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PCOS is characterized by insulin resistance in many (though not all) patients the body's cells don't respond normally to insulin, leading to compensatory hyperinsulinemia (high circulating insulin), which in turn drives excess ovarian androgen production (testosterone and DHEA), disrupts follicular development, and impairs ovulation

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Their study found that, even after adjusting for body mass index (BMI), T2DM remains a causally related risk factor for IDD

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