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New Position Statement for Glucose Intolerance in PCOS

Posted: Wednesday, January 23, 2008

The Androgen Excess Society has released a new position statement on glucose intolerance in women with polycystic ovary syndrome.

The new recommendations highlights the high risk for glucose intolerance in women with PCOS.

Generally, screening for glucose intolerance is recommended in these women because it is often asymptomatic. Recommendations have varied with regards to PCOS and the method and timing of screening for impaired glucose tolerance. Therefore, an expert panel was created to make evidence-based recommendations.

“[The position statement] provides evidence and rationale for the recommendation that women with PCOS be screened for glucose intolerance at the initial visit, using an oral glucose tolerance test and that the women be retested every two years,” said Nestler, William G. Blackard Professor of Medicine Chair and division of endocrinology and metabolism vice chair at Virginia Commonwealth University.

The panel recommended screening with a two-hour OGTT specifically. However, several panel members recommended alternate screening using an OGTT only in patients with BMI >30 or lean patients with other risk factors.

For high-risk patients, rescreening should occur every two years or more frequently. The panel members also suggested annual screening for women found to have IGT.

Intensive lifestyle modification and weight loss should be considered for PCOS patients with IGT, as it can help delay progression to type 2 diabetes. The panel recommended at least 30 minutes of moderate activity at least five days a week. They also recommended a hypocaloric diet for overweight and obese women, with a target weight loss of 5% to 7%.

Women with PCOS should be screened for glucose intolerance, regadless of age, weight, BMI or ethnicity, even in the absence of additional risk factors and a two-hour OGTT should be performed at the initial diagnosis.

The same screening method should be utilized for adolescents with PCOS at least once every two year or more frequently if they present with an abnormal screen.

Source: Diabetes In Control: The position statement was recently published in The Journal of Clinical Endocrinology & Metabolism, Jan.2008.