- What is insulin resistance?
- Insulin resistance and PCOS
- How can it be resolved?
- Are there any specific medications?
What is insulin resistance?
Insulin resistance is the reduction of the capacity of body cells, in particular of muscular and adipose cells, to respond to insulin and therefore to use it. Insulin is a hormone produced by beta cells in the pancreas; small quantities are released after each meal to allow the entry of glucose enabling its use as an energy source. Insulin resistance causes a minor entry of glucose in the cells, an increase in insulin levels and therefore insulinemia, and in particular a hyper stimulation of those tissues that are sensible to the action of this hormone.
Insulin resistance and PCOS
The organs that are more affected by this syndrome are: skeletal muscle, liver, adipose tissue, ovaries, uterus; for this reason, insulin resistance is one of the metabolic causes of PCOS.
Insulin resistance causes an increased production of androgens by the ovary theca cells, leading to a dysregulation of LH activity (ovulation hormone) and to a simultaneous abnormal growth of the endometrium.
In the majority of cases, insulin resistance treatment leads to the resolution of PCOS with consequent improvement of symptoms and increased fertility. The appearance of dark spots, known as acanthosis nigricans, is a common sign of insulin resistance and PCOS.
How can it be resolved?
One of the ways to resolve insulin resistance is to follow a diet with low glycemic index. The glycemic index of food is the speed at which the concentration of glucose in the blood occurs after the intake of such food. After the intake of carbohydrates with high glycemic index, glycaemia undergoes a sudden increase; great quantities of insulin are secreted with the consequent hyper stimulation of tissues. Foods with low glycemic index are fruit and vegetables, dairy products, cereals like oats and barley, al dente pasta, while those with high glycemic index are all those foods that are easily assimilated: sugar, refined cereals, rice, potatoes, wafers, biscuits, sweets and cakes, sugary drinks, fizzy drinks, foods that contain sugar, dextrose and glucose syrup in their ingredients.
Are there any specific medications?
In addition to a change in lifestyle through a low-calorie diet, weight loss and exercise to improve symptoms, the treatment includes the use of medications that control high blood sugar like metformin. These drugs make the body more sensible to insulin and help cells to better use glucose in the blood, thus regulating the menstrual cycle.
If used appropriately, these drugs can regulate the menstrual cycle and ovulation, reduce infertility, and minimise hirsutism and acne. A better use of insulin in the body also reduces the risk of cardiovascular diseases and diabetes that is more common in women affected by PCOS.