Dear Doctors: When you talk about metabolic syndrome, diabetes always gets mentioned. I don’t have diabetes, but my doctor says my lab tests show I do have metabolic syndrome. Can you have that even if you don’t have diabetes? Is there a cure?
Dear Reader: A diagnosis of metabolic syndrome means that your doctor has identified a cluster of conditions that significantly increase the risk of developing coronary heart disease, diabetes or having a stroke. Any one of the conditions involved in metabolic syndrome can individually have an adverse effect on health; however, when they occur at the same time, the threat of a poor outcome becomes greatly amplified.
This all sounds pretty alarming, so we’ll get right to the good news: Metabolic syndrome is preventable. For those who have been diagnosed with it, it is also reversible. In both instances, it requires a range of lifestyle changes and the possible use of medications. To understand why and how this all works, let’s look at the specifics.
Having three or more of the following conditions means you may have metabolic syndrome. These include having a large waistline, sometimes referred to as abdominal obesity. Carrying extra fat around the stomach is a known risk factors for heart disease. High blood pressure, which stresses the heart and blood vessels and can damage the organs, is another component of metabolic syndrome. So is poor blood sugar control, which can lead to Type 2 diabetes. Both of those raise the risk of developing blood clots. Unhealthful blood lipid levels, including high triglycerides and low levels of HDL cholesterol, often called the “good cholesterol,” are also on the list.
It is estimated that one-third of adults in the U.S. are living with metabolic syndrome. Unfortunately, because the metabolic markers that flag the diagnosis often don’t cause symptoms, many of those individuals don’t know it. If you check one of the boxes for metabolic syndrome, such as a large waist or elevated blood pressure, it’s a good idea to talk to your doctor about tests for the other factors of the syndrome. And to answer your question regarding diabetes, yes, you can have metabolic syndrome and not have diabetes.
When it comes to both prevention and treatment, reaching and maintaining a healthful weight is important. Even a small decrease in body weight -- just 5% or 10% -- has been shown to have a positive effect on insulin metabolism and blood pressure. Ease your way into a well-rounded fitness routine that includes aerobic exercise, strength training and stretching. Get enough sleep, take steps to manage stress and eat a healthful diet, with a focus on fresh produce, lean proteins, healthful fats and plenty of dietary fiber. Depending on individual test results, it is possible that medications to manage blood pressure, blood sugar control or blood lipid levels may be prescribed.
Be kind to yourself as you make these changes in your life. And be realistic. Set small goals, and take the time you need to reach them. Developing metabolic syndrome didn’t happen overnight, and neither will the process of reversing it.
(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10960 Wilshire Blvd., Suite 1955, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)
