PCOS: women with normal weight may not share T2DM risk similar to overweight

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  • Type 2 diabetes mellitus (T2DM) was not observed in women with polycystic ovary syndrome (PCOS) having normal weight.
  • Greatest weight gain in women with PCOS, who developed abnormal glucose tolerance (AGT), was observed between 14-31 y.

Why this matters

  • Endocrine Society, the Androgen Excess and PCOS Society, and the Australian PCOS Alliance guidelines recommend screening for T2DM in all women with PCOS regardless of weight.

Study design

  • In this prospective study, general population-based birth cohort 1966 (5889 women) was followed up at 14, 31, and 46 y with questionnaire and clinical examination.
  • Funding: Finnish Medical Foundation, North Ostrobothnia Regional Fund, and Academy of Finland.

Key results

  • 6.5% of normal weight women with PCOS had prediabetes, and none had T2DM.
  • In overweight/obese women, PCOS significantly increased the risk for T2DM (OR, 2.45) and AGT (OR, 1.8) vs overweight/obese control women.
  • At age 46 y, the presence of PCOS and BMI ≥ 25.0 kg/m2, significantly increased the risk for prediabetes (OR, 4.4), T2DM (OR, 12.4), AGT (OR, 6.2) and newly detected AGT (OR, 5.4), vs normal weight control women.
  • Median weight gain was highest between 14 and 31 y in women with PCOS and T2DM vs women with PCOS and normal glucose tolerance (P<.001).


  • Self-reported symptoms and diagnosis of PCOS.