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Insulin Resistance: A Role in PCOS

By Breea Johnson, MS RD

When most people hear the term “insulin” they immediately think of someone with diabetes- not knowing why or how they use insulin but knowing that something with their levels just isn’t right. Most diabetics in this country have Type II diabetes which is developed later in life and usually attributed to “insulin resistance.” Insulin resistance is also common in PCOS (Polycystic Ovary Syndrome), as a large percentage, but not all, of women with PCOS also have insulin resistance.

To understand insulin resistance it is first important to understand how glucose and insulin work together to provide energy for our body. Glucose is derived from the food we eat. Carbohydrates break down most efficiently into glucose.  Protein and fat eventually can eventually convert to glucose but take a longer time to do so.

Insulin is a hormone that is secreted by the pancreas that enables the liver to utilize and/or store glucose.  Insulin is absolutely necessary to life.  Without it, glucose circulates at high levels in the blood but cannot penetrate into cells and provide energy for our bodies.  Normally, a person would eat a meal containing carbohydrates, their blood sugar (glucose) would rise and insulin would signal cells to allow glucose to enter and be used for energy or stored for later use.  When insulin is present but cells don’t respond to its signals the condition is termed “insulin resistance” because insulin and glucose are both being produced but are unable to communicate.  This communication breakdown causes glucose levels to be very high (outside the cells) but very low (inside the cells) resulting in increased hunger. Because insulin is our “store and save” hormone, higher levels of this hormone in the bloodstream discourage our body from burning the existing stores of energy in our fat reserves.   Taken together these conditions can make it very difficult for a person with insulin resistance to lose weight.

So, what causes insulin resistance? The largest contributor is excess body weight, as an increase in adipose (fat) tissue can interfere with the communication between glucose and insulin. Weight gain in the central stomach area is most detrimental to insulin resistance.  Vitamin D deficiency is also associated with insulin resistance (so be sure to get your Vitamin D levels checked). Chronic inflammation is also a leading cause of insulin resistance and can be improved by a change in diet and lifestyle.  A lifelong diet of highly processed carbohydrates (cakes, cookies, sodas, candy, desserts, etc.) and poor nutritional intake may also be a key cause in the development of insulin resistance. While the causal connection of insulin resistance and PCOS has yet to be established, it is something of concern as the associated conditions of insulin resistance – overweight/obesity, increased risk of developing gestational and Type 2 diabetes, increased cognitive aging, increased risk of some cancers – are very serious conditions.

Luckily, insulin resistance is something that can be modified through diet and exercise.  There are many nutritional strategies to help with insulin resistance and PCOS.  If you are interested in learning more about our nutrition program to help with PCOS, please call (312) 321-0004 or visit for more info.