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Two people can eat the exact same meal and get very different blood sugar responses. When researchers continuously tracked glucose in hundreds of people eating identical standardized meals, the responses varied widely from person to person, and one person could spike more from bananas than from cookies while another showed the reverse. Those differences were tied to each person's gut bacteria, sleep, activity and other traits, and in a smaller follow-up trial, diets tailored to each person's own responses lowered their after-meal glucose. This is one reason I'm such an advocate for continuous glucose monitors. General food lists can only go so far, and a CGM shows how a person's own body handles a specific meal. If someone wants to know how well they tolerate carbohydrate, their own glucose response tells them more than a food's general reputation.

Insulin is one of the main drivers of PCOS. High insulin pushes the ovaries to make more androgens and lowers SHBG, the protein that keeps those androgens in check, which is why so many women with PCOS also struggle with insulin resistance. In a new 12-week trial, women with PCOS who cut free sugar lost more weight and had larger drops in fasting glucose and triglycerides than women on a standard diet. There was a modest signal toward better insulin sensitivity, but it didn't hold up after adjusting for other factors, and some of the benefit may have come from the weight loss. If a woman with PCOS is looking for a practical first step, cutting added sugar is a reasonable way to lower the insulin burden.