"Women with polycystic ovary syndrome (have) twice the risk of developing type 2 diabetes or pre-diabetes", summarized in October the University of Birmingham, accompanying the publication of a study in which have participated some of its researchers.

This work, published in the journal Diabetes Care, stands out for its scope, as it retrospectively examines data from tens of thousands of British patients.

It confirms an already well-established link between diabetes, whose World Day takes place this Sunday, and this syndrome.

What are we talking about ?

Polycystic ovary syndrome (PCOS) is one of the most common disorders in women of childbearing age.

It hits roughly a tenth of them, although estimates vary.

This disorder, linked to an overproduction of male hormones, results above all in disturbed ovulation, therefore irregular cycles and difficulties in procreating.

It is one of the main causes of infertility in women.

However, this syndrome is not limited to fertility problems.

Thus, patients often react poorly to insulin, the hormone that regulates the level of sugar in the blood.

However, this resistance directly promotes the onset of type 2 diabetes, the most common.

This disease, which usually appears after 40 years, is in fact caused by the body's resistance to insulin.

It is still unclear what mechanisms link PCOS and insulin resistance.

Among the possible explanations, patients are often overweight, which tends to promote insulin resistance and therefore, subsequently, diabetes.

This weight gain could be linked to poor appetite regulation due to another insulin dysfunction often seen in PCOS patients: higher than normal production.

But "even patients of normal weight are not spared" by the higher risk of diabetes, warns endocrinologist Michel Pugeat to AFP.

It particularly emphasizes the high risk of gestational diabetes, that is to say during pregnancy.

This diabetes may stop after the birth of the child, it makes the onset of type 2 diabetes more likely later.

Poor prevention

More broadly, the production of insulin and that of male hormones maintain a close relationship.

This line of research has a good chance of explaining the links between PCOS and diabetes, although it remains largely to be determined where the causes and effects lie.

What to do, in the meantime, to limit the risks of diabetes in patients?

The Diabetes Care study provides a clue: Researchers have established that diabetes was less common in patients who took the main type of birth control pill, the combined pill.

This observation "shows for the very first time that there may be a treatment possible" to prevent the onset of diabetes in these patients, said one of the researchers, Wiebke Arlt.

This is still only a hypothesis, made from observations on the population, and it will have to be confirmed by clinical trials.

Especially since the difference - a quarter of cases of diabetes or prediabetes less in patients who have taken this type of pill - is not so marked.

For Mr. Pugeat, the main interest of this study is to show that the pill does not have the opposite effect: increasing the risk of diabetes in patients.

This in itself is important information, since the pills are often used to treat other manifestations of the syndrome, such as severe acne.

But, against diabetes itself, the endocrinologist considers it especially necessary to diagnose PCOS as early as possible, from adolescence.

Patients can thus be quickly invited to adopt habits - physical exercise, diet - which limit the risk of diabetes.

However, the syndrome is frequently discovered later in a woman's life, often during difficulties in having a child.

"The early prevention of this risk (of diabetes) is currently unfulfilled", regrets Mr Pugeat.

© 2021 AFP