The Link between PCOS and Diabetes

Polycystic ovarian syndrome, commonly known as PCOS is an endocrinal disorder caused due to hormonal imbalance in the body. 8 in 10 women suffer from the condition but most of the time women are left undiagnosed. Women with PCOS have no periods or have very irregular periods, which ties back to the fact that PCOS is a major cause of infertility. PCOS is not curable but early diagnosis and treatment can help control symptoms and prevent long-term consequences.

Symptoms of PCOS tend to develop gradually although it may become rather an evident post weight gain. Other symptoms of the condition include very few or no menstruation with irregular bleeding, male pattern of balding, acne or oily skin, excessive hair growth etc. PCOS, if left undiagnosed and untreated may lead to serious consequences like infertility and Type 2 diabetes. Insulin resistance is also a major cause of PCOS.

Insulin resistance is a condition in which the body cells fail to respond to insulin and the cells are unable to effectively utilize the insulin. When the body becomes insulin resistant the muscles, fat and liver cells do not respond to insulin the way they should and become unable to absorb glucose from the bloodstream. The sugar is then retained in the blood, hence leading to excess blood sugar. For a brief period of time, the pancreas produces more insulin to keep up with the increased need. Over time the pancreas fails to keep up with the increased need for insulin, leading to Type 2 diabetes. Excess buildup of blood glucose leads to pre-diabetes, type 2 diabetes, and various other health complications. As stated by research, understanding the link between insulin resistance and PCOS is rather crucial in the UAE because 1 in 5 women here suffer from type 2 diabetes.

In other cases, women with PCOS are also at the risk of gestational diabetes, a condition when pregnant women who have never had diabetes, have high sugar levels during pregnancy. If diagnosed with PCOS, complications of developing Type 2 diabetes and gestational diabetes increases drastically.

Another factor linked to both PCOS and diabetes is obesity. Half of the population of women in the UAE is clinically obese. According to the 2015 World Health Statistics report, UAE’s female residents are overweight as compared to men. This data is clearly worrying because of the health complications obese women face, the most common ones being heart diseases and type 2 diabetes.

Experts suggest that PCOS may be linked to hereditary factors but the definitive cause is still unknown. Changing lifestyle habits, early diagnosis to control symptoms and prevent complications, maintaining a healthy body weight, exercising regularly, having a balanced diet etc. will help in controlling symptoms. PCOS and diabetes have a well-established link and creating awareness about the same are extremely necessary.

 

Dr. Jayacy C Jayankar

Specialist Obstetrician & Gynaecologist

Aster Hospital Mankhol

 

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Risk Factors and Symptoms of Diabetes

Diabetes Mellitus is a chronic disorder in which the blood sugar levels are very high due to inadequate production of insulin by the pancreas (insulin deficiency) or resistance to the action of insulin (insulin resistance).

There are 2 major types of Diabetes – Type 1 and Type 2 Diabetes

In Type 1 Diabetes there is absolute insulin deficiency whereas in Type 2 diabetes there is a dual defect of insulin deficiency as well as insulin resistance as described above.

Type 1 Diabetes / Insulin Dependent Diabetes / Juvenile Diabetes is usually seen in children, adolescents, and young adults, though it is also seen in the very elderly population. It is an autoimmune disorder in which the immune system of the body perceives the beta cells of the pancreas (that produce insulin) as alien and mount an attack by producing antibodies against them and destroying them. This leads to an absolute insulin deficiency in the body. These patients need insulin for treatment and survival, else they can go into a coma and can even die.

Genetic factors determine which patient gets Type 1 diabetes – these genetic markers are located on chromosome 6 (HLA complex). Children of parents with Type 1 Diabetes and siblings of patients with Type 1 Diabetes are more susceptible to developing the disorder. Other risk factors for Type 1 Diabetes include certain viral infections, race/ethnicity, geographical factors (northern climates), early exposure to cow milk and other autoimmune disorders like Graves’ disease, pernicious anemia etc.

Type 2 Diabetes / Noninsulin-dependent diabetes is commonly seen in the middle-aged and elderly population though it is now commonly also seen in children, adolescents, and young adults.

Type 2 Diabetes is a lifestyle disorder wherein the hereditary factors, as well as environmental factors, play an important role in its etiology. A strong family history is invariably seen in Type 2 Diabetes. Sedentary lifestyle along with physical inactivity, compounded by stress lead to obesity, which in turn leads to diabetes. Type 2 diabetes is also commonly associated with hypertension and hyperlipidemia.

The most common presentation of diabetes, whether type 1 or type 2, is that it can be asymptomatic (without any symptoms). These are incidentally detected when investigated for other unrelated problems. At times the complications of diabetes like neuropathy, retinopathy or nephropathy could itself be its presenting feature.

However, the most common symptoms of severely uncontrolled diabetes are excessive thirst, excessive hunger, excessive urination (especially during the night time), bedwetting in children, unexplained weight loss, easy fatigability, blurry vision, dizziness, delayed wound healing and fungal infections of the genitals.

 

Dr. Prakash Pania

Consultant Endocrinologist

Aster Clinic, Bur Dubai (AJMC)

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It’s never too late to prevent diabetes

Did you know that as per the Dubai Health Authority (DHA), almost 20 percent of the UAE population is diabetic and another 20 percent is pre-diabetic?

Today on the World Diabetes Day, Khaleej Times looks at different aspects of the condition.
The globally increasing pattern of unhealthy diet and sedentary lifestyle has led to the rise in obesity, further driving the prevalence of diabetes. “Diabetes is a silent killer and the condition will only worsen if it is not controlled, because diabetes rates are on the rise in this region now, given the lifestyle choices of people in the UAE, said Dr. Maneesha Pandey, specialist endocrinologist, Aster Jubilee Medical Centre, Dubai.

“Earlier, it was seen in people above the age of 50. These days there are innumerable cases of youngsters who have diabetes.”

Dr. Maneesha handled a case of a 13-year-old Asian boy with short stature. He had a history of type 1 diabetes since he was only 1.5 years old and his blood glucose was uncontrolled over last several years. As compared to his peers his height was very less. “On further checkup, I diagnosed that his short stature was entirely due to uncontrolled blood sugar. On improving his glycemic control, he started gaining height. The take home message from this case is that poor glycemic control in the growing age can adversely affect the overall growth including height.”

In another case, a 12-year-old was suffering from type 1 diabetes for last two years. Recently, his six-year-old sister was also diagnosed with type 1 diabetes and both are currently on insulin. However, there is no other family history of diabetes including the parents and other siblings. “This shows that first degree relatives of patients with type 1 diabetes are at a higher risk of developing the disease,” Dr Maneesha added.

“Our fast-paced lifestyle and eating out regularly combined with the lack of exercise increases rates of obesity and high blood cholesterol levels. These factors, in turn, increase the risk of developing diabetes, which over time, leads to serious damage in many organs of the body, especially the nerves and blood vessels,” said Mohamed Nabil Hassan Abdelrazik Mahna, a specialist endocrinologist at Medcare Hospital, Jumeirah.

 

Dr. Maneesha Pandey

Specialist Endocrinologist

Aster Clinic, Bur Dubai (AJMC)

 

News Source – http://www.khaleejtimes.com/lifestyle/health-fitness/its-never-too-late-to-prevent-diabetes

Maneesha Pandey

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Gestational Diabetes

Gestational diabetes is a form of diabetes which is seen in pregnant women who have increased blood glucose levels during pregnancy. Studies suggest that the prevalence of gestational diabetes can be as high as 9.2%.Unlike other types of diabetes, gestational diabetes isn’t permanent. Once the baby is born, the blood sugar will return to normal levels most of the times.

Gestational diabetes is seen affecting mothers in the late pregnancy, ie after the baby’s body has been formed. Therefore it does not cause any birth defects, however, may interfere with the normal growth pattern of babies.

Effect on the baby

  • If your blood glucose levels are high your baby will also have high blood glucose.
  • Baby’s pancreas will have to make extra insulin to control high blood glucose.
  • The extra glucose in baby’s blood is stored as fat if untreated or uncontrolled.
  • Baby born larger than normally called macrosomia, which can lead to difficult delivery.
  • Can have breathing problems called respiratory distress syndrome.
  • More likely for baby as it grows to become overweight and develop type 2 diabetes.

Effect on the woman

  • Preeclampsia (high blood pressure, sometimes with fluid retention and proteinuria)
  • Polyhydramnios (excessive accumulation of amniotic fluid )
  • Maternal birth trauma
  • Higher chances for C-Section
  • Developing Type 2 Diabetes
  • Reoccurrence in next pregnancy

Who is at a risk of Developing Gestational Diabetes?

About 5 to 18 percent of all pregnant women are likely to get gestational diabetes during pregnancy. The following factors may predispose you to gestational diabetes:

  • Age of 25 or older
  • Family history of Diabetes
  • Overweight as suggested by the Body mass index
  • Have Polycystic Ovarian Syndrome (PCOS)
  • Have a medical condition that makes diabetes more likely such as Glucose intolerance
  • Have had Gestational diabetes before
  • Certain ethnic subgroups such as African American, Native American, Hispanic or Pacific Islander

Prevention of Gestational Diabetes

Unfortunately, there is no way to guarantee that you won’t get Gestational diabetes. However, there are some things you may do to reduce the risk of developing it:

  • Eat a balanced diet: chose food high in fiber and low in fat and calories. Focus on eating fruits, vegetables, and whole grains.
  • Control on portion sizes
  • Regular exercise: Try and exercise for 30 minutes daily with some moderate form of exercises such as swimming or a brisk walk
  • Lose excess weight before pregnancy: If you are planning a baby, losing a few extra kilos may help you have a healthier pregnancy. Doctors do not recommend losing weight during pregnancy so plan the weight loss before you conceive.

 

Dr. Sejal Devendra Surti

Specialist Obstetrician/Gynaecologist

Aster Hospital Mankhool

 

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Aster & du’s Wellness Hub Initiative

More than 2 million people reached by Aster & du’s Wellness Hub Initiative. Around 2500+ free health checks offered during Ramadan for all

During Ramadan visitors to Wellness Hub, du’s online portal, are able to access free basic health checks from Aster DM Healthcare, the leading healthcare service provider in GCC. More than 2500+ health check vouchers have been downloaded till date and around 2 million people are being reached by spreading the message of health & wellness during the holy month of Ramadan.
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