Surprisingly Low Infertility Rate in Married Type 2 Diabetic Women: A Curious Paradox to the Current Opinion of Insulin Resistance as the Joint Pathogenesis of Polycystic Ovary Syndrome and Type 2 Diabetes Mellitus

In a study of 265 married women with type 2 diabetes mellitus (T2DM) from a religious community that does not use contraception, researchers found a low infertility rate of 2%, with an average of 5 ± 2.5 pregnancies per woman and a range of 0-15 pregnancies. Only 6 women sought medical advice for delayed pregnancy. The findings challenge the common belief that T2DM and polycystic ovary syndrome (PCOS) are closely related due to shared insulin resistance. The study suggests that T2DM and PCOS may represent different manifestations of insulin resistance, potentially influenced by the level of compensatory hyperinsulinemia and B-cell competence. This indicates that T2DM and PCOS should be considered distinct medical conditions.