Graphic identifying there are 4 types of pcos including insulin resistant PCOS

Insulin Resistant PCOS: Do you have it?

Have you been diagnosed with PCOS and feel frustrated with the constant hunger, cravings, binge eating and weight gain that has come with the diagnosis? 

You knew that being diagnosed with PCOS meant that you were going to struggle with weight gain, but you had no idea that it was also going to affect your relationship with food or that it was going to cause skin tags and dark colored patches on your skin. 

If you are experiencing these symptoms and are at a complete loss of what the heck is going on in your body to cause them, you likely have insulin resistant PCOS. 

In this article, I’m going to share more about insulin resistant PCOS, which is one of the four PCOS types, what you can expect, what tests can confirm it as the main driver of your symptoms and what you can start doing today to improve insulin resistance. 

What is insulin resistance? 

Insulin resistance basically means that your body’s insulin is not working properly. Insulin’s job is to be the key of your cells. When you eat a food, it is broken down into glucose to be transported through the blood stream. Your pancreas is then signaled to do it’s job. Which is to take the glucose to the cells and store it for energy for use later on. 

However, when you are insulin resistant, insulin is unable to unlock the cell door. This causes your pancreas to make more insulin, which increases your insulin levels in the blood stream and causes hormone imbalances that promote androgen production.

Graphic summarizing the physiology of insulin resistance and how it impacts blood sugar, appetite and energy levels.

Insulin Resistant PCOS Symptoms 

To see if you have insulin resistant PCOS, take a look at the list of common symptoms and see if those are similar to the symptoms you have been experiencing. 

  • Weight gain in the abdominal region 
  • Intense sugar and carb cravings that seem to come out of nowhere
  • Difficulty feeling full even after eating a meal 
  • Binge eating episodes
  • Shakiness, dizziness or irritability if you don’t eat for long periods of time
  • Dark patches on neck, underarms are other areas of the body (acanthosis nigricans) 
  • Skin tags 

If you said yes to several of these symptoms, it could mean that insulin resistance is the main driver of your PCOS symptoms. And you’re not alone! Around 80% of women with PCOS have some insulin resistance. So this is usually a good place to start! 

It’s also important to note that insulin resistance is a driver of PCOS. This means it can drive androgen excess and result in symptoms such as hirsutism, cystic acne and hair thinning or loss. 

Tests to Confirm Insulin Resistance 

When working with clients, tests and labs can be helpful to confirm the driver of your symptoms and monitor improvements. However, with insulin resistance not all tests will be a true indicator of what’s going on in your body. 

It can be helpful to have your healthcare provider monitor your Fasting Glucose and A1c, which is your blood sugar after fasting for at least 2 hours and your 3 month average of fasting blood glucose, respectively. However, the best indicator of insulin resistance is an Oral Glucose Tolerance Test (OGTT) with Fasting Insulin pulled at the same time. This is because your insulin can still be taking longer to open the cell doors and store the glucose, but not long enough for it to show up on a Fasting Glucose and A1c test. 

In later stages of insulin resistance, you will start to see elevated Fasting Glucose and A1c tests. That is why it is helpful to monitor to ensure that you do not become prediabetic or diabetic later. 

How Do You Treat Insulin Resistant PCOS? 

Now you know whether or not insulin resistance is the main driver of your PCOS symptoms. If it is, you want to work on improving diet and lifestyle to alleviate symptoms as well as reduce the risk of developing Type 2 Diabetes later. 

Here is how you can improve insulin resistance: 

  1. Modify carbohydrate portions
  2. Balance carbohydrates with protein, fat and fiber for blood sugar balance
  3. Choose more whole grain, fiber-rich carbohydrate options 
  4. Incorporate strength and resistance training 
  5. Ensure you get adequate sleep (7-8 hours every night) 
  6. Work on stress management 

The Takeaways

Improving insulin resistance is typically a good place to start considering it affects so many women with PCOS. I suggest having your doctor perform an OGTT with fasting insulin and check/monitor your fasting glucose and A1c. Medication is an option, however insulin resistance can be improved through diet and lifestyle modifications like the ones suggested above.

Are you tired of band-aid treatments like Metformin and birth control? I can help you gain more clarity and confidence in your PCOS management. Click this link to work with me 1:1!

  1. […] for longer and your body secretes more insulin during this time. For a more in depth explanation check out this blog post about insulin resistant […]

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