What are the risks associated with metabolic syndrome?

Syndrome X increases your risk of coronary heart disease and stroke by four times, and of developing diabetes by as much as 6 – 8 times. Those with the syndrome are also more likely to suffer from sleep disorders, back pain and joint problems. Women affected by this syndrome are at a higher risk of developing polycystic ovarian disease [PCOD] and infertility.

How common is metabolic syndrome?

In the last decade, this syndrome has become much more common in India. It is estimated that about 30 per cent of adults or one in 3 – 4 adults have it; the syndrome is more common in women than in men.

Syndrome X increases your risk of coronary heart disease and stroke by four times, and of developing diabetes by as much as 6 – 8 times

How is metabolic syndrome diagnosed?

It is diagnosed when a patient has at least three of the following five conditions:

• Central obesity, which is measured as waist circumference of more than 35 inches in men and more than 32 inches in women
• Fasting blood triglycerides of more than 150 mg/dL or being on medication for high triglycerides
• HDL cholesterol levels of less than 40mg/dL in men and less than 50mg/dL in women
• Blood pressure of more than 130/85 mmHg or being on medication for high blood pressure
• Fasting blood sugar of more than 100 mg/dL or being on medication for high blood glucose.

How is metabolic syndrome treated?

The best way is to lose weight, increase physical activity and modify your diet.  Exercise should be intensified over the time. The ‘exercise prescription’ should be obtained from a qualified exercise specialist. Daily activity should be encouraged. Abnormal cholesterol levels may be controlled with medication.

Metabolic surgery is recommended for individuals who are morbidly obese and are unable to lose weight or keep the lost weight off despite repeated attempts. It also helps individuals who are obese and have developed uncontrolled diabetes, high blood pressure, heart disease or fertility issues.

The best way to treat metabolic syndrome is to lose weight, increase physical activity and modify your diet

If you are suffering from metabolic syndrome, make sure that you:

• Routinely monitor your body weight [especially abdominal girth]. Also monitor blood glucose, lipoproteins and blood pressure
• Get treated for high cholesterol, high blood pressure and high blood glucose
• Adopt an overall healthy lifestyle and take measures to manage your stress.

It’s important to focus on all the components of this syndrome for holistic management.

This was first published in the April 2015 issue of Complete Wellbeing.

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Q. How can one know whether he or she is suffering from diabetes?

A. The classic symptoms of diabetes—increased thirst and increased frequency of urination—are not always present and many patients are unaware that they may have diabetes. Hence, doing periodic blood tests to check blood sugar levels is recommended. HbA1c [Glycosylated haemoglobin] is the blood test, that indicates your glycaemic status accurately. This test does not require fasting but should be carried out in an accredited laboratory. A level of less than 5.7 is normal and 5.7 to 6.5 is considered pre-diabetes or “diabetes at risk” category. A level of 6.5 and above is definitely indicative of diabetes. Other tests like fasting blood sugar and post-meal blood sugar can also be done, but theses parameters can show variable results on different occasions.

Q. What lifestyle modifications can help us to prevent/treat diabetes?

A. Obesity is a social problem and the solution to it begins in the home. The family should adopt a healthier lifestyle and switch to eating a healthier diet. It’s understandable that high calorie foods are difficult to resist, but we should avoid foods that are rich in simple sugars, oil/ghee and processed refined flours. It is also difficult to find the time to exercise in today’s busy life schedule, but it should be made a habit. Sedentary lifestyles contribute to a lot of diseases including diabetes. Lifestyle modification should not be looked at as a punishment because you have diabetes or you are putting on weight—it should become a commitment to living a fuller life.

Q. How should one keep diabetes under check?

A. Follow the ABC approach—

• Quarterly monitoring with HbA1c [Blood test] helps to gauge the blood sugar control. The target level should be <6.5 – 7.
• Blood pressure should also be <140/90 mmHg. If persistently high, medications may be required to bring it under control.
• Cholesterol should be under control. LDL should be <70 – 100 mg/dl and HDL levels should be <40 – 50mg/dl. Triglycerides should be <150mg/dl.

Controlling blood sugar, blood pressure and cholesterol is critical to prevent complications like heart disease and kidney failure.

Q. Why is the number of diabetics increasing these days?

A. Obesity is the mother of diabetes. With the recent transition in our economy, and changing lifestyle, obesity has become rampant. Excess fat in the body leads to insulin resistance and high blood sugars. Heredity also plays an important role. Research has shown that recognising and tackling obesity with lifestyle changes can prevent diabetes.

Q. What medicines are available for diabetes control?

A. There are different classes of medicine available [oral/injectables]. Metformin is the basic and first line drug. It not only decreases blood sugar but also causes some weight loss and does not produce hypoglycemia [excessively low sugar level]. Other drugs like DPP4 inhibitors, sulphonylureas, glitazones, and insulins are to be used judiciously as add on drugs if metformin alone fails. Patients need to understand the dosing, frequency and other specifications attached with different medications prescribed.

This was first published in the November 2015 issue of Complete Wellbeing.

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