Editing Polycystic ovary syndrome (section)

==== Glucose tolerance testing ====
* Two-hour oral [[glucose tolerance test]] (GTT) in women with risk factors (obesity, family history, history of gestational diabetes)<ref name=BMC2010 /> may indicate impaired glucose tolerance (insulin resistance) in 15–33% of women with PCOS.<ref name=emedicine_workup /> Frank diabetes can be seen in 65–68% of women with this condition.<ref>{{cite journal | vauthors = Andersen M, Glintborg D | title = Diagnosis and follow-up of type 2 diabetes in women with PCOS: a role for OGTT? | journal = European Journal of Endocrinology | volume = 179 | issue = 3 | pages = D1–D14 | date = September 2018 | pmid = 29921567 | doi = 10.1530/EJE-18-0237 | s2cid = 49315075 | doi-access = free }}</ref> Insulin resistance can be observed in both normal weight and overweight people, although it is more common in the latter (and in those matching the stricter NIH criteria for diagnosis); 50–80% of people with PCOS may have insulin resistance at some level.<ref name=BMC2010 />
* Fasting insulin level or GTT with insulin levels (also called IGTT). Elevated insulin levels have helped predict response to medication and may indicate women need higher doses of metformin or a second medication to significantly lower insulin levels. Elevated [[blood sugar]] and insulin values do not predict who responds to an insulin-lowering medication, low-glycemic diet, and exercise. Many women with normal levels may benefit from combination therapy. A hypoglycemic response in which the two-hour insulin level is higher and the blood sugar lower than fasting is consistent with insulin resistance. A mathematical derivation known as the HOMAI, calculated from the fasting values in glucose and insulin concentrations, allows a direct and moderately accurate measure of insulin sensitivity (glucose-level x insulin-level/22.5).<ref>{{cite book |vauthors=Muniyappa R, Madan R, Varghese RT |chapter=Assessing Insulin Sensitivity and Resistance in Humans |date=2000 |chapter-url=http://www.ncbi.nlm.nih.gov/books/NBK278954/ |veditors=Feingold KR, Anawalt B, Boyce A, Chrousos G |title=Endotext |place=South Dartmouth (MA) |publisher=MDText.com, Inc. |pmid=25905189 |access-date=19 October 2022 |archive-date=16 June 2022 |archive-url=https://web.archive.org/web/20220616022426/https://www.ncbi.nlm.nih.gov/books/NBK278954/ |url-status=live }}</ref>