What should I do for the proper management of PCOS?

Q: My wife's blood sugar level (post prandial) is 71 mg. Her leucocyte count is 10,000. She is under medication for polycystic ovary syndrome (PCOS). Please advise the dos & don'ts about the food intake. Are regular check ups required & at what duration?

A:Polycystic ovarian disease is a condition in which a woman has multiple ovarian follicles with menstrual abnormalities, hyperandrogenism (elevated male hormones), infertility, obesity and diabetes along with other some other features, in varying severity. This results from abnormalities in the metabolism of androgens (male hormones) & oestrogen and associated peripheral insulin resistance with increased level of insulin in blood. Medical treatment aims to correct the menstrual irregularity and anovulation along with management of the metabolic derangements and hirsutism. One common drug used is metformin, an anti-diabetic medicine, and this may be responsible for the low blood sugar levels. Dietary restriction and exercise greatly benefit the patient by lowering the abnormal hormone levels and return of normal ovulatory cycles. A low-calorie diet for weight reduction along with regular exercise will prevent diabetes from developing. Patients need regular follow-up for early detection and management of any untoward sequelae associated with the disease. Please consult the treating physician and a nutritionist to help your wife plan a programme.