Endocrine Abstracts

Introduction and aims: Women with polycystic ovary syndrome (PCOS) are at significantly increased risk of developing impaired glucose tolerance (IGT; prevalence 9–35%) and type 2 diabetes (T2DM; prevalence 2–10%), hence screening for these complications is recommended. The American Androgen Excess Society (AAES) recommends a biannual oral glucose tolerance test (OGTT) in all women with PCOS but this is costly and inconvenient. Alternative strategies which minimise the need for OGTT have thus been proposed, based on anthropometric variables alone (clinical decision tree modelling; DTM), anthropometry, clinical history, age and fasting plasma glucose (FPG) (Royal College of Obstetricians and Gynaecologists; RCOG), or FPG and a risk assessment questionnaire (All Wales Guidelines; AWG). We sought to determine the prevalence of glucose intolerance in our patients with PCOS and compared the performance of these 3 strategies with OGTT in identifying subjects with IGT/T2DM.

Methods: R&D and ethical approval was granted for this study. Clinical details and anthropometric measurements were collected in 28 consecutive clinic patients with PCOS (16–45 years). Patients with previously documented IGT/T2DM and those taking metformin were excluded. Subjects underwent a 75 g OGTT after an overnight fast.

Results: Nine patients (32%) were identified with abnormal glucose tolerance on OGTT; 5 with IGT and 4 with T2DM. Of these 8 had FPG values of <5.6 mmol/l.

Conclusions: These preliminary results confirm a high prevalence of IGT/T2DM in our local population of women with PCOS and highlight the limitations of FPG as a screening test for glucose intolerance in this population. The AAES guidance represents the only strategy which reliably identifies all patients with glucose intolerance but DTM may offer a reasonable alternative.