Metabolic syndrome care measures

Do risk stratification first, prioritize lifestyle adjustments, and then match medications as needed based on combined underlying diseases. There is no universal formula, and the one that suits you is the most effective.

Last Wednesday, I was attending a general practice clinic and met a 42-year-old man who worked on the Internet. He came in with a physical examination report and looked indifferent. He said that the unit test showed high triglycerides, fasting blood sugar was off the mark, and his blood pressure was stuck at the critical value of hypertension. His waist circumference of 92cm was just enough to meet the standard of central obesity. I thought he had been working overtime recently, so he could just rest for two days. I didn't realize that this was already a typical metabolic syndrome. I meet 20 to 30 such patients every month, mostly young and middle-aged people in their 30s and 40s. They have no obvious symptoms and do not take abnormal indicators seriously. When problems such as dizziness and polydipsia and polyuria occur, they have often developed into clear diabetes or high blood pressure.

There is a lot of quarrel on the Internet about Daizong's diet plan. Some people say it should be strictly low-carb, some say the Mediterranean diet is the gold standard, and some people recommend a completely vegetarian diet. Let's be honest, these plans are all effective, but only if you can stick to it. Our domestic endocrine guidelines are now more inclined to make gradual adjustments. Just replace all rice and noodles with quinoa and avocado. First, replace the 2 cups of full-sugar milk tea you drink every day with sugar-free ones. Remove 1/3 of the white rice at lunch and replace it with corn or sweet potatoes. Take-out dishes should be washed with warm water to remove the oil. With these three points, if you can stick to it for a month, your blood lipids and blood sugar will be reduced. There was a patient who was a middle school teacher who followed this method and lost 8 pounds in 3 months, and his fasting blood sugar returned from 6.7 to 5.4. The effect was much better than those who couldn't stop overeating after half a month of low-carb diet.

After talking about food, let’s talk about exercise. Many people have misunderstandings about the exercise requirements of Dai Zong. They think that they have to go to the gym, train, and run 5 kilometers every day to be effective. This is really not the case. Studies in the past two years have shown that HIIT (high-intensity interval training) is very effective in improving insulin resistance. 10 minutes of HIIT is equivalent to half an hour of jogging. I have recommended it to several young patients before, and one young man with high blood pressure became dizzy after a week of training. Later, colleagues in the cardiology department reminded that if the systolic blood pressure has exceeded 140mmHg, or people who do not exercise at all, do not do HIIT as it can easily induce cardiovascular risks. The advice I give patients now is very practical. If you usually sit in an office, stand up for 5 minutes every 40 minutes, get some water and stretch twice. Take one less bus stop after get off work and walk 10 minutes home. Don’t stay at home and check your mobile phone on weekends. Take your family to the park for two hours or play badminton for half an hour. As long as you can move, it is 10 times better than sticking to the hard standard of "150 minutes of moderate-intensity exercise per week" but never moving.

Of course, not all patients with generation syndrome can be adjusted by lifestyle. Whether or not to take medicine is actually the most difficult point for many people. There are indeed two voices. One thinks that as long as the patient is suffering from diabetes, medication should be intervened as soon as possible to avoid developing diabetes and coronary heart disease. The other thinks that if the patient can adjust his lifestyle, he should not take medication to avoid the side effects of the medication. Our current clinical standard is stratification: if the waist circumference is simply excessive, the blood sugar, blood lipids and blood pressure are only borderline, and there are no other underlying diseases, then a three-month lifestyle adjustment period and regular re-examination will be enough. ； If you have been diagnosed with high blood pressure, type 2 diabetes, or your blood lipids are more than twice the normal upper limit, you must take the medicine you should take. Don't believe the nonsense that "meal replacement can cure the disease" or "health supplements can stop taking the medicine." Last year I met a 52-year-old aunt who had suffered from high blood pressure for three years. She heard others say that taking a certain meal replacement could lower her blood pressure, so she secretly stopped her antihypertensive medicine. After two months of eating, she suffered a cerebral infarction and was sent to the emergency room. Although she was rescued, her left hand and foot are still in trouble, which is really a pity.

Another point that many people ignore is emotional care. Daisy syndrome is not a terminal disease, but many people go to two extremes as soon as they are diagnosed. Either I am so anxious that I dare not eat anything, and counting calories every day is almost giving me an eating disorder, or I am broken and broken, but I have no symptoms anyway, and I drink and stay up late when I should. Our department now distributes a small notebook to all newly diagnosed patients. They don’t need to remember the calories, but just write down what they ate and whether they moved every day. When we come for follow-up visits every week, we will read it together and pay attention to which meals we ate too much next time. We will give a small reward for each week of exercise that is good, and slowly help the patients develop habits. Compared with the previous period where they were given a bunch of "no eating and no drinking" prohibitions, the acceptance rate is much higher.

In fact, metabolic syndrome is simply a warning signal sent by your body, telling you that your recent lifestyle is too bad and it is time to adjust. Don't be overly anxious or take it seriously. You say it's complicated, but it's actually just three things: eating, moving, and sleeping. You say it's simple, but many people just can't bear to drink milk tea and stay up late. There is no standard answer to nursing care. The one that suits you and can stick to it is the best.