Endocrinology-Diabetes Questions Polycystic Ovary Syndrome

Does Metformin ensure that I won't have diabetes because of my PCOD?

My insulin levels are a bit high and the doctor says it's because of my PCOD. So she has recommended me to have metformin. However, does it guarantee I will never get diabetes?

9 Answers

PCOS is associated with a high incidence of diabetes. Met Forman helps to control male hormones but also controls glucose level and treats and or delays the development of diabetes, but it doesn’t prevent it. DM 2 is genetically based and may become evident with weight excess, pregnancy, or aging among other things.

I presume you mean PCOS (polycystic ovary disease). Measuring insulin levels are not valuable. The normal levels are not clearly defined. However PCOS is associated with insulin resistance. Metformin helps this and sometimes the menstrual cycle returns to normal. It also prevents diabetes form developing. No it does not guarantee, as there are no guarantees in life, that you won't get diabetes. It decreases the incidence by 30%. As we all know, a healthy and active lifestyle with a normal weight may keep diabetes at bay for over a decade or even longer. There is no escape from doing what we all know we should be doing, though it is hard.
Unfortunately, there are no guarantees. PCOS predisposes to insulin resistance (high insulin levels) that in turn can progress into pre-diabetes and overt diabetes. If your insulin levels are already elevated, Metformin will help to lower them, by helping preserve your pancreas function (to help delay progression to diabetes). However, diet and exercise are very important add-ons in helping prevent insulin resistance to progressing further, in addition to Metformin. Many patients after they start taking medication like Metformin, think they can stop paying attention to the food they eat because they feel a false sense of protection with medicine. That is not true. These agents work together with lifestyle modifications to help protect your body from disease progression.
Metformin is frequently prescribed for patients with polycystic ovary syndrome because it improves insulin sensitivity and restores menstrual regularity. It has also been shown to benefit fertility and may protect the pregnancy once the woman has conceived. Women with polycystic ovary syndrome are characterized by significant insulin resistance which may lead them to develop diabetes mellitus later in life. Metformin use does not guarantee that they will never develop diabetes. The Diabetes Prevention Trial has shown that metformin is no better than lifestyle change (diet, exercise) in preventing diabetes. Controlling our weight with a healthy diet and remaining physically active is the best protection against chronic metabolic illness, including diabetes.
Good question. No, it doesn't mean that you will never develop diabetes. The Diabetes Prevention Program studied several thousand prediabetic patients for several years breaking them down into two groups; one which was placed on Metformin 850 twice a day and other on diet with goal to lose 7% of their body weight along with exercise, combination of both called lifestyle changes. These two groups were compared to a prediabetic group receiving no care or placebo meds. The diet and exercise group demonstrated an over 50 percent reduction in the development of diabetes and in those who did develop the disease a delay by several years. The metformin group also showed a decrease in the number of people who developed diabetes by 30 percent with a similar delay in onset in those who went on to develop the disease. However, type 2 diabetes is a progressive disease involving both beta cell dysfunction (insulin producing cells) and insulin tissue resistance and this progressive nature was shown in further studies when the metformin was stopped.with the development of diabetes.
Your take home message is to diet, exercise and take metformin to delay the development of diabetes.


Marvin A. Leder, MD, FACP, FACE
No, but it lessens it and may delay the onset.
It will improve insulin sensitivity and there is a high chance of preventing diabetes. Diet and life style changes are still a very important component of prevention.
Nothing is 100%. Yet Metformin and diet and exercise may prevent you from developing diabetes type 2, YES.
No it does not. In a study of pre-diabetes a few years ago, showed that life style change would decrease the chances of progression over 5 years by 60%. Treatment with metformin decreased the chances of pregression to diabetes by 30%. So metformin may help some but is not a good prevention. Your metformin was prescribed to treat PCOD & will have a side effect of lowering your blood insulin (thus removing some hard work by the pancreas) & controlling blood sugar levels (all good) but will not stop what your genetics has pre-determined. Eating right, weight loss & exercise will work better at preventing diabetes than metformin.