Women with PCOS harbor a lower cumulative risk for T2DM-related complications

A new study aimed to assess whether the increased prevalence of type 2 diabetes (T2DM) in women with polycystic ovary syndrome (PCOS) correlates to a higher risk of diabetic complications. 

This cohort study utilized data from the nationwide Diabetes in Finland database. The study selected 1,288 women with both PCOS and T2DM – tests; and 177,555 women with T2DM but without PCOS – controls. Additionally, a sub-analysis compared each woman with PCOS and T2DM to five matched controls based on the age and date of T2DM diagnosis. Diabetic complications—including retinopathy, neuropathy, nephropathy, cardiovascular and cerebrovascular events, foot complications, and all-cause mortality—were analyzed between 1996–2017. Cox regression modeling, adjusting for education level, T2DM diagnosis year, and age at diagnosis, was used to assess risk. 

The results revealed that women with PCOS were diagnosed with T2DM at a significantly younger median age (33 years) than controls (62 years). The 20-year cumulative incidence of diabetic complications was lower in the PCOS group (35%) compared to matched controls (48%). Further, women with PCOS exhibited a reduced adjusted hazard ratio for diabetic complications.

The findings suggested that PCOS does not appear to elevate the risk of diabetic complications in those who develop T2DM. However, given the prolonged duration of T2DM in this population, further long-term studies incorporating clinical data such as basal metabolic rate (BMI) and glucose levels are necessary to confirm these results and better understand the underlying mechanisms.

Source: Ollila MM, Hautakoski A, Arffman M, et al. Eur J Endocrinol. Published online (ahead of print) February 21, 2025.