Prediabetes, Diabetes and Insulin Resistance in PCOS

We know that women with PCOS tend to struggle with insulin resistance but not all of have insulin resistance. We also know that we are at risk of developing Type 2 Diabetes (in fact 40% of us will develop Type 2 Diabetes by the time we’re 40 (1)– seriously scary stuff)! Or we may be prediabetic. But what does this all mean and how are all of these things related? Even more important, how can we manage these things using a PCOS Diet?

Let’s have a look at each term, what it means in general and how it applies to us. Then we’ll try and connect the dots.

Insulin Resistance in PCOS

The first thing to understand is that insulin resistance is closely linked with chronic inflammation (2). Now chronic inflammation is also inherent in PCOS, putting us at risk of developing insulin resistance.

So, we know that we’re prone it IR as a result of our inflammation. Our cells slowly start losing their sensitivity to insulin, forcing our body to release more insulin for our cells to respond. This consistently high insulin level is called insulin resistance.


So what are the symptoms of insulin resistance?

For me, my next question would be, “How do I know if I have insulin resistance?” Well the symptoms of IR include:

  • Lethargy
  • Hunger
  • Brain fog or difficulty concentrating
  • High blood pressure

Well, if I’m honest, I occasionally have those symptoms as a result of my PCOS, not necessarily insulin resistance. So, the only way to absolutely sure if you have insulin resistance is to consult with your doctor and have blood tests. Normally, a fasting blood test is done to measure your fasting blood sugar and insulin levels (3).

Okay, so just because you may have insulin resistance, doesn’t necessarily mean you will go on to develop prediabetes or diabetes.

Prediabetes and PCOS

Prediabetes-Diabetes-and-Insulin-Resistance-in-PCOS-diabetes-aheadIf your insulin resistance remains unchecked and untreated, it could develop into Prediabetes. But what does that mean? Well, it means that your blood sugars are consistently on the higher end of normal. This suggests that your cells are losing their sensitivity to insulin and some of the glucose remains in your blood stream, instead of moving into the cells (4).

That fasting blood test will look at your blood sugar levels when you haven’t eaten and if these levels are higher than they should be, you would be diagnosed as prediabetic.

If your insulin resistance and blood sugar levels remain untreated, you could develop Type 2 Diabetes.

Type 2 Diabetes and PCOS

Okay, so the statistics suggest that 40% will develop Type 2 Diabetes by the time we’re 40. Basically, our blood sugar levels continue to climb as our body loses sensitivity to insulin or cannot produce enough insulin (5). Symptoms of Type 2 Diabetes include:

  • Being thirsty all the time
  • Frequent need to urinate
  • Increased hunger (this can also be linked to PCOS)
  • Extreme tiredness
  • Sudden loss of muscle mass (as your body starts to use your muscles for energy)

Type 2 Diabetes can have serious complications so you need to make sure that you get it investigated if you suspect you may have Type 2 Diabetes.

Right, so now you can see the full picture with insulin resistance, prediabetes and diabetes. The good news is that you don’t have to be one of the statistics. There are some things you can do to prevent or even reverse the development of all these things.

Follow a good PCOS Diet

It’s really important that you are eating well to manage your PCOS as a whole. This will help to manage insulin levels, as well as alleviate any inflammation that you may be struggling with. Here are the principles that I would suggest are part of a good PCOS diet.

Prediabetes, Diabetes and Insulin Resistance in PCOS THE PCOS DIET


Research has shown that exercise helps to increase the body’s sensitivity to insulin (6).  Now, before you ask what type of exercise you should be doing, let me point you to another article that suggests that even walking for about an hour a day can hugely improve insulin sensitivity (7).  So, it doesn’t really matter what you do, just get moving!

Exercise is also crucial in helping to manage that chronic inflammation we all struggle with (8).


There are also supplements that you can take to help with insulin sensitivity and inflammation. These are also the supplements that I most commonly recommend for women with PCOS.

Omega 3’s

Prediabetes, Diabetes and Insulin Resistance in PCOS supplementsOmega 3’s are important in lowering testosterone levels in women with PCOS and also play a role in improving chronic inflammation in the body. Omega 3 is readily available in fatty fish like Salmon which I try to incorporate in my diet at least once a week. I also strongly recommend an Omega 3 supplement, such as this one.


I’ve already written about the benefits of Inositol (you can find that article here) so I won’t rehash it now. This has been one of the moist effective supplements I have used in managing my own PCOS and I strongly recommend it. You can find Inositol at most pharmacies or on Amazon.

Another wonderful brand of inositol is Ovasitol from Theralogix. Ovasitol is a combination of myo-inositol and d-chiro-inositol in a 40:1 ratio and it is a high quality supplement.

So, to summarise, women with PCOS are at risk of developing Insulin resistance and Type 2 Diabetes. You don’t have to be one of those statistics though and following a good PCOS diet, exercising regularly and taking some supplements can really help to improve all of your symptoms of PCOS, including insulin resistance.

I would love to hear from you! Have you had any success reversing your prediabetes or are you in the process of making the above changes? Leave me a comment below!

The PCOS Weight Loss Program Inclues:


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Tarryn Poulton

Tarryn Poulton

Tarryn Poulton is a PN1 Certified Nutrition Coach and PCOS expert who has been a leader in the online PCOS space for over 8 years. Tarryn has the support of leading clinicians from around the world who support her scientific approach to understanding and talking about PCOS this includes all medical journals and ongoing research. You can read more about Tarryn and the team here.

18 Responses

18 Responses

  1. Could I just use hormone free dairy products? What would be good to replace them with? I really enjoy my milk, yogurt, and other dairy products. 🙂

  2. if a dr says I’m PCOS would I have been most my life? I have been up and down with weight all my life … easy to gain.. I’m so tires a lot that I can almost not function and think … I have low thyroid but not medically low its just not optimal I also have enlarged thyroid my hair falls out easy i again weight easy I’m sore .. also have endometriosis and chronic pain .. I really needed help I suffer anxiety and panic attacks … where do I start to get better what do I have to take ?

  3. Hi, Tarryn!

    I have recently started taking the fish oil (1000mg per day at bedtime) and am also on Metformin 1000mg per day.

    In regards to the fish oil, how do you know how much to take?

    I was diagnosed with PCOS and IR back in 2008 but was able to have my son in 2010. Now, I am struggling more with these issues and am doing more research to get more answers. Your website has been so helpful and I am looking forward to learning more. My next article to read is the one on Inositol. Haven’t even heard of this!!

    Thanks in advance for your help!


  4. Hi, I take ovasitol which has myo-inositol d-chiro-inositol and maltodextrin along with meyformin 1000mg my cycle comes every other month I have to change my eating habits and excercise regularly

  5. I was Diagnosed with PCOS a few months ago and I was given 500mg Metformin and I haven’t seen any change. I have been trying to eat different and exercise more but still no good results.I will be getting married in February and I want to feel beautiful even though I might not be at the desired weight.I want more kids even though I have one. Any suggestions?? I’m really discouraged

    1. Hello, Janae!

      I hope it’s okay if I reply to your post! It’s important to follow the things the have been posted above. PCOS dieting (not just normal dieting is important), exercise, and supplements.

      I can’t imagine that 500mg of metformin would help me either. The standard dose it 1,500 mg per day (either taken once a day or 3 times a day in 500 mg amounts). Some doctors start you out slow, since metformin can be hard on your digestional track. I would just make sure that your doctor intends on bumping up your metformin soon. My dr. had me take 1 for 3 weeks, 2 for 3 weeks, and finally all 3.

      While some really good supplements are posted above, there are even more out there that can help. Another help site is made by the PCOS diva. Seriously, give a good google or pinterest search on insulin resistance and you’ll find very useful info. The info on here is amazing as well.

      Lastly, you are going to be beautiful no matter what! PCOS has a way of making us feel less feminine, but you have to feel the beauty in your self. You are a beautiful creature of God. I am also a mom and getting caught up in motherhood can make us feel like not taking care of ourselves, but please do the things that make you more confident… paint those nails, stand up tall, put on some makeup, and realize that the beauty you feel inside is what will reflect on the outside!

  6. I have very recently had a marena coil inserted. I am 36 and gave no children and not really thinking I will. I have been told I need to lose 3 stone in weight to enable a laparoscopy. I have no idea where to start or if there would be any supplements that would help me lose this weight safely. Thanks in advance

  7. I have the jarrow inositol 227g powder .dosage on the bottle says1/4 tsp is 600mcg. How much do you recommend

    Folic acid I have is 400ug is that dorrect

    1. H Philippa,

      The suggested dose is 2g morning and evening. So, I normally have a tsp in the morning and one in the evening of the Jarrow powder. Also, you have the right dose of folic acid (400mcg or 400 ug)!

  8. Hello. I am a 57 year old with PCOS. I wans wondering if inositol would be helpful to me for weight loss and excess hair issues. Obviously it is not needed for pregnancy so should I still take the folic acid? I would be grateful for your advice. I have type 2 diabetes already and trying to follow your diet advice but struggling a little.

    1. I would definitely recommend taking Inositol, Gill. I think it could be really helpful. all of the research has been done on a combination of Inositol and Folic Acid so I tend to take both. Some people suggest that the folic acid is just in case of pregnancy and take Inositol on it’s own…

    1. Hi Heather,

      You can take it with Metformin but I would start off at a lower dose – maybe 2g per day instead of the recommended 4g per day…

  9. Thanks Tarryn!
    My question is should I take Inositol (Or Myo-Inositol tablets) while I’m on birthd control?? It seems like it could help with some symptons, but obviously not reproductive health– does this matter?

    1. Hi Rebeca,

      I would definitely recommend taking it. When you decide you are ready to start a family, it will help to maintain your hormone balance as you come off the pill as well!

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