title: Effect of metformin therapy on 2-h post-glucose insulin levels in patients of polycystic ovarian syndrome.
abstract: OBJECTIVE
  To evaluate if 2-h post glucose insulin level is an effective tool to monitor insulin resistance in response to metformin therapy, in infertile women with polycystic ovarian syndrome (PCOS).
  
  
  METHODS
  This prospective observational study was carried out in a tertiary care infertility clinic.
  
  
  METHODS
  40 women with PCOS were categorized as having insulin resistance if fasting or 2-h post glucose insulin levels were >25 or >41μU/ml respectively. Post glucose insulin was compared before and after six months of metformin therapy along with other clinical, hormonal and metabolic parameters by using McNemar and the Student's t-test.
  
  
  RESULTS
  Fasting insulin was elevated in 4 (10%) and post-load insulin in 34 (85%) patients; after metformin therapy respective values were 2 (5%) and 16 (40%). Metformin therapy reduced post glucose insulin levels (P<0.001), improved the regularity of periods (P<0.001) and resulted in reduction of LH levels (P<0.001), total testosterone (P<0.001) and mean Body mass index (BMI) (P=0.047). Metformin therapy did not alter waist-hip ratio and fasting insulin levels.
  
  
  CONCLUSIONS
  2-h post glucose insulin level is an effective tool to monitor insulin resistance in PCOS patients and improves significantly after metformin therapy, similar to improvements observed in clinical, hormonal and metabolic parameters.
authors.affiliation: Department of Obstetrics and Gynecology, Lady Hardinge Medical College and Smt. Sucheta Kriplani Hospital, New Delhi, India.
authors.forename: Pikee
authors.initials: P
authors.lastname: Saxena
authors.forename: Anupam
authors.initials: A
authors.lastname: Prakash
authors.forename: Aruna
authors.initials: A
authors.lastname: Nigam