Metabolic Syndrome: Therapy

General measures

  • Adjustment of existing underlying diseases to optimal levels
  • Nicotine restriction (refraining from tobacco use).
  • Alcohol restriction (abstaining from alcohol)
  • Aim for normal weight!Determination of BMI (body mass index, body mass index) or body composition by means of electrical impedance analysis and participation in a medically supervised weight loss program.
  • Increase in physical activity!
  • Regular examinations of the feet and footwear (foot care) due torisk of diabetic foot.
  • Get enough sleep! (ideal is a sleep stint between 6.5 and 7.5 hours
  • Review of permanent medication due topossible effect on the existing disease.
  • Avoidance of psychosocial stress:
    • Bullying
    • Mental conflicts
    • Stress
  • Avoidance of environmental stress:
    • Nitrosamines (carcinogenic substances).
    • Beryllium
    • Lead

Bariatric surgery/Bariatic surgery

In severely obese patients, gastric bypass (artificially reduced stomach) may be indicated in terms of metabolic surgery. According to a study by Schauer et al, 42 percent of diabetic patients have a normal HbA1c (laboratory parameter for determining blood glucose over the past days or weeks/HbA1c is the “blood glucose long-term memory,” so to speak) after surgery. In another study by Mingrone, as many as 75% of patients achieved remission of diabetes mellitus.

Vaccinations

The following vaccinations are advised, as infection can often lead to worsening of the presenting conditions:

  • Pneumococcal vaccination
  • Flu vaccination

Regular checkups

  • Regular medical checkups

Nutritional medicine

  • Diets without medical supervision almost never lead to the desired result.
  • Nutritional counseling based on a nutritional analysis → permanent change of diet.
  • Observance of the following specific dietary recommendations:
    • Energy-reduced mixed diet
    • Avoid fasting cures
    • Distribute food over 3 meals a day, no snacks between meals
    • Low purine diet
    • Meals of diabetics should contain 15-20% protein (protein), 30% fats and 50-60% carbohydrates.
    • Choose food with a low caloric density (defined as kilocalories per gram). The effect is greatest if, on the one hand, the patient eats little fat – fat has the highest caloric density (9.3 kcal/g) – and, in addition, prefer to consume food with a high water content – that is, fruits, vegetables or low-fat soups. Participants who followed these dietary recommendations had lost an average of 7.9 kg after one year, obese with only low-fat food only 6.4 kg.
    • Reduce intake of triglycerides (neutral fats, dietary fat), contained in butter, margarine, oil, meat, sausage, milk, eggs, nuts.
    • Strongly limit consumption of foods containing monosaccharides (simple sugars) and disaccharides (double sugars).
    • Sugar substitutes (fructose, sorbitol, xylitol) increase triglyceride formation and should also be avoided in the context of hyperuricemia. Fructose-containing beverages lead to an increase in uric acid serum levels in circa 5% of patients.
    • A total of 5 servings of fresh vegetables and fruits daily (≥ 400 g; 3 servings of vegetables and 2 servings of fruits).
    • Diet rich in fiber (whole grains) – fiber is important for the binding and excretion of bile acids, which lowers cholesterol levels
    • The daily drinking amount should be at least 2 liters, so that the kidney has an adequate supply of fluid for uric acid excretion.
    • Intake of table salt < 6 g / day (“moderately low sodium diet“).
    • Liquorice because of blood pressure-increasing effect only rarely consume
    • Chew slowly and consciously, so that a feeling of satiety can arise
  • If necessary, also urinary alkalinization (dietary supplement).
  • See also under “Therapy with micronutrients (vital substances)” – if necessary, taking a suitable dietary supplement.
  • Detailed information on nutritional medicine you will receive from us.

Sports Medicine

  • Endurance training (cardio training) and strength training (muscle training) → sporting activity is an important measure for weight reduction and leads to maintaining the weight permanently afterwards. In addition, the increased fat levels in hyperlipoproteinemia and glucose serum levels (blood sugar levels) can be reduced and insulin sensitivity improved.
  • Preparation of a fitness or training plan with appropriate sports disciplines based on a medical check (health check or athlete check).
  • Detailed information on sports medicine you will receive from us.

Psychotherapy

  • Behavioral therapy: first, as with any eating disorder, there must be a will on the part of the sufferer to reduce the excess weight and, with it, the numerous associated health risks. This is achieved with the help of behavioral therapy. Once this step is taken, it is important to change the diet sensibly.
  • If necessary, stress management
  • Detailed information on psychosomatic medicine (including stress management) can be obtained from us.

Training

  • In a diabetic training, the affected persons are primarily shown the correct use of insulin, the importance of blood glucose self-monitoring and the adapted diet. Furthermore, in such groups, a mutual exchange of experience can take place.