What Patients Should Know About Metabolic Syndrome

by Jonathan Fialkow MD FACC

A GOOD physician is fluent in two languages—one for colleagues, the other for patients. When speaking to patients, many physicians forget to put aside the medical jargon and to speak in layman’s terms. Yet, it is crucial to do so when talking about a condition such as metabolic syndrome. That name alone is enough to unleash a barrage of questions from an apprehensive patient: ‘What is it? How did I get it? How can it be treated?’ It is essential that a physician answer such questions in the patient’s ‘language.’

At HeartWell, physicians have as a goal to do more than treat sick people; their aim is to emphasize prevention so that risks can be reduced.  Such is the case with regard to metabolic syndrome.

Consider three things that patients who have just been diagnosed will need to know: (1) What is metabolic syndrome? (2) How does it develop? and (3) How can it be treated?

What is Metabolic Syndrome?

Patients may not know that a “syndrome” involves a cluster of symptoms. In the case of metabolic syndrome that cluster would include at least three of the following: increased blood pressure, high fasting blood sugar, insulin resistance / glucose intolerance, high triglyceride level, abdominal obesity, and a low HDL cholesterol level. Any one of these symptoms is reason for concern, and since one symptom often leads to another, it is not unusual for patients to have three or even more—hence, the diagnosis of metabolic syndrome.

Patients need to know that metabolic syndrome is serious. According to the National Heart, Lung, and Blood Institute, a person who has the condition “is twice as likely to develop heart disease and five times as likely to develop diabetes as someone who doesn’t have metabolic syndrome.” Metabolic syndrome is directly linked to increased inflammatory state in our body and, specifically, our blood vessels.  It is directly linked to carbohydrate intake.

What Causes Metabolic Syndrome?

As its name suggests, metabolic syndrome is related to the metabolism, and a number of factors may contribute to it. Some of the causes are within the patient’s control (such as dietary intake or an inactive lifestyle) while others are not within the patient’s control (ethnicity and genetics) The hallmark of metabolic syndrome is insulin resistance. Insulin is the hormone, released in response to carbohydrate intake, that determines where energy (food) in our blood goes. With metabolic syndrome, the body does not respond to the normal signals which would send energy to our muscles and store in our liver and, instead, energy gets stored as fat in our abdominal cavity (hence the big belly)

People with insulin resistance develop high glucose levels in the blood—a condition that can lead to diabetes or pre-diabetes as a later condition but early signs are abdominal weight gain, elevated triglycerides (the storage of energy) and blood pressure elevations. High glucose levels also interfere with the kidneys and can lead to even higher blood pressure. All of this puts the patient at greater risk of heart disease and stroke.

How Is Metabolic Syndrome Treated?

While medication can help a patient deal with the individual symptoms of metabolic syndrome (such as high blood pressure), the patient needs to know that a lifestyle change is an essential component of treatment. Heart-Well physicians emphasize the important of physical activity along with a healthy diet that will promote weight loss. There is a clear correlation with carbohydrate intake, especially refined and processed simple carbohydrates, and insulin resistance and metabolic syndrome.

The dietary recommendations regarding metabolic syndrome improvement and control as well as prevention often coincide with an effective weight loss strategy. These are not as simple as previously thought and often not related to fat intake. Your HeartWell physicians are able to use the current medical scientific knowledge and apply it to each patient individually to create a treatment plan for them.  After beginning a program of treatment, patients should get regular checkups with their HeartWell physician so that they can have their blood pressure, cholesterol and lipids, and blood sugar levels monitored. Adjustments to diet and exercise can be made as needed.