Screening for Diabetes in Women with Polycystic Ovary Syndrome

In a retrospective study of 105 Canadian women with polycystic ovary syndrome (PCOS) assessed at an academic reproductive-endocrine clinic, Gagnon and Baillargeon examined the predictive value of the fasting glucose cutoff for screening abnormal glucose tolerance. They found that a fasting plasma glucose limit of 5 mmol/L had a sensitivity of 79% and specificity of 66%, indicating that only 3 out of 4 women with abnormal glucose tolerance were detected. The study suggested that all women with PCOS should undergo an oral glucose tolerance test for proper diabetes screening. The authors argued that earlier diagnosis of prediabetes and diabetes should lead to better treatment and improved health outcomes. However, the study had limitations, including a small and homogeneous sample size, and did not consider the cost-effectiveness of the oral glucose tolerance test. Despite these limitations, the recommendations of the Canadian and American Diabetes Associations to screen women with PCOS for diabetes with a fasting plasma glucose test, followed by a 75-g oral glucose challenge when results are abnormal, were considered logical and should be followed. The study highlighted the importance of early diagnosis and treatment of metabolic abnormalities in women with PCOS to reduce long-term risks of diabetes and heart disease.