Effect of metformin on insulin levels, blood sugar, and body mass index in polycystic ovarian syndrome cases

Introduction: Polycystic ovarian syndrome (PCOS) presents as an extremely heterogeneous condition that includes chronic anovulation, hyperandrogenism, hyperlipidemia, and hyperinsulinemia along with enlarged polycystic ovaries. Insulin resistance is thought to be a pathogenic factor in women having PCOS along with increased incidence of metabolic disturbances. Materials and Methods: After obtaining ethical clearance, the girls of various colleges in Patiala were verbally sensitized to the symptoms of PCOS, and then given semistructured proformas subsequent to written informed consent. The students suspected on self-evaluation, and on evaluation of the proformas were investigated in the Out Patient Department, and patients reporting to Obstetrics and Gynecology Department with similar symptoms were also included after written informed consent. The patients were divided with simple randomization into two groups of 25 each. Group 1 (treatment group) was put on metformin therapy for three months (500 mg thrice a day), and Group 2 (control group) were given placebo thrice a day for the same duration. The patients were followed up after three months of metformin therapy (500 mg thrice a day) in Group 1, and placebo therapy in Group 2. Body weight, fasting blood glucose, blood glucose after 2 h of 75 g of glucose, and fasting serum insulin levels were assessed initially, and then after three months. Results: The mean age of patients in the present study was 21.46 +/- 4.45 years. About 54% patients in the present study had BMI >= 25 kg/m2. About 68% of the patients had menstrual irregularity and PCO on ultrasonography (USG). About 44% patients in Group 1 (metformin) had increased insulin levels initially (>20 mu U/ml), which were decreased to 16% after three months of metformin therapy. About 52% patients in Group 2 had increased insulin levels that were decreased to 48% after the placebo therapy. Conclusion: It has been concluded from this study that metformin significantly lowers insulin levels in patients with PCOS; in both obese and nonobese; which points towards its potential usefulness in treatment of PCOS patients, though it had no significant effect on body mass index in 12 weeks.