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Abstract
To review the definition and prevalence of two insulin resistance (IR)-associated
phenotypes, polycystic ovary syndrome (PCOS) and type 2 diabetes mellitus, as well
as the risk and nature of their simultaneous presentation.
Review of published literature.
Insulin resistance affects between 10% and 25% of the general population. Two common
disorders frequently associated with IR are PCOS, affecting 4% to 6% of reproductive-aged
women, and type 2 diabetes mellitus, which is observed in about 2% to 6% of similarly
aged women. Overall, about 50% to 70% of women with PCOS and 80% to 100% of patients
with type 2 diabetes mellitus have variable degrees of IR. Insulin resistance and
its secondary hyperinsulinemia appear to underlie many of the endocrine features of
PCOS in a large proportion of such patients. The risk of type 2 diabetes mellitus
among PCOS patients is 5- to 10-fold higher than normal. In turn, the risk of PCOS
among reproductive-aged type 2 diabetes mellitus patients appears to be similarly
increased.
It remains to be determined whether PCOS and type 2 diabetes mellitus represent no
more than different clinical manifestations of the same IR syndrome, with their phenotypic
differences due to the presence or absence of a coincidental genetic defect at the
level of the ovary or pancreas, respectively, or representing the result of etiologically
different subtypes of IR syndromes.