A case of lean polycystic ovary syndrome with early stage of type 1 diabetes successfully treated with metformin

Endocrine Journal
Fumika ShigiyamaTakahisa Hirose

Abstract

Polycystic ovary syndrome (PCOS) is common in obese women with insulin resistant type 2 diabetes for which metformin treatment is getting established in addition to clomiphene. However, lean PCOS patients are sometimes accompanied with type 1 diabetes. It remains unclear whether these patients are insulin resistant and whether metformin is effective for them. A 32-year-old woman, who suffered from acne, hirsutism, and menstrual disorders since age 29, was diagnosed as PCOS by serum high LH levels and polycystic ovary on echography. Interestingly, her body mass index (BMI) had consistently been 21.0 kg/m2 since age 20. She was first treated with clomiphene for one year for infertility but it did not improve her menstrual cycle nor did she get pregnant during that period. She was then assessed with diabetes mellitus and subsequently diagnosed as type 1 diabetes with mild hyperglycemia (HbA1c 6.0%). Since her insulin secretion was still well preserved, to assess insulin sensitivity, hyperinsulinemic-euglycemic clamp test was performed and showed her to be insulin resistant. Low dose insulin and low dose metformin treatment was started without clomiphene. After her ovulation and menstrual cycle were ameliorated only one month later...Continue Reading

References

May 26, 2005·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·UNKNOWN American Association of Clinical Endocrinologists Polycystic Ovary Syndrome Writing Committee
Jan 31, 2007·Human Reproduction·Michael F CostelloPeter Sjoblom
Feb 9, 2007·The New England Journal of Medicine·Richard S LegroUNKNOWN Cooperative Multicenter Reproductive Medicine Network
Jun 20, 2012·Human Reproduction Update·E CodnerM Tena-Sempere
May 21, 2014·Journal of Diabetes Investigation·Arina MiyoshiHideaki Miyoshi

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Citations

Apr 22, 2019·Journal of Pediatric Endocrinology & Metabolism : JPEM·Mona HafezMaha Amin

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