Communications: Patient Education

Patient Education: A Pre-cursor to Diabetes and Heart Disease

Monday, August 8, 2005  
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Family Physicians Say Patients Should Understand the Dangers of Metabolic Syndrome

Family physicians say thousands of Minnesotans are unaware they have a condition that puts them at higher risk for Type 2 diabetes, heart disease and stroke. That’s because metabolic syndrome – sometimes called insulin-resistance - is not an illness in itself, but rather a clustering of issues that together make it more likely that a person will develop life-threatening health problems.

"We’re actually looking for a grouping of symptoms that suggests a person is insulin resistant,” said George Schoephoerster, M.D., a St. Cloud family physician and president of the Minnesota Academy of Family Physicians. "The problem is that many of these people feel healthy and don’t see a doctor. They have no idea that the combination of these symptoms is putting them in danger.”

A person with metabolic syndrome has problems with the way that their body metabolizes sugar. Their body makes ineffective insulin, which can lead to Type 2 diabetes, hardening of the arteries and an increased risk of blood clots which can cause heart attacks or strokes. The major characteristics of metabolic syndrome include obesity in the abdominal area; high blood pressure; a high blood sugar level, but one that is not high enough to be classified as diabetes; and abnormal fat levels such as a high level of triglycerides (fat that forms in the blood) or a low level of high-density lipoprotein (HDL-C) (the so-called good cholesterol). People who have three or more of these characteristics are said to have the syndrome.

Although most of those diagnosed with metabolic syndrome are considered overweight or obese, those with a normal weight can have it too. Findings from the Center for Disease Control and Prevention’s most recent National Health and Nutrition Examination Survey show that at least 47 million Americans have metabolic syndrome. Experts predict many more have it and don’t know it. Risk factors include a poor diet, sedentary lifestyle and a person’s genetic makeup.

"Males with a waist circumference greater than 37 inches and females with a waist circumference greater than 31 inches should consider talking to their doctor about metabolic syndrome,” said Doctor Schoephoerster. He added that patients with hypertension, those with a family history of diabetes, those with a lot of skin tags (another indicator of insulin resistance) and those older than 45 years old would likely benefit from a conversation with their physician.

"Excess weight and lack of physical activity are underlying contributors to metabolic syndrome, but the good news is that healthy lifestyle changes can reverse the complications associated with it. Making smart choices early on can even prevent a person from developing it in the first place,” said Doctor Schoephoerster.

Doctors agree the best way to fight metabolic syndrome is to make an effort to lose weight. Exercising not only improves insulin levels, but it speeds up weight loss. Another suggestion is to reduce the amount of refined sugars you take in while increasing the amount of fiber and complex carbohydrates that you consume.

"Making this kind of change in a person’s life is not always easy. That’s why working with a family physician you trust is so important,” said Doctor Schoephoerster. "A good relationship with a doctor helps you to make good choices based on both your personal values and the best scientific information available.”

The Minnesota Academy of Family Physicians is a professional association of approximately 3,000 family physicians, family medicine residents and medical students organized to assist family physicians in providing quality medical care in Minnesota. The MAFP is the largest medical specialty organization in Minnesota and is a state chapter of the American Academy of Family Physicians, one of the largest national medical organizations in the United States with more than 103,000 members.

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