Metabolic Syndrome and DiabetesMonday, December 01, 2014
Do you know what the metabolic syndrome is, and why it is important? Do you know how it relates to diabetes? Do you know that approximately 25 percent of all of the adults in the world have this condition? (1) In the United States, approximately 34 percent are affected. (2) The occurrence of metabolic syndrome also increases with age. It is estimated that 40 percent of people over the age of 60 have developed it. (3) Have you discussed this important topic with your physician? This blog will discuss other terms that are the same as the metabolic syndrome, the definition of the metabolic syndrome and what to if you have it or are trying to prevent it.
Other terms for the Metabolic Syndrome
According to the National Heart Lung and Blood Institute (part of the National Instututes of Health in the United States), other terms for the metabolic syndrome include:
- Dysmetabolic syndrome
- Hypertriglyceridemic waist
- Insulin resistance syndrome
- Obesity syndrome
- Syndrome X (4)
What is the metabolic syndrome?
The metabolic syndrome is a group of medical conditions. When taken one by one they have a likelihood of being harmful to one’s health. When compiled in a “syndrome”, this significantly increases the chance that a person will develop type 2 diabetes and/or possibly suffer from a heart attack or stroke and die from the event. (1) Statistics have suggested that a person with metabolic syndrome has five times the risk of developing diabetes and twice the risk of developing heart disease as those without the metabolic syndrome. (5) It also puts individuals at risk for fatty liver, certain types of cancer and bone loss. (6)
The International Diabetes Federation (IDF) has defined the metabolic syndrome as central obesity plus 2 of 4 other factors. The IDF takes into account differences in ethnic groups when defining central obesity. Males that have ancestors from Europe are considered obese with a waist circumference of 94 cm (approximately 37 inches) and women 80 cm (approximately 31.5 inches). (7) The American Heart Association and the National Heart, Lung, and Blood Institute (NHLBI) define central obesity differently as: Waist circumference ≥102 cm (40 in) in men or ≥88 cm (35 in) in women; if Asian American, ≥90 cm (35 in) in men or ≥80 cm (32 in) in women (8)
For other ethnic groups go to: http://www.idf.org/webdata/docs/MetS_def_update2006.pdf
Besides central obesity, at least two of the following problems must also exist:
- Raised triglyceride (TG) level: ≥ 150 mg/dL (1.7 mmol/L), or on specific treatment to lower TG’s
- Reduced high density lipoprotein (HDL) cholesterol: < 40 mg/dL (1.03 mmol/L) in males and < 50 mg/dL (1.29 mmol/L) in females or talking medication to help increase these levels
- Raised blood pressure: systolic BP ≥ 130 or diastolic BP ≥ 85 mm Hg, or treatment of previously diagnosed hypertension
- Raised fasting plasma glucose (FPG) ≥ 100 mg/dL (5.6 mmol/L), or previously diagnosed type 2 diabetes. If above FPG is above the threshold, an Oral Glucose Tolerance Test is strongly recommended but is not necessary to define presence of the syndrome (7)
The American Heart Association and NHLBI include the following under signs and symptoms:
- Shortness of breath
In people with insulin resistance or diabetes:
In people with altered lipids:
- xanthomas (8)
Criteria for the metabolic syndrome in Children and adolescents are found on the International Diabetes Federation website.
Steps to take to help if you have the metabolic syndrome or if you are trying to prevent it:
- Central (abdominal) obesity is the hallmark of the metabolic syndrome. To prevent or if you have it, it makes sense to seek help to control your weight.
- Call your insurance to see if they will pay for a visit to see a registered dietitian to help you with weight loss. Use your resources! Ask to see if a visit with a physical therapist would also be paid for to help design an exercise program.
- If you are a veteran, let your VA primary care team know you would like to be involved in the “Move” program.
- Ask your doctor if you have permission to exercise and what he/she would recommend for you.
- Some people seek the help of bariatric surgery or medication to help with weight loss. Ask your doctor if this would be an option for you. The medication metformin when accompanied by weight loss and exercise may help to reverse changes that happen due to the development of the metabolic syndrome. (9)
- Follow the research, in a small study intestinal microbiota was donated from lean donors into individuals with metabolic syndrome. In this small study, it was associated with improved (reduced) insulin resistance. More work needs to be done in this area. (10)
Diabetescare.net has a great deal of information on weight loss. Take notes and make an appointment with your health care team to discuss the information. Weight loss almost always helps blood glucose control in people with pre-diabetes and type 2 diabetes. Please use our resources to help you understand this very important topic.