Polycystic ovary syndrome (PCOS) is a heterogeneous disease that is characterized by a combination of signs and symptoms of androgen excess (hirsutism and/or hyperandrogenemia) and ovarian dysfunction (oligo ovulation and/or polycystic ovarian morphology (PCOM)), provided that other specific diagnoses have been excluded.
The main features of PCOS include reduced fertility due to dysfunctional follicular maturation and ovulation, disturbance of reproductive hormones including luteinizing hormone (LH) hypersecretion, and hyperandrogenism which causes acne and hirsutism.
Insulin resistance and compensatory hyperinsulinism have been demonstrated to be related to androgen excess in PCOS, as according to many studies, insulin acts as a co gonadotropin on the ovaries, facilitate androgen secretion from the adrenal glands and modulate luteinizing hormone pulsatility.
Insulin resistance is considered a major risk factor for the development of type 2 diabetes mellitus in PCOS. Patients with PCOS are predisposed to consequences of IR such as: central obesity, acanthosis nigricans, hirsutism, and early pregnancy loss.
So, screening of all PCOS women for T2DM and prediabetes is mandatory.