Metabolic Syndrome/Obesity

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Author:
wcameron
ID:
200390
Filename:
Metabolic Syndrome/Obesity
Updated:
2013-02-13 19:05:02
Tags:
Metabolic Syndrome
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Description:
Diagnostics and treatment
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  1. Criteria for Metabolic Syndrome
    3 of 5 required for diagnosis:

    * Abdominal obesity: waist circumference > 35inch. in Men, > 40inch. Women

    * Glucose intolerance: FBG > or = 110

    * Elev.TG: > or = 150

    * Low HDL-C: < 40 men, < 50 women
  2. Metabolic Syndrome
    A cluster of factors that drastically increase one's risk of CVD and DM
  3. Underweight BMI
    BMI <18.5
  4. Normal BMI
    18.5-24.9
  5. Overweight BMI
    25-29.9

    - mild risk of complications; initiate nutrition change, physical activity, behavior management, medication
  6. Obese BMI
    > or = 30
  7. Obese, Class I BMI
    30-34.9

    - moderate risk of complications; initiate nutrition/physical/behavioral change, medication
  8. Obesity, Class II
    BMI 35-39.9

    - High risk of complications; initiate nutrition/physical/behavior change, medication & Surgical options
  9. Obesity, Morbid
    BMI > or = 40

    -Extreme risk of complications; initiate nutrition/physical/behavioral change, medications, bariatric surgery
  10. Caloric Restriction in Obesity
    Goal: 5-10% weight loss in 12 mos.

    BMI 27-35 - cut 300-500kcal/day to equal 1lb loss/week (10% in 6mos)

    BMI > 35 - cut 500-1000kcal/day to equal 10% weight loss in 6 mos

    Calculate from BME (basal metabolic energy), current wt. in lbs x10
  11. A1C monitoring
    q3mos if change in regimen or not at goal.

    q6mos if at goal.
  12. DM testing/screening in asymptomatic adults (ADA)
    Begin at age 45y.o. & q3years.

    If prediabetic, yearly.

    Consider for: 

    - overweight, physically inactive, high-risk ethnicity, had a baby > 9lbs or GDM, HTN, HDL <35, TG >250, PCOS, A1C > or = 5.7, IGT, IFG, S&S of insulin resistance (acanthosis nigricans), or hx of CVD.

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