PCOS and hyperinsulinemia

[michelle_bm93]

I'm wondering if anyone can help. Apologies if this has been posted in the wrong place!
I've had Type 1 for 18 years. Last year I was also diagnosed with PCOS (the lean version; I have a BMI of 19.5.)
I received no advice from the GP/diabetic nurse/gynaecologist, other than 'Unless you want to get pregnant straight away, go back on the pill to control your cycles.' But I don't want to do that; I want to treat the cause, rather than simply mask the symptoms!
Through my own research I have discovered that it's not uncommon for Types 1s to develop PCOS due to high insulin levels in the bloodstream. I have drastically changed my diet and inject as little as I possibly can, while still keeping in the safe, normal ranges. It's a constant juggling act, but I'm prepared to do it if it helps get my cycle back to normal.
My question is, how many units of insulin count as being evidence of hyperinsulinemia? Eg. my basal dose is 12 or 13, then I usually take 6/8/8 (ish) of Novorapid throughout the day. Is that 'normal'?! Is that more/less that a non-diabetic would release into their bloodstream throughout the day? Because all I've seen anywhere is the advice to 'Reduce your insulin levels to help improve PCOS', but reduce them to what?!
Help! 🙂

 

[grovesy]

I did not that about PCOS , I thought it was related to been overweight!

 

[michelle_bm93]

I didn't know either until I was diagnosed with it!

 

[grovesy]

I have known a number of people with it all had weight problems and some even tried on Metformin for the insulin resistance despite not having Diabetes!

 

[trophywench]

Err - you can't reduce them that much - since it would be difficult to stay alive frankly - since it's my belief that a non-D produces and uses approx. 10u of endogenous insulin a day. I mean - I'm on a pump - and I use just over 10u a day basal - and though I don't need to eat shedloads of anything to stay alive - if I want to have a reasonable health and QoL - I do need to eat a balanced diet to do both of those - so does everybody!

Remember - however scant - there's even carb in ruddy cucumber and lettuce!

Cut out unnecessary 'stodge' by all means - but you'd be unlikely to cut out ALL carbs - and they reckon that you'd probably need a small amount of insulin to deal with higher amounts of fats and proteins - so avoiding bolus insulin is impossible !

You don't need massive amounts of basal insulin by the looks - I cut mine down with ease from approx. 18u a day to the current level by changing to pumping and only having what I actually needed, exactly when I needed it - which is the only difference compared to when I was on MDI. My carb ratio is still 1u to 10g - do you have an especially high carb ratio ?

All in all - I seriously doubt whether excess insulin is what has caused your PCOS. It may well be one of the things they think causes it/exacerbates it - but it can't be the ONLY thing, can it?

 

[bilbie]

This is an example of a very low carb diet of 20g/day. I don't know if you would need to go this low? perhaps start 100-130g?
http://au.atkins.com/new-atkins/the-program/phase-1-induction.html

Being a slight bulid, you will need to come to terms with 40-70% of your energy coming from healthy fats and oils. Normally people will chose low carb because they can't get decent BG and are carrying some weight. So they have a weight loss period, to break the last 40 years of low fat everything.

Dr.Trudy Deakin a diabetic educator and dietitian.
http://www.xperthealth.org.uk/
Her daily intake is 82% fat
http://www.dailymail.co.uk/health/a...carbs-fuelling-obesity-diabetes-epidemic.html

 

[michelle_bm93]

Thanks for the links bilbie, I will have a read through them all.

Trophywench: http://www.nhs.uk/Conditions/Polycystic-ovarian-syndrome/Pages/Causes.aspx

http://www.scirp.org/journal/PaperInformation.aspx?PaperID=18360

http://press.endocrine.org/doi/full/10.1210/jc.2006-2641

The only complex carbs I eat are my morning porridge oats. All other carbs come from vegetables and small amounts of fruit. My HbA1c is 5.3 so I'm doing something right.

I don't want to be diabetic any more; who do I complain to?!

 

[Cleo]

Hi. I've heard of PCOS but don't have any direct experience with it, sorry. Have you tried reaching out to other type 1 women who have it ?

 

[trophywench]

I think your Links were meant for @grovesy - rather than me? Otherwise , I don't understand ? I already said there were other things that had a part to play.

 

[michelle_bm93]

Trophywench: I don't think you do understand. All three links state that hyperinsulinemia causes ovarian hyperandrogenism, or, in layman's terms, too much insulin in the bloodstream increases the production of male sex hormones, one of the three main features of PCOS. The other two are irregular periods and cysts on the ovaries, which are caused by hyperandrogenism.
You stated that you 'seriously doubt whether excess insulin is what has caused [my] PCOS'. Why do you seriously doubt it? Are you an endocrinologist? Studies have shown it is the case. My question wasn't whether you doubted the cause of my PCOS; it was how much insulin a non-diabetic releases into their bloodstream every day. You replied that a non-diabetic releases 10 units approx of endogenous insulin a day, which was helpful, thank you. That was all I wanted to know.

Cleo: I don't personally know any other Type 1 women, only men! It's surprising how little information there is online without trawling through scientific research papers.

 

[Redkite]

Hi Michelle. I can't comment from the type 1 perspective (I'm Mum to a type 1 boy), BUT I do have PCOS (not overweight when first developed), and the advice I received from endocrinologists is that it is not necessarily a discrete condition, but often is part of a "continuum" of endocrine imbalances in the body. I have an underactive thyroid also. I had extremely irregular periods throughout my teens, then was on the Pill during my twenties, came off it around the age of 30, back to irregular periods and the fear of infertility. My thyroid was being treated with thyroxine. I also suffered reactive hypoglycaemia frequently (over sensitive pancreas?). Ironically, my pregnancy (happy accident) seemed to kick-start my ovaries back to normal function, because a year after giving birth, my periods restarted and have been regular ever since.

So my advice would be: 1. have you had your thyroid checked? and 2. don't rule out going on the Pill unless you're wanting to try for a baby, because the hormones it contains could be beneficial.

 

[KookyCat]

Hi Michelle
Have you heard of Verity? They are a charity focused on PCOS, I did some work with them many years ago, and if remember correctly they have a forum. Just thought it might be useful. I just did a quick check to see if they were still going and there seems to be one lady at least with T1 and PCOS on the forum, course she might not still be active but it might be worth a look if you don't already know about it.
http://www.verity-pcos.org.uk

 

[michelle_bm93]

Redkite: At my last twice-yearly blood test I believe my thyroid was OK, but I'll double check with the diabetic nurse when I see her tomorrow. Thanks for the advice!

KookyCat: I've heard of Verity but not really checked it out. Thanks for the heads-up, I'll have a look! 🙂

 

[Bloden]

Eg. my basal dose is 12 or 13, then I usually take 6/8/8 (ish) of Novorapid throughout the day. Is that 'normal'?! Is that more/less that a non-diabetic would release into their bloodstream throughout the day? Because all I've seen anywhere is the advice to 'Reduce your insulin levels to help improve PCOS', but reduce them to what?!
Help! 🙂

Hi Michelle.🙂 I take about the same doses as you and eat approx 130g of carb a day (breakfast 40g, lunch 45-60g, dinner 30g). Hope that's helpful...good luck!