Assessment of Glycemic Variability in Patients with Polycystic Ovarian Syndrome Using Continuous Glucose Monitoring System.

Abstract

Introduction: Polycystic ovarian syndrome (PCOS) predisposes females to metabolic syndrome, diabetes mellitus, and cardiovascular diseases. Continuous glucose monitoring system (CGMS) offers the advantage of better understanding of glycaemic variability as compared to oral glucose tolerance test (OGTT). There is scarce data regarding use of CGMS in understanding glycaemic variability in patients of PCOS.

Methods: Fifty nondiabetic PCOS patients of age group 16-45 years diagnosed by Rotterdam criteria (2003) were included and subjected to CGM for 72 hours.

Results: The mean age of participants was 23.32 ± 4.58 years. Family history of diabetes mellitus in a first degree relative was present in 40% patients. On OGTT, dysglycemia was present in 14 patients-5 (10%) had impaired fasting glucose (IFG), 6 (12%) had impaired glucose tolerance (IGT), and 6 (12%) had both IFG and IGT. Glycemic variability and post prandial glycaemic excursion (PPGE) were found to have significant positive correlation with Luteinizing hormone: Follicle-stimulating hormone (LH: FSH) ratio [r = 0.37 (P = 0.008) and r = 0.39 (P = 0.004)], respectively. Fasting and 2-hour OGTT plasma glucose, serum testosterone, mean blood glucose (MBG), eA1c, total PPGE, and PPGE for breakfast values were significantly higher in patients having homeostatic model assessment insulin resistance (IR) >2.5. MBG, eA1c, and PPGE for lunch and dinner were significantly high in patients with family history (FH) of diabetes mellitus (DM). There was no significant difference in CGM metrics among patients with or without hyperandrogenism (HA).

Conclusion: CGMS detected high glycaemic variability and exaggerated post meal glycaemic excursions in Indian non diabetic PCOS patients having either positive family history of diabetes mellitus or IR or higher LH: FSH ratio.