PCOS Messages for June, 2002: Re: Testing for IR (was) Re: anorexic individuals with pcos

Re: Testing for IR (was) Re: anorexic individuals with pcos

From: Belle (anonymous@obgyn.net)
Tue, 4 Jun 2002 13:10:37 -0500 (CDT)

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1) The test for insulin resistance (IR) is very expensive and is only done in research settings. The only test that we have is a glucose tolerance test with insulin levels (IGTT). This is not a very sensitive test, but it is the best that we have. The fasting tests alone are not good enough to show insulin resistance in most people.

2) If your doctor is not very familar with diabetics and the associated problems, s/he may be referring to the lab "norms" in order to diagnose insulin or glucose problems. Most doctors in the forefront of endocrinology admit that insulin levels above 10 mIU/ml at a fasting level or 50 mIU/ml at a non-fasting blood draw is an indication of an insulin problem even though the norms for labs are usually below 25 for fasting or below 80 for non-fasting levels.

You can see that even if you have been told that you are not insulin resistant, you very well could be.

3) The original studies for effects of Glucophage on women with PCOS were not done on women who were specifically IR. They were done on women who were non-ovulatory. The overwhelming majority of these women ovulated (91%) within 6 months. This indicate that there was an underlying insulin problem or that Glucose - for some other reason - just helps women ovulate.

Doctors who are familiar with the research on PCOS will prescribe Glucophage to see how the patient responds on the medication. More and more often, I have seen doctors who do not even wait for the results of the IGTT before starting Glucophage because it does not change the course of treatment.

Even women who are "borderline" IR can respond to Glucophage. They frequently have the best responses to insulin sensitizing drugs.

If you are not receiving treatment for PCOS, you may want to see another doctor. Before the late 90s, the only treatment for PCOS was the birth control pills, ovarian drilling and hysterectomy. As women who have depended on these options for years will tell you, these options do not work to prevent the problems that are associated with PCOS. We are very fortunate that there is so much research that has been done in the last few years.

At Wed, 29 May 2002, Jessica wrote: >
>People say that sometimes when pcos patients test for IR, it doesn't
>show up. If IR is what is wrong with all pcos patients, does this mean
>these people will eventually develop IR? I don't think doctors will
>prescribe meds to increase your insulin sensitivity if tests show that
>you are not IR. Furthermore, doctors don't keep testing for IR if your
>tests come out normal. What should the patient do then? Just sit and
>wait?
>

-- Hope this helps,

Belle

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