Diabetic network

I recently received an invite to attend a meeting organised by our local diabetes network. A local biochemist was discussing "Metabolic Syndrome". Well I have to say that I really did not know what to expect and was intrigued by what I heard. As a medical student I was well aware of the association between abdominal obesity and heart disease. What I hadn't kept up to date with was how biochemists and in particular North American biochemists seem to have significantly developed this idea.
Abdominal obesity associated with insulin resistance, raised BP (130/85 or more) and raised triglycerides is linked with an increased risk of type 2 diabetes and atheromatous vascular disease. The American criteria -

• Central obesity as measured by waist circumference:
  Men — Greater than 40 inches
  Women — Greater than 35 inches
• Fasting blood triglycerides greater than or equal to 150 mg/dL
• Blood HDL cholesterol:
  Men — Less than 40 mg/dL
  Women — Less than 50 mg/dL
• Blood pressure greater than or equal to 130/85 mmHg
• Fasting glucose greater than or equal to 110 mg/dL

are about to be replaced by European criteria which are even more stringent.

Why make the diagnosis? Well one good reason seems to be that it is possible to reduce adverse outcomes by increasing exercise (1 hour of moderate exercise daily) and dieting. Our local biochemist recommended starches with a low glycaemic index.

For more information the American Heart Association has a useful resource.

The most striking thing from the talk I attended was the prevalence data - it was suggested that 20% of adult males are affected! Now where is that exercise bike?