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The bigger problem is that PCOS isn’t talked about enough. Not in schools, not at home, and sometimes not even during doctor visits. Period problems are still treated like a taboo topic in many places, so girls grow up thinking they should just put up with the discomfort and move on. By the time they finally ask for help, bigger health issues like diabetes, high cholesterol, anxiety, or fertility problems may already be in the picture.That’s why awareness matters so much. Catching PCOS early can change everything. The more openly we talk about it, the sooner women can get answers, support, and proper care, and the better their chances of staying healthy in the long run.”Polycystic Ovary Syndrome (PCOS) is a hormonal disorder and an endocrine condition that affects 1 in 5 women in India. In PCOS, the ovaries produce higher-than-normal amounts of androgens (male hormones). This hormonal imbalance can lead to irregular ovulation, formation of small cysts in the ovaries, acne, hair growth, and weight gain,” says Dr. Preeti Prabhakar Shetty, MBBS, MD (OBG), Senior Consultant – Obstetrics, Gynaecology& Laparoscopic Surgery, Apollo Hospital, Bannerghatta Road, Bengaluru.

“But PCOS is not just a reproductive issue, it also has a strong metabolic component, which is where the link with high blood sugar comes in,” Dr Preeti adds. A 2012 long-term prospective study followed 255 Italian women with PCOS for a mean of 16.9 years. It found an incidence rate of type 2 diabetes at 1.05 per 100 person-years and an age-standardized prevalence of 39.3%, far higher than the general population’s 5.8%.As per a 2025 UK Biobank analysis women with PCOS show a 1.47-fold higher hazard ratio for type 2 diabetes, alongside elevated cardiovascular risks. The root problem in many women with PCOS is insulin resistance, the doctor says. Insulin resistance is a condition where the body’s cells do not respond insulin in a healthy way and in order to keep blood sugar levels normal, the pancreas produces more insulin. Unfortunately high insulin levels worsen PCOS symptoms by stimulating excess production of androgen leading to higher blood sugar levels over time and this increases the risk of type 2 diabetes.PCOS leads to 4 to 7 times higher risk of developing type 2 diabetes, a higher chance of gestational diabetes and increased risk of heart disease. So managing PCOS early is not only about periods, fertility, or weight, it is about long-term health and prevention of lifestyle diseases, Dr Preeti explains.

Why PCOS as a diabetes risk factor needs more attention

PCOS needs more attention as its risk shifts from a hormonal disease to a metabolic disorders. Diabetes affects women differently from men in areas like cardiovascular risk, complications, and treatment responses, with women often facing higher relative risks despite lower absolute prevalence. Peer-reviewed studies highlight greater mortality rates, adverse outcomes, and psychosocial burdens in women. As per a 2023 study published in Diabetologia, women with type 2 diabetes exhibit higher relative cardiovascular disease (CVD) and mortality risks than men, particularly younger women, due to factors like greater obesity burden at diagnosis, menopause- changes, and prior gestational diabetes. A systematic review published in Diabetologia, of 47 cohorts including 12 million individuals found women with type 2 diabetes have a higher relative risk of heart failure than men. Women also report more severe hypoglycaemia and poorer glycemic control in some therapies .

What can be done?

Eat well: Focus on whole grains, fresh vegetables, fruits, lean proteins, and healthy fats. Exercise: Move your body, even a 30-minute brisk walk each day can help your body.Weight control: If you’re carrying extra weight, losing just 5–10% can improve hormone balance. Medicine: Some people may also need medication like Metformin to support insulin control. Don’t skip regular check-ups.