Ask the Pharmacist: Metabolic Syndrome

May 7, 2014
Specialist pharmacists in the Express Scripts Diabetes Therapeutic Resource Center® can help counsel patients about metabolic syndrome, minimize their risk and learn how to solve health-related problems.
  • Diabetes
  • High Blood Pressure/Heart Disease

Metabolic “syndrome” really refers to a collection of conditions or risk factors that can make someone more likely to develop serious medical conditions such as cardiovascular disease or diabetes. In the past, it has also been called syndrome X or dysmetabolic syndrome. About 35% of adults in the U.S. have metabolic syndrome.

There are many other risk factors for heart disease and diabetes, but the ones that make up the metabolic syndrome are:

  • High blood pressure: High blood pressure puts excessive strain on the cardiovascular system, causing damage to the heart and blood vessels, which can lead to a heart attack or stroke.
  • Abdominal obesity: Metabolic syndrome is closely linked to being overweight and not getting enough exercise.
  • Unhealthy cholesterol levels (high triglycerides and low HDL): Cholesterol in the blood can build up in your blood vessels and cause damage or a blockage, leading to a heart attack.
  • High blood sugar: High blood sugar is an indication of diabetes, and if it remains high, it can cause damage to the nerves, and small blood vessels of the kidneys and eyes. Metabolic syndrome is associated with insulin resistance, which means the body is not responding efficiently to insulin and increases the risk of developing Type 2 diabetes.

Metabolic syndrome doubles the risk of heart disease and increases by fivefold the likelihood of developing diabetes.

Specialist pharmacists in the Express Scripts Diabetes Therapeutic Resource Center® can help counsel patients about the metabolic syndrome, minimize their risk and learn how to solve health-related problems.

A self-care action plan based on easy-to-accomplish steps can help patients significantly reduce the risk of developing a serious illness – including heart disease or stroke.

Specialized Action Numbers

To best manage metabolic syndrome, these are the benchmark measurements:

  • Waist measurement should be less than 40 inches for a man and less than 35 inches for a woman
  • Blood pressure should be below 135/85 
  • Fasting blood sugar should be less than 100 mg/dL 
  • The good cholesterol number (HDL) should be higher than 40
  • Triglycerides should be below 150 mg/dL

Specialized Action Advice

These guidelines from evidenced-based research can help patients form the foundation of a personalized self-care action plan:

  • For those not at ideal body weight, reduce by at least 5% to 10%. A variety of diets have shown to be beneficial, including Mediterranean-style diets, dietary approaches to stop hypertension (DASH) style plans, plant-based plans (vegan or vegetarian), low-fat diets and lower-carbohydrate plans.
  • Keep blood pressure below 135/85. Reduce sodium intake to  less than 2,300 mg daily. Achieving the target blood pressure may require a consultation with a physician to consider medication therapy.
  • Increase activity level to reach 150 minutes of aerobic exercise per week (50% to 70% of maximum heart rate).
  • Get at least seven hours of quality sleep daily.
  • Control blood sugar by eating small, well-balanced meals and healthy snacks and monitoring carbohydrate intake. This may also require medication.
  • Minimize unhealthy fat content of meals and snacks. Keep saturated and trans fats to less than 10% of the diet, and increase amounts of omega-3 fatty acids.
  • Eat healthier. Food choices should include whole grains, fruits and vegetables, and low-fat dairy products. Try to eat fish twice a week while avoiding butter, lard and shortening as much as possible.
  • Take cholesterol, blood pressure and diabetes medications as prescribed. Do not miss any doses. Ask your doctor or pharmacist if you have any question about your medication.
  • Keep doctor’s appointments. Make sure to have routine checkups and lab work and ask the healthcare provider to explain the results.

Self-Care Action Plans

Creating a personalized self-care plan that fits a patient’s lifestyle and is easy to accomplish is the first step toward healthier outcomes. Once these goals have been accomplished, patients should create a new self-care plan that builds upon past success and keeps them on track to achieving their goals. Patients should create a written action plan and start each sentence with change talk phrases such as “I can” or “I will.”

Click here to download an example of a self-care action plan: Six Steps for Controlling Metabolic Syndrome


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