Thursday 23 May 2013

LIVING WITH DIABETES - Syndrome X - Part 1


SYNDROME X

About 25 percent of Americans (figures for SA are not available) are afflicted with what’s known as insulin resistance syndrome or syndrome X.

Despite the confusion on what to call this group of symptoms, the clues are the same: high blood pressure, high cholesterol, overweight and insulin resistance, a condition in which the body cannot properly utilize a hormone that allows the body to convert food into fuel.
Taken together, these symptoms put patients at sky-high risk for developing type 2 diabetes, heart disease, stroke, kidney failure, cancer and circulatory problems.

There’s no question that we are getting fatter and exercising less. According to studies published in the Journal of American Medical Association, more than half of all American adults are overweight or obese. And while there are a myriad of symptoms that contribute to this metabolic syndrome, being overweight or obese is the most inflammatory. Obesity really is the starting point. Weight gain leads to insulin resistance, high blood pressure and diabetes.
While the exact mechanism is unknown, researchers do know that obesity and physical inactivity aggravate insulin resistance. And because both obesity and inactivity are still on the rise, experts predict that a large part of our population is or will become insulin resistant.

Insulin resistance occurs when the normal amount of insulin produced by the pancreas is not able to remove glucose from the blood into the cells for use as energy or storage for future use. The body is forced to produce more insulin to get the same effect as before, but now there is extra insulin in the blood with no glucose to convert. Other studies have shown that such high insulin levels can directly raise blood pressure, and blood pressure is another of the symptoms of the syndrome.

And the compensatory activities of the pancreas force the rest of the body to pay a price. Insulin resistance affects multiple organ systems. At the cellular level, it causes disturbances in chemical responses by and in the body’s cells. This effect promotes high blood pressure, coronary artery disease and abnormalities in blood lipids such as cholesterol and triglycerides. The problem is that as time passes, the pancreas loses the ability to produce all this extra insulin and compensate. The insulin levels come down, and they’re not enough to maintain a normal blood glucose level. Once a person’s fasting blood glucose level reaches 7,1 mmol/L or higher, diabetes is diagnosed. Normal blood sugar levels range from 4mmol/L to 6,5 mmol/L.
Excess fat — called adipose tissue — also leads to an overproduction of dangerous blood fats called triglycerides. Doctors are particularly focused on patients who carry extra abdominal fat because it is an accurate predictor of insulin resistance, diabetes and syndrome X. Patients who carry their excess weight in the belly area, rather than the buttocks, legs or arms, have a much higher incidence of metabolic syndrome.

Physical inactivity goes hand in hand with obesity, and not coincidentally, it is the second major component in metabolic syndrome. Exercise helps insulin to work more effectively, which is why exercise is such an important component of diabetes management.
According to the American Heart Association, 24 percent of Americans age 18 or older are not active at all. Adults are better: 54 percent of adults get some exercise, but they don’t do it regularly or intensely enough to protect their hearts. Only 22 percent of American adults get enough leisure time exercise to achieve cardiovascular fitness. 


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