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Andrea Dunaif Part 1, PCOS and Diabetes

In part 1 of this Exclusive Interview, Andrea Dunaif talks with Diabetes in Control Medical Editor Joy Pape about the importance of understanding PCOS and its associated risks.

Andrea Dunaif, MD is system chief of endocrinology, diabetes & bone disease for Icahn School of Medicine at Mount Sinai Health System in New York, NY.

Transcript of this video segment:

Pape: Hi. I’m Joy Pape, Medical Editor for Diabetes in Control. And we’re here today at the American Diabetes Association 2018, Scientific Sessions. And well, I couldn’t be happier to be here with Dr. Dunaif because [of] my personal relationship with PCOS and she has taught me so much that I’m just so glad that we’re here, so she can teach the world more and tell more about it, so many people don’t know. You have a new position, so if you can tell us something about you and then I have some questions for you.

Dunaif: So, now I’m, for just about last year, System Chief of Endocrinology Diabetes and Bone Disease for the Icahn School of Medicine, Mount Sinai Health System. So, I not only have responsibilities at Mount Sinai Hospital and School of Medicine but throughout our very large network, one of the largest in the country.

Pape: Congratulations. Yes. From Chicago to New York which neither one of them weren’t too bad, but now you got the country. So, congratulations.

Dunaif: (Laughs) Thank you.

Pape: So, why is it important for diabetes care providers to diagnose PCOS? Well, first of all what is PCOS?

Dunaif:  So, PCOS is an unfortunately named syndrome that’s diagnosed by its reproductive disturbances which are ovulatory disturbances. The symptom of that is irregular menstrual cycles, usually less frequent but occasionally prolonged frequent bleeding, male hormone or androgen excess, and the most common symptoms of that are increased hair growth but it can also lead to acne or occasionally to hair loss. And then there can be what are called polycystic ovarian changes, but they aren’t cysts in the ovaries. They are the normal structures that carry the eggs and they’re rested in development because of the hormone imbalance. And if we give them the appropriate stimulation, the follicles, which are what we’re calling the cysts, will mature and ovulate and there can be fertility but there is often decreased fertility with PCOS.

Pape: Is PCOS what they used to call Stein-Leventhal?

Dunaif: Yes. It was originally popularized by two gynecologists from Chicago in 1935, Stein and Leventhal. And it was a condition that surgeons really liked because they could do this surgical procedure called ovarian wedge resection where they took out pie-shaped wedges from each ovary and that would lead to improvement in the syndrome and ovulation, so it was a hormonal disorder imbalance that was correctable by a surgical procedure. And it really remained in the realm of gynecology until the early 1980s when it became recognized that women with PCOS had insulin resistance and an increased risk for diabetes. And that sort of goes to the question that you led off with, “Why should we know about PCOS as diabetes care professionals,” and it’s because it’s a major risk factor for type 2 diabetes.

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