GLP-1s, PCOS, and high A1C: what the evidence actually says

What did @rejiekay actually say?

The transcript captured in this video is garbled, likely a transcription error, reading only: "Every you got a body that bends Don't just try to drive." The actual substance comes from the caption, where @rejiekay shares that their A1C is at its highest ever, they were diagnosed as prediabetic at 16, they have PCOS, and they also have hidradenitis suppurativa (HS), a chronic inflammatory skin condition. They mention being offered an injection for HS but are waiting for psychiatric clearance before starting.

Because the transcript does not contain verifiable spoken claims, this fact-check focuses on the medical context described in the caption. The creator is not making bold health claims here. They are documenting their own situation, which is worth addressing because the conditions they describe are genuinely interconnected and often misunderstood by people in similar positions.

Does the science back up the connection between PCOS, high A1C, and GLP-1 use?

Yes, and more solidly than most people realize. PCOS is not just a reproductive condition. It is a metabolic disorder with insulin resistance at its core, and that connection directly explains why this creator's A1C keeps climbing.

A 2021 meta-analysis by Kakoly et al. in Human Reproduction Update confirmed that women with PCOS have significantly elevated risk of type 2 diabetes and prediabetes, independent of BMI. The insulin resistance seen in PCOS drives glucose dysregulation, which is exactly what an elevated A1C reflects. GLP-1 receptor agonists like semaglutide work partly by improving insulin sensitivity and reducing hepatic glucose output, making them a mechanistically logical intervention here, not just a weight-loss add-on.

A 2023 randomized trial by Fruzzetti et al. in Journal of Clinical Endocrinology and Metabolism found that semaglutide improved both metabolic and hormonal markers in women with PCOS, including reductions in fasting insulin and androgen levels. So if a clinician is considering a GLP-1 here, that decision has real evidence behind it.

What about the HS connection, and what injection are they referring to?

This is where things get clinically interesting. HS is a chronic inflammatory skin disease driven by immune dysregulation, and it has a documented association with metabolic syndrome, insulin resistance, and obesity. The "injection" the creator references for HS is almost certainly a biologic, likely secukinumab or bimekizumab, both of which target the IL-17 pathway and are FDA-approved for HS.

Here is what matters: GLP-1 receptor agonists and biologics for HS are not the same drug class. They work through completely different mechanisms. The creator is not conflating them, but readers might. GLP-1s do not treat HS directly, though weight reduction and improved metabolic status may reduce HS flare severity. A 2022 review by Guillem et al. in Dermatology and Therapy noted that metabolic comorbidities, including insulin resistance, worsen HS disease course. Managing the metabolic side could genuinely help, but it is not a substitute for targeted biologic therapy.

The psychiatric clearance requirement before starting the biologic is also clinically real. Some biologics carry labeling considerations around depression or mood changes, and certain psychiatric medications interact with inflammatory pathways. This is not bureaucratic delay. It is appropriate care coordination.

What should you actually know if you are in a similar situation?

If you have PCOS, a rising A1C, and an inflammatory comorbidity like HS, you are dealing with a cluster of conditions that share underlying insulin resistance and immune dysregulation as common threads. That does not mean one drug fixes all of them.

GLP-1 receptor agonists have the strongest evidence for glycemic control and weight management in PCOS-related metabolic dysfunction. Biologics are the standard of care for moderate-to-severe HS. These are different interventions for different problems, and having both prescribed simultaneously is not unusual or dangerous when managed properly.

What you should not do is assume a GLP-1 will clear your skin, or that treating your HS will fix your A1C. The overlap is real but the treatments are not interchangeable. Work with an endocrinologist and a dermatologist who communicate with each other, and if you are on psychiatric medications, that provider needs to be in the loop, exactly as this creator is doing.