Mayo Clinic Q&A
DEAR MAYO CLINIC: My mother is in her 70s and was just diagnosed with metabolic syndrome. Is this just another name for diabetes? What will she need for treatment?
ANSWER: Metabolic syndrome and diabetes are not the same, but the two are related. When a person is diagnosed with metabolic syndrome, it means he or she has several conditions that, if left untreated, significantly raise the risk for developing diabetes. Metabolic syndrome also increases the risk for heart and blood vessel problems. Treatment for metabolic syndrome typically focuses on healthy lifestyle changes.
Although the specific definition health care providers use may vary somewhat, metabolic syndrome generally includes having three or more of the following characteristics: a large waistline, a high triglyceride level, low HDL cholesterol (also called “good” cholesterol), high blood pressure, and blood sugar that is higher than normal, but not high enough to qualify as diabetes.
High blood sugar is the hallmark sign of diabetes. When a blood sample is taken after a person fasts overnight and blood sugar measures 80 to 100 milligrams per deciliter, or mg/dL, that level is considered normal. A fasting blood sugar measurement of 126 mg/dL or higher on two separate tests is considered diabetes. The range between the two — 100 to 125 mg/dL — is referred to as prediabetes. The blood sugar level of people who have metabolic syndrome often falls into the prediabetes range.
After a diagnosis of metabolic syndrome, the first step in treatment usually involves making lifestyle changes. Many people who have metabolic syndrome are overweight. Getting to and staying at a healthy weight can make a big difference in reducing the risk of health problems associated with metabolic syndrome.
Losing weight may help lower blood pressure, blood sugar and triglyceride levels. It also can help reduce waist size. That’s important because studies have shown that carrying a lot of weight around your abdomen raises the risk of developing diabetes, heart disease and other complications of metabolic syndrome. To reduce the risk, doctors generally recommend a waistline of less than 35 inches for women and less than 40 inches for men.
Regular exercise can help with weight loss, as well as improve some of the medical concerns associated with metabolic syndrome. A good goal is thirty minutes or more every day of activity that is moderately intense, such as brisk walking, swimming or biking.
Healthy eating is a crucial component of treatment for metabolic syndrome. Encourage your mother to talk with her doctor or to a dietitian about the right diet for her situation. Two diets that are often recommended for people with metabolic syndrome include the Dietary Approaches to Stop Hypertension (DASH) diet and the Mediterranean diet. Similar to many healthy-eating plans, these diets limit unhealthy fats and focus on fruits, vegetables, fish and whole grains. Beyond weight loss, studies have shown that both diets offer important health benefits for people who have components of metabolic syndrome.
Finally, if your mother smokes, it’s very important that she stop. Smoking cigarettes can make many of the health complications of metabolic syndrome worse. It also can significantly raise the risk for other illnesses and diseases. If needed, your mother’s doctor can work with her to help her stop smoking and connect her with other resources to support her as she quits.
If lifestyle changes are not enough to control metabolic syndrome, medication also may be part of the treatment plan. Medicine to control blood pressure, manage triglycerides and lower blood sugar can be useful in treating some cases of metabolic syndrome. — Robert Rizza, M.D., Endocrinology, Mayo Clinic, Rochester, Minn.