"Why is my blood sugar acting up when I don’t even have diabetes?"
That’s a question many women with Polycystic Ovary Syndrome (PCOS) quietly ask themselves, and for good reason. Research shows up to 70% of women with PCOS have insulin resistance, even if they are not overweight. Yet, it remains one of the most overlooked aspects of PCOS.

Insulin resistance doesn’t just make managing PCOS harder, it also increases the risk of developing Type 2 diabetes, cardiovascular disease, and other metabolic complications.

Understanding how PCOS and insulin resistance fuel each other, and more importantly, how to break that cycle, is essential. Let’s explore the connection, and the research-backed lifestyle strategies that can enhance insulin sensitivity and promote healthier blood sugar control.

How PCOS Increases the Risk of Diabetes: The Role of Insulin Resistance

Credits: MDPI 

Insulin is a hormone that helps move glucose from the blood into the body’s cells for energy. When cells become resistant to insulin, the pancreas compensates by producing more of it to keep blood sugar in check.

In women with PCOS, this hyperinsulinemia worsens hormonal imbalances, leading to higher androgen levels, irregular periods, acne, and excessive hair growth. Over time, persistent high insulin and blood sugar levels increase the likelihood of developing Type 2 diabetes.

Research insight:
A systematic review published in Human Reproduction Update estimated that about 65–70% of women with PCOS have insulin resistance, regardless of their weight. This underscores the importance of screening and management even in lean women with PCOS.

PCOS and Blood Sugar Management: Why It’s Crucial

Stabilizing blood sugar levels is vital for women with PCOS, not only to prevent diabetes but also to:

• Improve ovulation and menstrual regularity
  
  

• Reduce androgen-related symptoms
  
  

• Support fertility
  
  

• Lower cardiovascular risks

Proactive management of insulin resistance is central to both symptom relief and long-term health.

Insulin Resistance in Women with PCOS: What You Need to Know

The table below summarizes the impact of insulin resistance on PCOS and overall health:

Recognizing and addressing these pathways is key to effective PCOS management.

Managing Insulin Resistance with PCOS: Lifestyle Changes That Work

Credits: MDPI

Fortunately, lifestyle changes can significantly improve insulin sensitivity in women with PCOS.

A randomized controlled trial in Clinical Endocrinology found that diet and exercise interventions improved insulin resistance and reproductive outcomes in women with PCOS, even without significant weight loss. This emphasizes that improvements in metabolic health can occur independent of body weight.

Evidence-Based Strategies

• Balanced nutrition

Eating whole, minimally processed foods rich in fiber, healthy fats, lean proteins, and low-glycemic carbohydrates helps regulate blood sugar. Reducing added sugars and refined carbohydrates is particularly beneficial.

• Regular physical activity

Both aerobic and resistance exercises enhance insulin sensitivity. Aiming for at least 150 minutes of moderate-intensity activity per week is recommended.

• Stress management and sleep hygiene

Chronic stress and poor sleep impair insulin action. Mindfulness practices and prioritizing sleep can support hormonal and metabolic balance.

• Sustainable habits

Building gradual, realistic lifestyle changes leads to more sustainable results over time.

Practical Recommendations for PCOS Blood Sugar Control

Credits: Dr. Jolene Brighten