| April 2005 · Vol. 17, No. 4 PCOS
Sizing up insulin resistance—one treatment doesn’t fit all
There is no single best intervention for all women. It depends on the severity of glucose intolerance and metabolic abnormality in each patient.
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Fast Track
Intensive lifestyle modification reduces the risk of diabetes by 58%, versus 29% for drugs
Monitor treatment by measuring waist circumference, as well as BP, fasting lipids, and glucose tolerance
Because many payers do not reimburse for routine screening, indicate that these tests are to screen for a suspected condition
2,000 mg metformin daily in 2 divided doses may improve glycemic values more effectively than 850 mg twice a day
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Richard
Legro,
MDProfessor, Department of Obstetrics and Gynecology
Pennsylvania State University College of Medicine
Hershey Medical Center
Hershey, Pa
Insulin resistance. Some clinicians take it for granted, assuming every woman with polycystic ovary syndrome (PCOS) has it and treating her the same as every other patient with the syndrome.
Admittedly, some evidence supports this approach. For example, a recent meta-analysis1 demonstrated that metformin improves ovulation and, in conjunction with clomiphene citrate, boosts pregnancy rates. That may be rationale enough to use the drug routinely for ovulatory-related infertility in women with PCOS.
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