The Link Between PMOS and Diabetes
Updated on June 26, 2026
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In May 2026, the Endocrine Society and other international experts have officially renamed polycystic ovary syndrome (PCOS) to polyendocrine metabolic ovarian syndrome (PMOS). This change better reflects the condition’s nature as a systemic metabolic disorder. This article has been updated to reflect the new terminology.
Symptoms of polyendocrine metabolic ovarian syndrome (PMOS) include irregular periods, excess body hair, acne, hair loss, and weight gain. It is a leading cause of infertility in women, but it's also linked to an increased diabetes and cardiovascular risk.
Nearly 1 in 3 people with PMOS develop prediabetes, and 1 in 10 will eventually develop type 2 diabetes, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). PMOS can increase the risk of weight gain, which can in turn increase the chances of developing type 2 diabetes. Between 35 and 80 percent of people with PMOS also have insulin resistance, which means their bodies don't use insulin (a hormone that lowers blood sugar) effectively. Having insulin resistance increases your risk of type 2 diabetes.
Learn more about the link between PMOS and type 2 diabetes, and how you can reduce your risk of type 2 diabetes with diet, exercise, and medication.
What Is PMOS?
PMOS is a hormonal condition that affects people who were assigned female at birth. It develops in up to 13 percent of women during their reproductive years (ages 15 to 49), according to the World Health Organization. Up to 70 percent of people with PMOS don't realize they have the condition because they've never been diagnosed.
The ovaries produce the hormones estrogen and progesterone, which help regulate the female reproductive system. They also produce small amounts of male hormones called androgens, including testosterone. In people with PMOS, insulin resistance leads to increased androgen production, causing irregular periods, weight gain, and signs of hyperandrogenism, including acne, excess hair growth, and scalp hair loss. It may result in a collection of small follicles pushed to the outer part of the ovary, producing what looks like a string of pearls in medical imaging. But instead of these follicles preparing the ova for ovulation, PMOS causes their development to stop too soon.
Having PMOS increases your risk for diabetes and other long-term health complications, including:
- High blood pressure
- High cholesterol or triglyceride levels
- Heart and blood vessel disease
- Pregnancy complications like gestational diabetes and high blood pressure
- Infertility
- Sleep apnea
- Depression and anxiety
- Uterine cancer
Treating PMOS can reduce the risk of these complications.
The Link Between PMOS and Type 2 Diabetes
Research has highlighted a link between PMOS and type 2 diabetes risk due to a few factors.
PMOS increases the risk of having obesity and being overweight; having extra fat cells makes the body more resistant to the effects of insulin.
In people with PMOS, the production of a protein called sex hormone-binding globulin is often suppressed due to insulin resistance. As a result, this can exacerbate hyperandrogenism because there are higher levels of free testosterone in the blood. This is why the diabetes medication metformin (Glucophage, Glumetza) can help treat PMOS and insulin resistance, and help restore ovulatory cycles.
Excess androgen production is another possible link. Higher than normal testosterone levels in women are associated with an increase in body fat and insulin resistance, both of which can contribute to diabetes risk.
Inflammation is another factor connecting PMOS to type 2 diabetes. People with PMOS tend to have chronic, low-grade inflammation, partly because fat cells release pro-inflammatory chemicals. Inflammation is one of the main drivers of type 2 diabetes.
More research is necessary to confirm the connection between PMOS and type 2 diabetes. But experts know that both conditions respond to some of the same interventions, including weight loss, exercise, and metformin.
Can I Lower My Risk of Diabetes?
If you live with PMOS, you can lower your risk for type 2 diabetes by making lifestyle changes such as losing weight and exercising more. Taking certain medications, like metformin or GLP-1 agonists, could help you manage PMOS, support weight loss, and improve insulin resistance. Research has also suggested that an over-the-counter supplement called myo-inositol can help lower fasting insulin levels and improve overall insulin sensitivity.
Lifestyle Modifications
Being active and eating a healthy diet can help you reduce your risk of insulin resistance with PMOS.
If you have prediabetes, losing just 5 to 7 percent of your body weight can help prevent prediabetes from progressing to type 2 diabetes.
What to Eat With PMOS to Reduce Type 2 Diabetes Risk Sticking to a diet low in inflammatory foods, such as avoiding diets high in saturated fats, refined sugars, and processed meats, can help you manage PMOS. Good examples include the Mediterranean and Dietary Approaches to Stop Hypertension (DASH) diets. These approaches to eating can also be helpful for preventing or managing type 2 diabetes. The DASH diet supports weight management, reduces blood pressure, helps protect blood vessels, and reduces blood sugar spikes. The Mediterranean diet can reduce blood sugar, insulin resistance, blood fats, and heart disease risk.
The NIDDK recommends filling half your plate with fruits and vegetables, one-quarter with whole grains, and the other quarter with a lean protein such as a skinless chicken breast or tofu. Add a dollop of healthy fat, like olive oil or peanut butter. Avoid refined sugar, saturated and trans fats, and processed meats, all of which can increase inflammation.
Exercise With PMOS to Prevent Type 2 Diabetes Getting at least 30 minutes of moderate-intensity exercise five days a week can help reduce your risk of type 2 diabetes if you have PMOS.
Engaging in aerobic exercise (workouts that make you breathe faster and increase your heart rate) can help your body use more blood glucose to lower blood glucose levels, reduce insulin resistance, and burn harmful fat around your organs, known as visceral fat. Resistance (or strength) training helps your muscles store more glucose, helps your body burn calories more efficiently, reduces circulating testosterone, and reduces markers of long-term metabolic disease.
Choose an activity that you like enough to stick with, whether that's walking, dancing, kickboxing, or swimming, and switch it up if you get bored. And even if exercise doesn't help you lose weight, it can delay or even prevent type 2 diabetes. Add in strength training at least two days a week to build lean muscle mass, which improves insulin sensitivity.
Research has found that high-intensity interval training (HIIT) can help people with prediabetes control blood sugar and decrease their risk of progressing to type 2 diabetes. However, it’s best to talk to your doctor before trying HIIT. This can reduce the risk of a complication called rhabdomyolysis, or rhabdo, in which the body starts to break down muscle tissue after intense exercise. Uncontrolled diabetes may increase your risk of rhabdo.
Medications
Multiple types of medications can treat PMOS and reduce type 2 diabetes risk, including:
- Metformin This diabetes drug improves insulin resistance, lowers blood glucose levels, and improves ovulation, so doctors prescribe it off-label – meaning outside of the use approved by the U.S. Food and Drug Administration – for PMOS.
- GLP-1 RA Researchers are investigating diabetes and obesity drugs called glucagon-like peptide-1 receptor agonists (GLP-1 RAs) as potential treatment options for PMOS. These drugs have decreased the risk of diabetes in some studies.
Some medications can help you manage other PMOS symptoms, such as hair growth and acne:
- Hormones Certain types of birth control can increase the amount of estrogen and progesterone in your body, and reduce androgens. These are available as pills, patches, shots, and a vaginal ring. Shifting the balance of these hormones can put your menstrual cycle back on track and make your periods more regular. Taking female hormones also helps reduce androgen side effects like acne and excess hair growth, and lowers your risk for endometrial cancer.
- Androgen-Blocking Medicines These medications reduce androgen levels in your body, which can help treat symptoms like hair growth and acne. However, your doctor won't put you on them if you're planning to get pregnant, as androgen-blocking medications can cause congenital anomalies in infants.
How Will I Know I Have Diabetes?
Seeing your doctor for regular checkups is important if you have PMOS. Your doctor can make sure that your PMOS is under control and screen you for complications, including high blood pressure and type 2 diabetes.
Type 2 diabetes often has no symptoms, especially in its early stages. You might only know that you have it after a doctor tests your blood glucose while seeing you about another health problem like PMOS. However, speak to your doctor as soon as possible if you have these signs and symptoms of type 2 diabetes:
- Increased hunger and thirst
- A need to urinate more often
- Unintentional weight loss
- Tiredness
- Sores that are slow to heal
- Numbness or tingling in your hands or feet
- Skin color changes in places like the armpit and neck, known as acanthosis nigricans
A two-hour oral glucose tolerance test is the gold standard for diagnosing insulin resistance in PMOS. Typical screening methods, such as A1C and fasting glucose, often miss it.
EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
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- Diabetes and Polycystic Ovary Syndrome (PCOS). Centers for Disease Control and Prevention. May 15, 2024.
- Amisi CA. Markers of Insulin Resistance in Polycystic Ovary Syndrome Women: An Update. World Journal of Diabetes. March 15, 2022.
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- Polyendocrine Metabolic Ovarian Syndrome (PMOS). Cleveland Clinic. February 15, 2023.
- Polyendocrine metabolic ovarian syndrome (PMOS): Symptoms and Causes. Mayo Clinic. May 21, 2026.
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- Sabag A et al. Exercise in the management of polycystic ovary syndrome: A position statement from Exercise and Sports Science Australia. Journal of Science and Medicine in Sport. October 2024.
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- Murawska-Ciałowicz E et al. Risk of Rhabdomyolysis and Kidney Injury after Intensive Exercise. Potential of Novel Biomarkers of Kidney Injury: A Narrative Review. Journal of Human Kinetics. April 2, 2026.
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- Brand KMG et al. Update on the therapeutic role of metformin in the management of polycystic ovary syndrome: Effects on pathophysiologic process and fertility outcomes. Women’s Health. February 3, 2026.
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Anna L. Goldman, MD
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Anna L. Goldman, MD, is a board-certified endocrinologist. She teaches first year medical students at Harvard Medical School and practices general endocrinology in Boston.
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