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Dear Diabetes: What Is Metabolic Syndrome?

Understanding metabolic syndrome

In my experience, people are often told they have “metabolic syndrome,” and yet still aren’t always clear about what exactly that is. First of all, it helps to know that a “syndrome” is a medical term used to describe a set of symptoms – or risk factors – that occur together. With metabolic syndrome, people are diagnosed when they have at least three of the following conditions occurring together:

Obesity (increased waist circumference)

Body mass index (BMI) is a number calculated from a person’s weight and height. A healthy weight is indicated by a BMI below 25, while a BMI over 30 is classified as obese. Measuring waist circumference around the middle of the body, just above the hipbones, is another way to test for obesity. A waist circumference above 40 inches for men and above 35 inches for women is considered obese and puts you at higher risk of developing type 2 diabetes.

Elevated blood pressure

Blood pressure is a measurement of systolic (top number) and diastolic (bottom number) blood pressure. A normal blood pressure level is 120/80 mm Hg. For a metabolic syndrome diagnosis, readings above 130 mm Hg for systolic and 85 mm Hg for diastolic blood pressure is considered elevated

Elevated fasting blood glucose

A fasting blood glucose test is a check of a person’s blood glucose level after the person has not eaten for eight to twelve hours. A normal fasting blood glucose level is below 100 mg/dL. An elevated fasting blood glucose level is any level above 100 mg/dL.

Elevated cholesterol or triglycerides

A desirable total cholesterol level is less than 200 mg/dL. Total cholesterol is the sum of healthy high-density lipoprotein (HDL) and low-density lipoprotein (LDL) levels. A healthy HDL (“good” cholesterol) level is greater than 40 mg/dL for men and greater than 50 mg/dL for women. A near or above optimal LDL (“bad” cholesterol) level is less than 130 mg/dL, with an optimal level being less than 100 mg/dL.

Triglyceride is the most common type of fat in the body. Triglyceride levels are measured after an overnight fast by using a common test called a lipid panel. A triglyceride level greater than 150 mg/dL is considered elevated (optimal is less than 100 mg/dL).

I think of metabolic syndrome as the body not working as efficiently as it needs to, which can be a result of being overweight or obese. Where an individual carries this extra weight has an impact on their risk for metabolic syndrome. People who carry extra weight around their middle (sometimes called “central or abdominal obesity,” “visceral adiposity,” “apple shape,” or even “belly fat”) have a higher risk for metabolic syndrome. Those who carry extra weight around their hips and thighs (sometimes called “pear shape”) have a lower risk for metabolic syndrome.

Metabolic syndrome has also been called “insulin resistance syndrome” and “syndrome X,” and a diagnosis means you are at higher risk of developing type 2 diabetesInsulin resistance is a situation where the body produces insulin, but does not use it effectively. With insulin resistance, glucose cannot get into the cells to be broken down to make energy, so the liver releases extra glucose and sends it into the bloodstream. This only serves to drive blood glucose levels even higher. In addition, the beta cells of the pancreas work overtime to produce more insulin to deal with all of the excess glucose. As long as the beta cells can produce enough insulin to overcome insulin resistance, blood glucose levels stay in a healthy range.  Once the beta cells are unable to keep up with the increased need for insulin, higher levels of glucose ensue. This continued build-up of glucose in the blood instead of being absorbed by cells can lead to a pre-diabetes or type 2 diabetes diagnosis.

The good news is that very often, with lifestyle changes including healthier food choices and regular exercise, metabolic syndrome doesn’t always lead to diabetes. Weight loss and physical activity may help the body return to working more efficiently again.

My message for those with metabolic syndrome is the same for those without: make healthy choices most of the time and (almost) everything in moderation!

Jane K. Dickinson, RN, PhD, CDE*, is the author of People With Diabetes Can Eat Anything: It’s All About Balance. She is a nurse and certified diabetes educator who has lived with type 1 diabetes since 1975. Dickinson lives in Steamboat Springs, Colorado, where she provides diabetes education to community members and health care providers. She is currently the program coordinator of and on the faculty for the Diabetes Education and Management Masters Program at Teachers College Columbia University. Dickinson is a paid contributor for The DX. All opinions contained in this article reflect those of the contributor, and not of Sanofi US, its employees, agencies, or affiliates.

*“Certified Diabetes Educator” and “CDE” are certification marks owned and registered by the National Certification Board for Diabetes Educators (NCBDE). NCBDE is not affiliated in any way with Sanofi US. NCBDE does not sponsor or endorse any diabetes-related products or services.

© 2013 The DX: The Diabetes Experience

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