PCOS and South Asian women, what the data shows

Polycystic ovary syndrome, or PCOS, is listed by the American Diabetes Association and the National Institutes of Health as a risk factor for type 2 diabetes [2][3]. That is the practical reason to understand what the data shows about PCOS in South Asian women. The only US prevalence numbers come from adolescents, not adults. Among US adolescent females with obesity, PCOS appeared in 7.8% of South Asian adolescents, compared with 2.4% in non-Hispanic white adolescents [1]. No published US study has measured adult PCOS prevalence by ethnicity. This article explains what those adolescent numbers mean, why PCOS matters for diabetes screening, and what to do if you have a diagnosis.

What the adolescent data actually shows

Khil and colleagues analyzed a large US cohort of adolescent females and reported an overall PCOS prevalence of 0.7% [1]. When they looked only at adolescents with obesity, the picture changed. Among adolescents with obesity, PCOS appeared in 7.8% of South Asian adolescents, 6.7% of Chinese adolescents, 5.7% of Filipina adolescents, 2.9% of Hispanic or Latina adolescents, 2.4% of non-Hispanic white adolescents, and 2.1% of Black adolescents [1].

These are adolescent figures. They do not tell you what happens in adult South Asian women. A condition that appears in one age group may be more common, less common, or the same in another. The study did not measure adults. No other US team has published adult PCOS prevalence broken down by ethnicity. That gap matters: you cannot know whether the adolescent pattern holds into adulthood without a study that follows people forward or measures adults directly.

What the numbers do show is that among young people with obesity, South Asian adolescents in this US cohort carried a higher PCOS prevalence than most other groups measured. That is a real finding. It is also a finding in one age group at one point in time, in a US sample. It does not predict what will happen to any one person.

Why PCOS matters for diabetes screening

PCOS is on the list of risk factors that should prompt screening for prediabetes and type 2 diabetes. The American Diabetes Association recommends testing in adults with overweight or obesity, meaning a BMI of 25 or higher, or 23 or higher in individuals of Asian ancestry, who have one or more additional risk factors [2]. PCOS is one of the named risk factors [2]. The National Institutes of Health lists PCOS among the conditions associated with insulin resistance and prediabetes [3].

The connection is real. People with PCOS have higher rates of insulin resistance, a condition in which your body does not respond to insulin the way it should [3]. Insulin resistance is the pathway to prediabetes and type 2 diabetes. That is why your clinician should know about a PCOS diagnosis: it changes the screening threshold and the urgency of the conversation.

South Asian adults already carry elevated type 2 diabetes risk. In the MASALA and MESA studies, US South Asian adults aged 44 to 84 had an age-adjusted type 2 diabetes prevalence of 23%, compared with 6% in white adults [4]. Add a PCOS diagnosis to that baseline risk, and screening becomes even more important.

What screening actually means

If you have PCOS, your clinician should order an A1C test or a fasting glucose test. The A1C test measures your average blood glucose over the past 3 months [2]. An A1C below 5.7% is normal. An A1C of 5.7% to 6.4% means prediabetes. An A1C of 6.5% or higher means type 2 diabetes [2].

Prediabetes usually has no symptoms. Most people who have it do not know [5]. That is why the test matters: it finds the condition before it becomes diabetes. If your A1C falls in the prediabetes range, your clinician can discuss what comes next. The National Institutes of Health reports that in the Diabetes Prevention Program, losing 5% to 7% of body weight lowered the chance of developing type 2 diabetes [3].

Here are the PCOS prevalence figures from the Khil study, showing adolescent rates by group:

These figures come from one US study of adolescents. They do not describe adult prevalence, and no published US data measure adult PCOS prevalence by ethnicity.

The screening conversation with your clinician

If you have been diagnosed with PCOS, bring that information to your next appointment. Tell your clinician about the diagnosis and ask whether you need screening for prediabetes or diabetes. If you have not been diagnosed but you are concerned about PCOS symptoms, ask your clinician whether evaluation makes sense for you.

The screening decision depends on your age, your BMI, your family history, and your other risk factors. The ADA recommends testing in adults with overweight or obesity plus one or more risk factors [2]. South Asian ancestry is itself listed as a risk factor [4]. PCOS is another. If both apply to you, screening is important.

If you are a parent of a South Asian adolescent with obesity, the same logic applies. The adolescent data show that PCOS is more common in this group [1]. That does not mean your child will have it. It does mean that if your child has symptoms like irregular periods, excess hair growth, or acne, or if a clinician has raised the possibility, it is worth exploring. And if PCOS is diagnosed, screening for prediabetes becomes part of the care plan.

What to do next

1. If you have a PCOS diagnosis, write it down and bring it to your next appointment with your primary care clinician.
2. Ask your clinician whether you need screening for prediabetes or diabetes, and if so, what test they recommend (A1C or fasting glucose).
3. If you have not been tested, ask about your baseline risk: your age, BMI, family history of diabetes, and whether you have other risk factors listed by the CDC [5].
4. If you are a parent concerned about PCOS in your adolescent, ask your clinician whether evaluation is appropriate based on symptoms or other signs.
5. If your screening result shows prediabetes, ask your clinician what the next step is and whether a lifestyle program or other support is available to you.
6. Review the family history and diabetes screening guide to understand what information about relatives matters for your own risk.
7. Learn more about South Asian diabetes risk to understand the baseline numbers and what screening thresholds apply to you.

Sources

1. Khil and colleagues, polycystic ovary syndrome among US adolescent females, PubMed, accessed 2026-08-06, https://pubmed.ncbi.nlm.nih.gov/35596599/
2. American Diabetes Association, Diagnosis and Classification of Diabetes, Standards of Care in Diabetes 2026, screening recommendations and risk factors, accessed 2026-08-06, https://diabetesjournals.org/care/article/49/Supplement_1/S27/163926/2-Diagnosis-and-Classification-of-Diabetes
3. NIDDK, insulin resistance and prediabetes, risk factors and prevention, accessed 2026-08-06, https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes/prediabetes-insulin-resistance
4. Kanaya and colleagues, MASALA and MESA diabetes prevalence, South Asian diabetes rates in US adults, accessed 2026-08-06, https://pubmed.ncbi.nlm.nih.gov/24705613/
5. CDC, diabetes risk factors, screening and risk factor list, accessed 2026-08-06, https://www.cdc.gov/diabetes/risk-factors/index.html