Should patients with polycystic ovarian syndrome be treated with metformin?: an enthusiastic endorsement.
Insulin resistance is a prominent feature of polycystic ovarian syndrome (PCOS), and women with the disorder are at increased risk for the development of other diseases that have been linked to insulin resistance-namely, type 2 diabetes and cardiovascular disease. This association between insulin resistance and PCOS must guide the chronic management of the disorder, and accumulating evidence suggests that administration of insulin-sensitizing drugs to individuals at high risk for type 2 diabetes decreases the rate of conversion to overt disease. In contrast, limited evidence exists to suggest that oral contraceptive pills-the currently standard therapy for PCOS-may actually decrease insulin sensitivity and induce impaired glucose tolerance in women with PCOS. Hence, PCOS should be regarded as a general health issue and the use of insulin-sensitizing drugs such as metformin should be considered for the prevention of type 2 diabetes.
Nestler
John E
JE
Division of Endocrinology and Metabolism, Medical College of Virginia, Virginia Commonwealth University, Richmond, VA 23298, USA. nestler@hsc.vcu.edu
D003276:Contraceptives, Oral / Q000009:adverse effects; D003924:Diabetes Mellitus, Type 2 / Q000209:etiology; D005260:Female; D018149:Glucose Intolerance / Q000139:chemically induced; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007333:Insulin Resistance / Q000502:physiology; D008687:Metformin / Q000627:therapeutic use*; D011085:Polycystic Ovary Syndrome / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology
D003276:Contraceptives, Oral; D007004:Hypoglycemic Agents; D008687:Metformin