Polycystic ovary syndrome is a reproductive disorder with a significant impact on fertility. It is secondarily, and perhaps for the individual primarily, a disorder with a marked increase risk for diabetes and glucose intolerance. Physicians need to be aware that women who have PCOS are at high risk for impaired glucose tolerance and type 2 diabetes. In the author's opinion, they should be screened for these abnormalities. Minority women with PCOS may have higher prevalence rates of glucose intolerance, and further study of minority groups is indicated. The author's data indicate that fasting glucose levels are inadequate for such screenings. Fasting glucose levels are relatively poor predictors of type 2 diabetes as determined by glucose challenge testing in PCOS. These findings may have substantial clinical relevance. They strongly suggest that all PCOS women should be screened for glucose intolerance, and that basal and 2-hour, glucose-stimulated levels rather than fasting glucose levels alone are required for such screening. Further study is necessary to document conversion rates to worsening glucose tolerance over time, as well as the cardiovascular risk associated with glucose intolerance in PCOS.