Diabetes, type 2 - The metabolic syndrome

Diabetes, type 2

The metabolic syndrome

What is it?

The metabolic syndrome isn't a disease. It's a group of features that are linked to your body's metabolism. Your metabolism is the name given to all the chemical processes that happen in your body. The metabolic syndrome is also known as syndrome X or insulin resistance syndrome.

Source:
Grundy SM, Cleeman JI, Daniels SR, et al.
Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute scientific statement.
Circulation. 2005; 112: 2735-2752.

The most common features of the metabolic syndrome are:

Extra fat around your abdomen
High levels of bad fats in your blood
Low levels of a good fat called

HDL cholesterol
Cholesterol is a fatty substance in your blood. You can get it from food and it is also made by the liver. Having a lot of cholesterol in your blood can cause health problems. But HDL cholesterol is sometimes called 'good' cholesterol, because it may lower the risk of heart disease. HDL stands for high-density lipoprotein.

high-density lipoprotein (HDL) cholesterol
blood pressure
Blood pressure is the amount of force exerted by the blood on the walls of the vessels that carry it. You can think of it like the water pressure in your home: the more pressure you have, the faster and more forcefully the water flows out of the shower. Blood pressure is measured in millimeters of mercury (written as mm Hg). When your blood pressure is taken, the measurement is given as two numbers, for example 120/80 mm Hg. The first, higher, number is called the systolic pressure, and the second, lower, number is the diastolic pressure. The systolic number is the highest pressure that occurs while the heart is pushing blood into the arteries. The diastolic number is the lowest pressure that happens when the heart is relaxing and is not pushing the blood.

Blood pressure that is higher than normal
Blood that clots too easily
Problems with how your body uses

insulin
Insulin is a hormone that helps your body use glucose, a type of sugar that gives you energy. Insulin keeps your levels of glucose steady. It also helps glucose get into your cells from your blood. People who have diabetes do not have enough insulin or do not react to insulin strongly enough. This leads to too much glucose in their blood.

insulin. You may have too much glucose (sugar) in your blood.

If you have any of features of the metabolic syndrome, your doctor will tell you what to do to stay healthy. Losing weight and exercising regularly are important. Your doctor might advise you to make other changes in the way you live, and you might also need medication.

If you have metabolic syndrome, you are more likely to get type 2 diabetes,

heart disease
You get heart disease when your heart isn't able to pump blood as well as it should. This can happen for a variety of reasons.

heart disease, a

stroke
You have a stroke when the blood supply to a part of your brain is cut off. This damages your brain and can cause symptoms like weakness or numbness on one side of your body. You may also find it hard to speak if you've had a stroke.

stroke and some other conditions.

How common is it?

The metabolic syndrome is common. In the United States, more than 20 percent of people have it.

Source:
Ford ES, Giles WH, Dietz WH.
Prevalence of the metabolic syndrome among US adults: findings from the third National Health and Nutrition Examination Survey.
Journal of the American Medical Association. 2002; 287: 356-359.

What causes it?

If you have the metabolic syndrome, your body's insulin doesn't work as well as it should. This is called insulin resistance. It can be caused by:

Being overweight
Not getting enough exercise
Having certain

genes
Your genes are the parts of your cells that contain instructions for how your body works. Genes are housed on chromosomes, structures that sit in the nucleus at the middle of each of your cells. You have 23 pairs of chromosomes in your normal cells, each of which has thousands of genes. You get one set of chromosomes, and all of the genes that are on them, from each of your parents.

genes.

How is it diagnosed?

There isn't any special test for the metabolic syndrome. And you don't get symptoms right away. The health problems it can cause, such as type 2 diabetes, happen over time.

Guidelines for doctors say that you might have the metabolic syndrome if you have three or more of the following things.

Your waist measures 40 inches or more if you are a man, or 35 inches or more if you are a woman. If you are Asian-American, it is 35 inches or more if you a man, or 31 inches or more if you are a women.
The level of fats called

triglycerides
Triglycerides are the form in which fat is stored in your body. Triglycerides are made from the fat found in food. They can be used by your body for energy.

triglycerides in your blood is 150 mg/dL or more before breakfast or you are taking medicine to lower your triglyceride). (The term mg/dL stands for milligrams per deciliter.)
Your level of

HDL cholesterol
Cholesterol is a fatty substance in your blood. You can get it from food and it is also made by the liver. Having a lot of cholesterol in your blood can cause health problems. But HDL cholesterol is sometimes called 'good' cholesterol, because it may lower the risk of heart disease. HDL stands for high-density lipoprotein.

good (HDL) cholesterol is less than 40 mg/dL if you are a man, or less than 50 mg/dL if you are a woman, or or you are taking medicine to raise your HDL cholesterol.
The level of glucose (sugar) in your blood is 100 mg/dL or more before breakfast or you are taking medicine to lower your blood sugar.
Your blood pressure is 130/85 or higher or you are taking medicine to lower your blood pressure. For more information, see High blood pressure.

To find out the levels of glucose, fats and cholesterol in your blood, your doctor will do a blood test.

How can it be prevented?

You can't change your genes. But you can:

Keep your weight down
Eat healthily
Exercise
Drink alcohol in moderation. That's one drink a day for women or two drinks a day for men. One drink is 1.5 ounces of hard liquor, 5 ounces of wine or 12 ounces of beer.

See your doctor if you think you might have the metabolic syndrome of any part of it.

Sources for the information on this page:

Grundy SM, Cleeman JI, Daniels SR, et al.Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute scientific statement.Circulation. 2005; 112: 2735-2752.

Ford ES, Giles WH, Dietz WH.Prevalence of the metabolic syndrome among US adults: findings from the third National Health and Nutrition Examination Survey.Journal of the American Medical Association. 2002; 287: 356-359.

This information was last updated on May 11, 2009

This information is for educational use only, and is not a substitute for prompt professional medical advice. Readers should always consult a physician or other professional for advice and treatment.
© BMJ Publishing Group Limited 2009. All rights reserved.

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