Re: To Belle: PCOS and no IR?
From: Belle (anonymous@obgyn.net)
Sun, 30 Dec 2001 13:44:03 -0600 (CST)
Yes, she is on Glucophage 1500 mg/day. She has just recently gotten a
prescription for Glucpohage XR. We are preparing to fill it for the
first time so we cannot report on how well that is going to work.
I cannot emphasize enough that her fasting glucose was *normal*. In
addition to that, her fasting insulin was in the normal range for the
normal testing procedures. Her fasting insulin was 14ľU/ml when the
normal range is 0 - 30ľU/ml (35 - 145 pmol/L). Since her
endocrinologist was a specialist in insulin disorders, she recognized
that the fasting level should ideally be below 10ľU/ml. Her regular
pediatricians were unable to detect this, not because they were bad
doctors but because they did not deal with insulin resistance. A blood
value may be below disease levels but this does not mean that it is at a
good level (see the explanation I had for glucose levels below). It was
only when we tested her body's reaction to sugar (IGTT)that we
discovered that she had higher than normal insulin levels after 1 hour
of ingesting sugar (simulating a meal).
Trying to watch your carb level is a wonderful thing to do. Since my
daughter was only 13 at the time, we did not do carb counting for her
because she was still growing and we did not want to risk losing any
vitamins that she may get from certain fruits or veggies. Now that she
is 15, we have been told to begin cutting out potatoes, white rice, etc.
At Sun, 30 Dec 2001, Missy wrote:
>
>Thanks! Did your daughter have to go on insulin senitizing drugs then?
>I've been trying to watch my carb and the type of carbs I intake. Is
>that enough especially since my fasting glucose levels is in the ideal
>range? Missy
>
>At Sat, 29 Dec 2001, Belle wrote:
>>
>>You can be thin and have PCOS. You can be thin and have IR. Fasting
>>glucose means nothing. 199mg/dl is not normal. 200mg/dl is diabetic.
>>Between 140 and 199 mg/dl is considered Glucose Intolerant. Fasting
>>levels should be less than 120 mg/dl but ideally between 60 - 80mg/dl
>>for a 8 - 12 hour fast. None-the-less, this does not have anything to
>>do with insulin. A fasting insulin may help detect if you are IR but
>>more likely, it will take a 2 hour Glucose Tolerance test with insulin
>>levels (IGTT)to help make that determination.
>>
>>The truth of the matter is that doctors who are involved in PCOS
>>research seem to feel that all women with PCOS would have IR if the
>>tests were sensitive enough to detect it. The IGTT can only help
>>diagnose IR because it is really only test for hyperinsulinemia. The
>>actual test for insulin resistance is not done on women because of the
>>costs. These are only done on research projects.
>>
>>Only about 1/2 of the women with PCOS are overweight according to some
>>reports. IR can have nothing to do with weight. My daughter was always
>>considered thin by her pediatricians to the point that this was
>>commented on several times. When she started her period and did not
>>regulate after a year, I took her in to the endo who did a a 2-hour IGTT
>>on her and guess what? Extremely thin, hard to put on weight and ...
>>diagnosed IR.
>>
>>At Sat, 29 Dec 2001, Missy wrote:
>>>
>>>I am not overweight nor do I have a
>>>problem controlling my weight but I still wonder if I have PCOS, but how
>>>could I if I am probably not IR?
>>>
>>>I read that only 10% of non-overweight women with PCOS have IR so how
>>>does one explain PCOS in them? What caused it?
>>>
>>>My fasting glucose level was 77 with 65-199mg/dl being the normal range.
>>>Does that mean anything? thanks, missy
>>
>>--
>>Hope this helps,
>>
>>Belle
>>
--
Hope this helps,
Belle
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