levels could have caused them to gain about 12.5 additional pounds of body weight in one year.  When you add these conclusions to the hectic lifestyle of working American parents, it is no wonder so many are struggling with their weight.

When we are young, we spend a lot of time fighting our parents over daily naps and early bed times, but once we grow up, we find it even harder to put ourselves to bed.  Perhaps this study will help us hardworking adults realize that it is no use staying up all night stressing about our busy lives, if it only gives us fewer nights to live.

 

– Yvonne S. Thornton, M. D., M. P. H.