At 29, Shalini Singh was once dealing with a fasting blood sugar level of 450 mg/dL and weighed 85 kg. Today, she’s a healthier 57 kg, meticulously counting calories, avoiding processed foods, opting for millets, sticking to a cardio routine, and getting enough sleep by 10 pm. Her strict regimen is a result of managing Type 2 diabetes, which could have been prevented with an earlier diagnosis and understanding of her triggers.
Shalini attributes her diabetes to factors she was unaware of, including hypothyroidism (an underactive thyroid) and childhood obesity, which triggered her PCOS (polycystic ovary syndrome) in adulthood. “I had been experiencing PCOS symptoms like hair loss and weight gain since adolescence, but the right questions were never asked by different specialists. There were missed opportunities for early diagnosis,” she says, emphasizing how it affected her health and future family plans.
What is PCOS and how many women are affected?
PCOS is a common condition affecting young women with irregular or absent periods, often due to excess male hormones (androgens). It typically begins in adolescence and can cause cysts on the ovaries. It’s the most common endocrine disorder in women and a leading cause of infertility. Worldwide, 6-26% of women suffer from PCOS, and in India, about 22.5% of women are affected, according to a 2019 meta-analysis.
When symptoms like missed or heavy periods, weight gain, and abnormal hair growth occur, doctors often check for PCOS and hypothyroidism. Dr. Subhash Kumar Wangnoo, senior endocrinologist at Indraprastha Apollo Hospital, New Delhi, explains that hypothyroidism, PCOS, and Type 2 diabetes are interconnected, particularly in women of reproductive age. “Addressing hypothyroidism and PCOS early can prevent diabetes,” he says, noting that he sees around 80 cases of women with both PCOS and Type 2 diabetes each month.
Red flags for PCOS
Shalini’s journey highlights some red flags she failed to notice early on. The first was her intense sugar cravings. “I couldn’t finish a meal without a soft drink and was overweight by class V,” she recalls. At the time, no one realized how childhood obesity could complicate her PCOS and later, lead to diabetes. She also faced liver complications and was diagnosed with hypothyroidism, which Dr. Wangnoo suggests may have contributed to her liver issues.
Another red flag came during her early teenage years when her periods were excessively heavy and painful. “I would sleep through the pain,” says Shalini. Dr. Wangnoo advises that girls with such menstrual irregularities, especially those with a family history of Type 2 diabetes, should consult a gynecologist. “Hormonal imbalances linked to PCOS can lead to obesity, high blood sugar, and cholesterol, all of which increase the risk of diabetes,” he explains.
The right diet for PCOS
Shalini’s third red flag was an inconsistent treatment approach. After her thyroid medication was reduced, no one coordinated her PCOS treatment, and her symptoms continued. “After 50 days of bleeding, I consulted a gynecologist and was diagnosed with PCOS. An ultrasound revealed cysts in my ovaries, and my fasting blood sugar was 450 mg/dL,” she explains. Since then, she has been on Metformin for diabetes and birth control pills for her periods. Her endocrinologist now coordinates her thyroid and PCOS treatments together.
Many girls mistakenly assume their menstrual cycles will stabilize, but Dr. Nupur Gupta, director of obstetrics and gynecology at Fortis Hospital, Gurugram, recommends early testing for PCOS if there’s a history of irregular periods, excessive hair growth, acne, or unexplained weight gain. Early diagnosis is key, and an ultrasound can help identify PCOS early.
A New Fitness Routine
Though Shalini struggled to maintain a disciplined routine during her time at IIT Delhi, she has now made lifestyle changes crucial for managing PCOS and diabetes. “I wake up at 5 am, walk for 30 minutes, then do cardio exercises. I stick to home-cooked meals that are low in carbs and gluten-free, with millet chapatis, lean proteins, and healthy fats. I avoid alcohol and fruit juices, and I finish dinner by 7 pm,” she shares. A 10% reduction in body weight can significantly improve PCOS symptoms, including insulin resistance and blood sugar levels.
Reflecting on her journey, Shalini says, “I wish I had known what to do in my teens. Now, managing my thyroid, PCOS, and blood sugar is a balancing act, but I never want to rely on medications again.”
