Riya (24) has had irregular periods and hair growth under her chin for years. She was diagnosed with PCOS (polycystic ovary syndrome), but a full metabolic workup was never done at the time. Later, when she got pregnant, Riya developed gestational diabetes mellitus, eventually developing full-blown diabetes and fatty liver as well. If full metabolic and hormonal tests had been done earlier, her metabolic risk might have been caught, and possibly, addressed years earlier.