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Diabetes is a complex and often misunderstood condition. One of the most important things you can do to manage or prevent it is to educate yourself about the facts. To help, we’ve debunked five common myths about type 2 diabetes and prediabetes.

Debunking Common Misconceptions About Type 2 Diabetes

Myth: Weight is the main risk factor for type 2 diabetes

Type 2 diabetes, the more common of the two main types of diabetes, develops gradually as the result of genetic, lifestyle, and environmental factors. (Type 1 diabetes is an autoimmune condition that most commonly develops in childhood.) Obesity is one of the type 2 diabetes risk factors that many people are familiar with, and there are several misconceptions about the relationship between diabetes and weight.

While being overweight or obese may increase a person’s risk of developing type 2 diabetes, it is not the only risk factor. Frequency of physical activity, genetics, and age are also contributing factors. Many people who are overweight or obese do not develop diabetes, and people who are at a healthy weight may develop the condition.

Diabetes is characterized by elevated levels of blood sugar, or glucose, a source of energy that carbohydrates are converted into during the process of digestion. This often leads to the misconception that eating sugar can directly cause diabetes, which is not the case.

Still, if you have prediabetes, it is often recommended to consume soda, sports drinks, and other sweetened or sugary beverages in moderation, as they do not contain any fat or protein to balance their carbohydrate content.

Myth: People with diabetes have to eat a special diet

Any time you digest carbohydrates, in the form of food or drinks, your body turns those carbs into glucose, causing your blood sugar levels to rise. For those without diabetes, the body’s natural insulin response helps to balance blood sugar levels. However, for those with diabetes, insulin resistance keeps blood sugar at a higher level.

For this reason, it is important that individuals with both prediabetes and type 2 diabetes are mindful of their carbohydrate intake. However, this doesn’t mean that you cannot consume bread, potatoes, pasta, or other foods that are high in carbs. Recent studies have found that eating a diet with a good balance of carbs, protein, and fat can help with blood sugar management.

If you have prediabetes or diabetes, work with your provider to develop a healthy, balanced meal plan that you can consistently follow.

1 in 3 U.S. adults have prediabetes, a health condition defined by higher than normal blood sugar levels that often precedes type 2 diabetes. If left untreated, prediabetes can lead to serious complications like heart disease and kidney damage.

While prediabetes is serious, it doesn’t need to result in diabetes. If you’ve received a diagnosis of prediabetes, work with your provider to prevent it from progressing into type 2 diabetes. Depending on your health history, that might mean increasing your physical activity, quitting smoking, or controlling blood pressure and cholesterol levels.

Myth: Taking insulin means you’re not managing your diabetes well

People with type 1 diabetes cannot produce any insulin on their own and rely on insulin therapy every day to maintain balanced blood sugar levels. Treatment is more varied for type 2 diabetes, which is characterized by insulin resistance.

Some people with type 2 diabetes are able to manage their condition with lifestyle changes alone while others need to take oral diabetes medications like metformin or insulin.

If you have type 2 diabetes and your doctor recommends adding insulin therapy to your treatment plan, it does not mean you haven’t done a good job of managing your blood sugar. An individual’s type 2 diabetes treatment needs may change with time; the condition is progressive for many, and often, the body gradually becomes less able to produce insulin on its own. 

We’re specialists in treatment for type 2 diabetes, and whether you’re beginning oral medications or transitioning to insulin, Alto’s pharmacists are here to support you on your health journey.

Additionally, we make it as simple as possible to stay on track with treatment, with free, same-day delivery right to your doorstep, temperature controlled packaging, and savings investigations.

Reach out via phone at 1-800-874-5881 or in-app messaging to learn how Alto can be a partner in your diabetes care.

This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition.

After an initial stroke, 1 in 4 individuals will have another within five years. Medications play an important role in preventing another stroke and treating stroke-related complications, often in tandem with lifestyle changes.

There’s no one-size-fits-all treatment plan. Your doctor may prescribe one or more medications based on the underlying cause of your stroke as well as its impact on your physical and mental health.

Medications Used After a Stroke

After an initial stroke, 1 in 4 individuals will have another within five years. Medications play an important role in preventing another stroke and treating stroke-related complications, often in tandem with lifestyle changes.

There’s no one-size-fits-all treatment plan. Your doctor may prescribe one or more medications based on the underlying cause of your stroke as well as its impact on your physical and mental health.

Here’s what to know about stroke causes and medications commonly prescribed during recovery.

A stroke disrupts the flow of blood and oxygen to the brain, potentially damaging brain tissue. This can lead to impaired speech, impaired cognitive function, memory loss, numbness, and paralysis.

Strokes can be life-threatening, so it’s important to seek immediate medical care if you exhibit signs of a stroke such as the following:

Sudden numbness or weakness in the face, arm, or leg

Sudden confusion or difficulty speaking or understanding speech

Sudden severe headache without another cause

There are two types of strokes, with different underlying causes:

An ischemic stroke occurs when blood flow to the brain is blocked, often due to a blood clot or the accumulation of plaque in blood vessels. It is the more common type of stroke. Associated health risk factors include high cholesterol, atrial fibrillation, and diabetes.

A hemorrhagic stroke occurs when a blood vessel in the brain leaks or ruptures, damaging brain cells as a result. Associated health risk factors include high blood pressure and aneurysms.

Additionally, a transient ischemic attack (TIA) — sometimes referred to as a ministroke — occurs when there is temporarily reduced or blocked blood supply to the brain, often as the result of a blood clot. Unlike ischemic and hemorrhagic strokes, a TIA does not result in permanent damage.

Many of the leading risk factors for a stroke are modifiable, including:

Aftercare may include management of these risk factors.

There are a variety of medication classes used during stroke recovery, including the following.

Since high blood pressure is a leading cause of hemorrhagic strokes, stroke recovery may involve the use of several types of blood pressure medications.

Beta blockers cause the heart to beat more slowly and less forcefully, lowering blood pressure. Commonly prescribed beta blockers include atenolol (Tenormin®), bisoprolol (Zebeta®), metoprolol tartrate (Lopressor®), metoprolol succinate (Toprol-XL®), acebutolol (Sectral®), and propranolol (Inderal®).

ACE inhibitors lower blood pressure by blocking production of a hormone called angiotensin II, which causes blood vessels to narrow. Commonly prescribed ACE inhibitors include benazepril (Lotensin®), enalapril (Vasotec®), fosinopril (Monopril®), lisinopril (Prinivil®, Zestril®), and ramipril (Altace®).

Calcium channel blockers prevent calcium from entering the smooth muscle cells of the heart and blood vessels so that the heart beats with less force. Commonly prescribed calcium channel blockers include amlodipine (Norvasc®), diltiazem (Cardizem CD®, Tiazac®), nifedipine (Procardia XL®), and verapamil (Calan SR®, Verelan®).

Diuretics lower blood pressure by helping the body get rid of excess sodium and water, reducing the volume of fluid in blood vessels. Commonly prescribed diuretics include chlorthalidone (Thalitone®, Tenoretic®, and Clorpres®), hydrochlorothiazide (HydroDiuril®, Microzide®, and Esidrix®), and indapamide (Lozol®).

Read Common Types of Blood Pressure Medications to learn more about these medications and potential side effects.

Anticoagulants interrupt the body’s natural blood clotting process to prevent new clots from forming and existing ones from growing. The following types of anticoagulants may be prescribed after an initial ischemic stroke.

Warfarin (Coumadin® and Jantoven®) prevents your liver from producing proteins that help form blood clots. It is taken orally as tablets. It has been associated with excessive bleeding in some individuals. Inform your doctor if you have a bleeding disorder so that they can prescribe an alternative.

Direct-acting oral anticoagulants (DOACs) directly block the blood’s ability to form new clots. Commonly prescribed DOACs include apixaban (Eliquis®), dabigatran (Pradaxa®), edoxaban (Savaysa®), and rivaroxaban (Xarelto®).

Read How Anticoagulants Prevent Blood Clots From Forming to learn more about these medications and potential side effects.

Like anticoagulants, antiplatelets prevent blood clotting and may be used during recovery from an ischemic stroke. They prevent platelets from coalescing, targeting a particular step in the formation of blood clots. Clopidogrel (Plavix®) is a commonly prescribed antiplatelet during stroke recovery.

Aspirin may also be used for antiplatelet therapy. If you are taking aspirin, avoid taking other nonsteroidal anti-inflammatories (NSAIDs) like ibuprofen and naproxen, as they may interfere with aspirin’s antiplatelet effect.

Atrial fibrillation, or Afib, is a rapid heart rate caused by irregularities in the heart’s upper chambers. It can lead to the accumulation of blood and the formation of blood clots, increasing an individual’s risk for stroke. (Having other conditions such as high blood pressure, diabetes, or heart failure in addition to Afib may further increase your risk for a stroke.)

There are several medications that may be used to control heart rate and prevent a secondary stroke, including beta blockers, calcium channel blockers, and an antiarrhythmic called digoxin (Digox®, Lanoxin®, Digitek®).

Since high cholesterol may be associated with an increased risk for an ischemic stroke or ministroke, statins — a type of cholesterol-lowering medication — may be prescribed during stroke recovery. Statins act on the liver to reduce the amount of cholesterol produced by your body, in turn preventing plaque accumulation.

Commonly prescribed statins include atorvastatin (Lipitor®), fluvastatin (Lescol®), lovastatin (Mevacor®, Altoprev®), pravastatin (Pravachol®), rosuvastatin calcium (Crestor®), and simvastatin (Zocor®).

Read How to Manage High Cholesterol: Diet, Medications, and More to learn more about these medications and potential side effects.

If you have diabetes, your doctor may revisit your diabetes treatment plan after an ischemic stroke. Individuals with type 1 diabetes require insulin every day to maintain healthy blood sugar levels. Treatment for type 2 diabetes is more varied and may involve insulin, oral medications such as metform, or a combination of both.

A stroke may lead to the loss of bone density. This can increase an individual’s risk for osteoporosis, a condition that weakens bones. After a stroke, your doctor may recommend increasing your intake of calcium and vitamin D — the most important nutrients for bone strength and health — depending on your symptoms.

Treatment for osteoporosis may also include medications such as bisphosphonates, which prevent the loss of bone mass. Commonly prescribed bisphosphonates include alendronate (Fosamax®, Binosto®), ibandronate (Boniva®), risedronate (Actonel®, Atelvia®), and zoledronic acid (Reclast®).

Many individuals experience depression after a stroke, both as a response to the emotional challenges of stroke recovery and due to stroke-induced biochemical changes in the brain.

Medication may be necessary to manage symptoms of depression. There are many types of antidepressants, including:

Selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine (Prozac®), sertraline (Zoloft®), citalopram (Celexa®), and escitalopram (Lexapro®)

Serotonin and norepinephrine reuptake inhibitors (SNRIs) such as duloxetine (Cymbalta®), venlafaxine (Effexor®), and desvenlafaxine (Pristiq®)

Atypical antidepressants such as trazodone, mirtazapine (Remeron®), and bupropion (Wellbutrin®)

A psychiatrist can recommend the best option based on your particular symptoms of depression, your overall health history, and other medications you’re taking.

Recovery from a stroke is often a gradual process. In addition to taking medication and practicing a healthy lifestyle, your doctor may also recommend speech therapy, physical therapy, and/or occupational therapy.

It’s important to take care of your emotional and mental health. Speak with your healthcare provider about resources that can support your recovery and help you adjust to the changes a stroke may bring. Individual psychotherapy or support groups can be helpful tools.

At Alto, we make it as simple as possible to follow the treatment plan your doctor recommends. We will work with your doctor, your insurance (if applicable), and any third party savings programs that you may qualify for to ensure your medications are as affordable as possible. And our team of pharmacists is available to chat whenever questions come up about side effects or how to take your medication properly.

Reach out any time through in-app messaging or by phone at 1-800-874-5881.

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 Stress doesn’t simply spill into our personal lives, it affects the body in many ways. And it isn’t only short-term ailments like tension headaches or muscle pain to be mindful of — ongoing stress can take a heavy toll on your long-term heart health. In recent years, numerous research studies have found that stress can increase a person’s risk for heart disease, the leading cause of death in the United States.

Understanding the Stress-Heart Health Connection

While many people know that high blood pressure, high cholesterol, genetics, and smoking are all key heart disease risk factors, stress isn’t always included in conversations about heart health. As you prioritize a heart-healthy lifestyle, regularly evaluate your stress levels, taking steps to reduce stress and manage it positively when it does arise.

Here’s more on the stress-heart health connection, including coping strategies that will benefit your heart as much as your mind.

Stress triggers physiological changes in the body that can influence heart health. It all starts in the brain. When you encounter a stressful trigger, the amygdala — a portion of the brain responsible for emotional processing — communicates that you are in distress, activating your nervous system.

As part of this process, the stress hormones adrenaline and cortisol are released, which can temporarily increase blood pressure and insulin resistance. Sometimes the body’s experience of stress also leads to inflammation in the arteries. Over time this can affect the function of your blood vessels, potentially resulting in atherosclerosis, or the accumulation of plaque in the walls of your arteries.

Less directly, stress has a ripple effect on lifestyle factors related to heart health. Everyone responds to stress in different ways. For some, exercise might be a positive outlet during challenging times. But for others, stress makes it difficult to fit in consistent exercise. (The American Heart Association recommends 150 minutes of moderate-intensity aerobic activity per week.) And stress frequently goes hand in hand with unhealthy behaviors like smoking and heavy alcohol consumption or other substance use.

There is also the link between stress and sleep, another less discussed heart health risk factor. The overactive nervous system created by chronic stress — and its continuous output of hormones — can create a vicious cycle of anxiety-fueled insomnia and insomnia-fueled anxiety.

Stress presents differently from one person to another. If you are experiencing any of the following symptoms, talk to your doctor about stress management techniques and other resources.

Stress relief doesn’t have to be a big endeavor. Look for small opportunities, like the following, to engage the body and mind in your daily or weekly routine. (Your heart will thank you!)

Exercise is fundamental to heart-healthy living, and it also happens to be a powerful source of stress relief.

Like the stress-heart health connection itself, the soothing effects of physical activity are grounded in hormones. Exercise is known to lower your levels of adrenaline and cortisol while stimulating production of endorphins, the body’s feel-good chemicals.

Longer blocks of regular exercise are important for your long-term heart health, but in moments of high pressure you’ll feel some stress-relieving benefits from even a quick burst of movement.

As you get moving, find ways to calm the mind. Many practices fall under the umbrella of mindfulness, the cultivation of present moment awareness and shift away from reactivity. Try meditation, yoga, tai chi, walking, or even bringing a bit more attention to your morning coffee or cup of tea.

With so many options for living more mindfully, focus on finding the habits and routines that work for you, and which fit easily into your day.

Deep breathing, a proven tactic for lowering stress hormone levels, is an accessible entry point. You may also benefit from the following resources:

Insight Timer, which offers a variety of free guided meditations

What’s Up?, which uses a cognitive behavioral therapy (CBT) approach to managing stress and negative thoughts

Healthy stress management isn’t just about using positive coping mechanisms in the moment. You may be able to stop stress before it happens — without getting too far into the future, of course.

Researchers have linked workplace stress, which many U.S. adults experience, to negative heart health. One Swedish study connected a poor experience of a manager to the risk of heart attack.

There are tangible ways to make the demands of a job or responsibilities at home feel more manageable (saying no when it’s necessary for starters). Stress management is personal, so consider what you need and don’t be afraid to ask for it.

At Alto, we make it as simple as possible to manage your risk for heart health issues and follow the treatment plan your doctor recommends. We will work with your doctor, your insurance (if applicable), and any third party savings programs that you may qualify for to ensure your medications are as affordable as possible. And our team of pharmacists is available to chat whenever questions come up about side effects or how to take your medication properly.

A child’s diabetes care needs don’t stop during the school day, and starting a new school year or returning to the classroom after a diagnosis can be overwhelming for students and parents alike. Advanced planning and coordination with school staff can ease the transition and ensure that your child has everything they need to stay safe and healthy while at school. Below, we highlight the most important steps to take.

Managing Your Child’s Diabetes at School

To ensure effective management of your child’s diabetes during the school day, school staff should be informed of your child’s treatment plan as well as what to do in the event of a hypoglycemia or hyperglycemia emergency. There are two important plans to finalize and share with the school.

A diabetes medical management plan (DMMP) is the foundation of your child’s care regimen at school. It translates your endocrinologist’s recommendations into actionable items for your child’s school nurse, teacher, and other school staff members who are responsible for students.

A DMMP should cover every aspect of your child’s diabetes management, including the following. The American Diabetes Association has a detailed DMMP template that you can use as a starting point.

Insulin therapy needs, including the delivery device and timing of dosages and whether to contact you to adjust a dose

Important considerations for physical activities

Diabetes care needs — and the amount of support a child needs with them — evolve with time. Include information about your child’s self-care skills in your plan, clarifying specifically what support will be required from staff. Each school year, revisit your child’s DMMP with your endocrinologist and make updates if needed.

As you finalize your child’s treatment plan and your DMMP, consult with your endocrinologist about your insulin delivery device options. Many children find it convenient to use an insulin pump while at school, given the ease of use and automated timing of injections.

Insulin pens, which combine insulin and a syringe into a single device, also allow for faster and easier administration than syringes. (Some types of insulin pens are covered under pharmacy benefits — Alto may be able to help your child get started with these devices.)

You may also want to explore a continuous glucose monitoring (CGM) device for your child’s blood glucose monitoring needs. In contrast to traditional blood glucose meters (BGMs), which provide a single blood glucose reading by pricking a finger, CGMs automatically collect glucose readings regularly throughout the day. They can identify patterns that aren’t as easily captured by a traditional BGM and eliminate the need to step away for blood sugar readings. (Some CGMs give you the option of adding “followers,” so that you can alert your child’s provider and the school nurse to a potential emergency.)

504 Plan or Individualized Education Program (IEP)

After your DMMP has been finalized, the next step is to draft a 504 plan or individualized education program (IEP). This plan takes all of the information about your child’s care needs from the DMMP and documents the school’s specific responsibilities.

If the school nurse will typically oversee your child’s care, a 504 plan should address who will step in if the nurse is unavailable. Account for after-school activities and events and field trips as well.

Share any relevant information with your child. For example, make sure they know who to go to for help with blood sugar testing or if they experience symptoms of low blood sugar.

This plan should be revisited each year and shared with anyone who will be responsible for your child during the school day or at school events. View the ADA’s template for a 504 plan.

Many staff members are integral to a child’s diabetes management during the school day: the school nurse, your child’s teacher, and administration, as well as the sponsors of extracurricular activities and nutrition service staff. Their knowledge of diabetes and level of comfort overseeing care may vary. In addition to distributing the DMMP and 504, consider asking your healthcare professional to lead a special training for key staff members.

Have one-on-one conversations as needed to get any information about school policies that impact your child’s diabetes. Here are some topics to cover with specific staff members.

Make sure that you, your child, and your child’s teacher are on the same page about each other’s needs. Ask about classroom rules and guidelines, such as what a student needs to do in order to leave the room — is it necessary to ask permission each time? Let the teacher know more about your child’s specific signs of hypoglycemia, as these vary by individual.

Many children with diabetes find it helpful to bring lunch to school, for carbohydrate counting purposes. If your child will eat meals in the cafeteria, request information about the menu and dietary guidelines from a member of the nutrition services team.

Participating in physical activities is both beneficial to your child’s diabetes management and important for their social life. Share any relevant information with the physical education instructor or another staff member to ensure that your child can safely participate.

Make sure your child’s school has all diabetes essentials on hand, including the following:

Blood glucose meter and extra batteries (include these as a backup even if your child uses a CGM)

Insulin and syringes or pens (include these as a backup even if your child uses a pump)

In addition, be sure that the school has the supplies needed to treat hypoglycemia in an emergency. Ideally, there will be one emergency kit in the nurse’s office and another in the classroom. Label it with your child’s name and include the following:

During your conversations with school staff, discuss a system for keeping track of supplies and notifying you when low.

Lastly, your child should wear a medical ID necklace or bracelet to school every day. This will ensure that they receive prompt and correct treatment in the event of an emergency.

A partner in your child’s diabetes care

Navigating your child’s diabetes diagnosis is easier with a reliable pharmacy partner. At Alto, we’re committed to making it as simple as possible to manage diabetes, with free same-day delivery and medication management tools like reminders and auto refills in our app. And our dedicated diabetes support team is here to ensure that you have all the information you need to follow the treatment plan your child’s doctor recommends.

Reach out any time by phone at 1-800-874-5881 or secure in-app messaging.

Navigating a Diagnosis of Prediabetes

1 in 3 U.S. adults have prediabetes, a health condition defined by higher than normal blood sugar levels and which often precedes type 2 diabetes. While it can be overwhelming to receive a diagnosis of prediabetes, the condition is both treatable and reversible. Simple lifestyle changes, sometimes combined with medication, can prevent prediabetes from progressing into type 2 diabetes.

Here’s an overview of common next steps after a prediabetes diagnosis. This is intended to provide general information about managing prediabetes. Always follow your doctor’s recommendations.

Prediabetes is primarily defined by blood sugar levels that are higher than normal but still below the official range for a type 2 diabetes diagnosis. Two tests may be used to diagnose prediabetes:

The fasting blood sugar test, which measures your blood sugar after an overnight fast. A fasting blood sugar level between 100-125 mg/dL indicates a prediabetes diagnosis.

The A1C test, which measures your average blood sugar levels over the past three months. An A1C level of 5.7%-6.4% indicates a prediabetes diagnosis.

Prediabetes does not have visible symptoms. More than 84% of all those living with the condition don’t know that they have it. It’s important to be proactive about testing if you are at risk. Speak with your doctor if you are:

Black, Hispanic/Latino, Native American, Asian American, or Pacific Islander — for reasons not yet understood, researchers have found higher rates of type 2 diabetes in these racial and ethnic groups

Nutrition plays a significant role in the management of prediabetes and type 2 diabetes. Prioritizing certain foods and avoiding or reducing your intake of others can help you maintain healthy blood sugar levels.

Here are general dietary considerations for people with prediabetes. It’s important to work closely with a doctor or dietitian before starting a new diet plan.

Fiber is a carbohydrate found in plant-based foods, and which the body can’t digest. Since it isn’t digested, it does not increase glucose levels. It is commonly found in:

Fruits including apples, bananas, oranges, and strawberries

Non-starchy vegetables including beets, brussels sprouts, broccoli, cabbage, and carrots

Nuts and seeds including almonds, chestnuts, chia seeds, flax seeds, sesame seeds, sunflower seeds, and pistachios

Whole grains - check nutrition labels for the words “whole” or “whole grains”

Legumes including black beans, chickpeas, kidney beans, lentils, and peas

Limit your intake of sweetened, sugary beverages

Without any fat or protein to balance carbohydrates, sweetened beverages are associated with a greater risk for type 2 diabetes. Limit your intake of soda, sweetened tea, sports drinks, and other sugary beverages.

Speak with your doctor about your recommended carbohydrate intake

Certain carbohydrates affect blood sugar levels more than others, specifically refined carbohydrates such as white bread, white rice, and some potatoes. (Soda and some types of juice also fall under this category.) They digest quickly and should be consumed in small amounts by those with prediabetes and diabetes.

At the same time, it’s a misconception that you should avoid all carbohydrates if you have prediabetes. Low-carb diets may not be appropriate for some individuals with other health conditions such as high cholesterol or heart disease. Speak with your doctor for individualized recommendations.

There are several reasons why physical activity is important for individuals with prediabetes:

It increases your body’s sensitivity to insulin.

It can help you maintain a healthy weight.

The American Heart Association recommends about 150 minutes of moderate-intensity physical activity a week, or 20-25 minutes each day. Activities that fall under that category include brisk walking, swimming, or biking.

To build a fitness routine that sticks, start off slower and build your way up to a more intense workout, and be sure to find activities that you enjoy.

Smoking is a known risk factor for type 2 diabetes. It increases inflammation and oxidative stress, both of which have been associated with diabetes. Heavier, more frequent smoking is linked to a greater risk for diabetes.

If you are finding it challenging to quit, ask your doctor for resources that may help. Nicotine replacement therapy can ease withdrawal symptoms and cravings.

In some cases, your doctor may recommend supplementing the above lifestyle changes with medication to keep your blood sugar levels in a healthy range.

Metformin is one of the most common oral medications used to treat prediabetes and type 2 diabetes. It regulates your blood sugar levels by reducing how much glucose is produced during digestion.

To experience the full benefits of metformin, it’s important to maintain a healthy lifestyle while taking the medication.

Read What to Know About Metformin for additional information.

Some individuals with prediabetes may be prescribed weight loss medications for short-term use, as maintaining a healthy weight is part of managing prediabetes. Many of these medications are associated with health risks like high blood pressure and may not be appropriate for some individuals.

Keep in mind that your treatment needs may change over time. If you are prescribed medication for prediabetes, you won’t necessarily have to take it indefinitely. For instance, if lifestyle changes and metformin are effective at restoring healthy blood sugar levels, your doctor may have you taper off of the medication.

Managing prediabetes is easier with the right pharmacy partner by your side. The Alto app simplifies medication management and our dedicated diabetes support team is here to make sure you have everything you need.

To learn more, reach out any time through secure in-app messaging or by phone at 1-800-874-5881.

Polycystic ovary syndrome (PCOS) is a condition that affects women of reproductive age and is characterized by a hormone imbalance. It can impact many areas of a woman’s health, including menstrual cycles, fertility, insulin levels, and risk of cardiovascular disease.

How Polycystic Ovary Syndrome (PCOS) Affects Fertility

Symptoms of PCOS can be treated through a combination of medications and lifestyle changes. Here’s what to know about the condition’s causes, symptoms, and treatment options.

Polycystic ovary syndrome has three defining symptoms: high levels of male hormones, irregular menstrual cycles, and the development of cysts in the ovaries. These features overlap.

Many women with PCOS have higher levels of androgen hormones, which are responsible for the development of certain male characteristics. For those with PCOS, overproduction of androgens leads to irregular menstrual cycles, hair loss, extra growth of hair on the face and body, and acne.

The cysts that develop in the ovaries are small follicles containing an immature egg. Since these eggs do not reach maturity, ovulation — the release of a mature egg from the ovaries — does not occur. The absence of ovulation leads to further imbalance of hormones, as progesterone decreases.

PCOS is the leading cause of female infertility.

Polycystic ovary syndrome can develop at any age after puberty. It is estimated that 5-10% of women between the ages of 15-44 have the condition.

The specific causes of PCOS have not been identified, but the medical community believes that condition is the result of several intersecting factors: insulin resistance, higher levels of androgens, higher levels of inflammation, and an irregular menstrual cycle.

Some evidence suggests that PCOS may have a genetic component. You may have a higher risk of developing PCOS if you have a mother, sister, or aunt with the condition. Obesity is also a risk factor.

Common symptoms of polycystic ovary syndrome include:

Irregular, absent, or abnormally short (i.e., less than 21 days) menstrual periods

Excess hair on the face, chin, chest, abdomen, or upper thighs, also referred to as hirsutism

Weight gain or difficulty maintaining a healthy weight

Patches of darkened skin, particularly on the neck, in the groin, and beneath the breasts

Small flaps of excess skin near the neck or armpits, sometimes referred to as skin tags

Infertility, defined as the inability to get pregnant after twelve months or more of unprotected sex

The hormone imbalances that characterize PCOS can affect many areas of a woman’s health, including the following.

Infertility is a common symptom of PCOS, as hormone levels interfere with ovulation, an important step in reproduction. However, PCOS is a highly treatable cause of infertility. Many individuals and couples affected by PCOS do become pregnant after fertility treatment.

During pregnancy, women with PCOS may face a greater risk for miscarriage, high blood pressure, and gestational diabetes. They are also more likely to deliver prematurely. If you have PCOS, you can set yourself up for a healthy pregnancy by maintaining a healthy weight and blood sugar levels before trying to conceive and during pregnancy.

Insulin is a hormone naturally produced in the pancreas. It helps convert sugar, or glucose, into energy. Type 2 diabetes occurs when blood sugar levels rise due to issues with the body’s production or use of insulin. Since insulin resistance is often a symptom of PCOS, many individuals with the condition have a greater risk for type 2 diabetes.

Individuals with PCOS are also more likely to develop metabolic syndrome, a group of conditions associated with a higher risk for diabetes and heart disease, including:

Abnormal cholesterol or triglyceride levels

Endometrial hyperplasia, a condition in which the lining of the uterus becomes too thick, is also associated with PCOS. It can increase a woman’s risk for endometrial cancer.

The process for diagnosing PCOS includes a conversation about your health history, a physical exam, and several tests that can rule out other causes of PCOS symptoms.

During the physical exam, a healthcare provider typically measures blood pressure, body mass index (BMI), and waist size. They will also check your skin for extra hair, acne, or discoloration.

Your doctor will likely conduct a pelvic exam to check for signs of high androgen levels and abnormalities with your ovaries. Then, a pelvic ultrasound, or sonogram, will check the ovaries for cysts and scan the uterine lining.

Blood tests may be used to measure levels of androgens as well as hormones linked to other health conditions with similar symptoms as PCOS. You may also be tested for high cholesterol and diabetes.

If other health conditions have been ruled out, you must have at least two of the following symptoms to be diagnosed with PCOS:

Irregular, absent, or abnormally short menstrual periods

Signs of high androgen levels such as hirsutism, acne, or thinning of hair on the scalp

PCOS and related medical conditions can be managed through a variety of treatments including medications and lifestyle changes. Treatment is tailored to an individual’s health history, PCOS symptoms, and reproductive goals. Here’s how different treatment options target various symptoms of PCOS.

Hormonal birth control, which may contain both estrogen and progestin, is often used to regulate a woman’s menstrual cycle. It can also reduce hirsutism and acne and lower the risk of endometrial cancer. Many women who do not have plans to get pregnant use hormonal birth control as a long-term treatment for PCOS.

Metformin, an oral medication most commonly used to treat type 2 diabetes, is sometimes used off-label to treat PCOS. It improves the body’s response to insulin and can lower blood sugar and androgen levels. In some cases, it may be effective at restoring ovulation, though it typically does not treat hirsutism or acne.

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