Definition
It would not be entirely correct to speak of a metabolic syndrome as a unique and well-defined pathology: more precisely, it is a pseudo-pathological condition characterized by the combination of multiple disorders, such as increased blood glucose levels, hypercholesterolemia, hypertriglyceridemia and hypertension.
Metabolic syndrome increases the risk of cardiovascular disease, diabetes, stroke and hepatic steatosis.
Causes
Given the complexity of the condition, the causes of origin are multiple and heterogeneous. Among the most recurrent etiological elements, we recall: unbalanced diet, insulin resistance (the most involved element, responsible for the propensity to diabetes, hypertriglyceridemia, hypertension), obesity, genetic predisposition, sedentariness.
Symptoms
As can be guessed, the typical symptoms that accompany the metabolic syndrome involve purely metabolic consequences: increase in blood pressure (min.> 85mmHh, max.> 130 mmHg), increase in blood glucose, increase in blood triglycerides and decrease in high lipoproteins density ("good cholesterol"), overweight / obesity.
- Complications: destruction of pancreatic beta cells and diabetes mellitus, cardiovascular diseases, kidney deficiencies, vision changes, liver disorders.
Diet and Nutrition
Information on Metabolic Syndrome - Metabolic Drugs for the Treatment of Metabolic Syndrome is not intended to replace the direct relationship between health professional and patient. Always consult your doctor and / or specialist before taking Metabolic Syndrome - Metabolic Drugs for the Treatment of Metabolic Syndrome.
drugs
The best cure for the metabolic syndrome is prevention: even in this case, it seems that there is no better drug than a balanced diet combined with a correct lifestyle, based essentially on the increase in sports activities and the reduction of body weight, especially for overweight patients.
Unfortunately, sedentariness, laziness and a good fork seem to be the preferred habits of the population; It should be stressed again that sport, the implementation of simple physical activities and the correction of dietary habits are indispensable therapeutic measures to avoid the metabolic syndrome. To give an example, sport prevents cardiovascular diseases, increases the sensitivity of cells to insulin, maintains constant blood sugar, prevents the onset of hypertension and keeps body weight in check.
If the change in lifestyle - intended as a correction of eating habits and the putting into practice of physical activities - is not sufficient to hinder the onset of the metabolic syndrome, drug therapy can be an excellent aid: drugs for the treatment of hypertension, cholesterol-lowering drugs and triglycerides, drugs to reduce blood sugar.
Patients with metabolic syndrome should stop smoking and, if necessary, reduce weight.
Antihypertensives : we have seen that the metabolic syndrome is often accompanied by the increase in pressure; therefore, your doctor may prescribe diuretic drugs, beta blockers, ACE inhibitors and calcium channel blockers. The most widely used for the treatment of hypertension are diuretics and beta blockers, such as:
- Spironolactone (eg Aldactone, Uractone, Spirolang): the drug belongs to the pharmacological class of potassium savers. The dosage for the treatment of hypertension is very variable (50-200 mg per day) and must be established by the doctor on the basis of the patient's blood pressure.
- Hydrochlorothiazide (eg Rasitrio, Esidrex): thiazide diuretic drug. It is recommended to start therapy for hypertension by taking a dose of 25 mg once a day. Maintenance dose: it is possible to increase the dosage of 50 mg, to be taken orally, also divided into two doses. Consult your doctor.
- Acebutolol Hydrochloride (eg Prent, Sectral): the drug belongs to the class of beta blockers, useful for the treatment of hypertension even in the context of the metabolic syndrome. As an indication, take a 200 mg tablet of medication, preferably before breakfast. It is possible to gradually increase the dosage up to a maximum of 400 mg per day.
- Carvedilol (eg Colver): another beta blocker drug, indicated for the treatment of hypertension associated with metabolic syndrome. It is recommended to take two tablets (for a total of 12.5 mg) per day for the first two days of treatment; then, take 25 mg of active, in a single dose, up to a maximum of 50 mg (divided into two doses). Consult your doctor.
For further information: see the article on drugs for the treatment of hypertension.
Antidiabetics : the presence of abnormal antibodies directed against pancreatic beta cells, causes diabetes mellitus (type 1); in this case, the patient will have to take insulin (through injections under the skin). Oral hypoglycemic agents are generally indicated exclusively for the treatment of type 2 diabetes mellitus, frequent in patients with inadequately treated metabolic syndrome. When the disease is diagnosed early, it is sometimes possible to reverse diabetes (prediabetic phase); otherwise, the patient will need to take hypoglycemic drugs or - in the most serious cases - insulin for life.
There are more types of insulin, essentially classified on the mode of action:
- ultra-fast insulin (Insulin Lispro and Insulin Aspart)
- fast-acting insulin (eg Actrapid, Insulin Human Winthrop, Insuman Rapid)
- Intermediate action insulin (eg Insuman Basal, Monotard)
- Slow / ultra-slow insulin (eg Ultraretard)
- Insulin Glargine (eg Lantus, Optisulin)
- Insulin and protamine (eg Protaphane)
The choice of one type of insulin rather than another depends on the severity of the condition and the needs of the patient. Consult your doctor.
For more information on oral hypoglycemic agents and insulin: read the article on drugs for the treatment of type 1 diabetes mellitus and on drugs for the treatment of type 2 diabetes mellitus
Cholesterol-lowering : anti-cholesterol drugs are useful when the correction of eating habits and lifestyle is not enough to regulate the levels of "bad" cholesterol in the blood. The most commonly used drugs in therapy are statins, fibrates, niacin (in high doses), bile acid sequestering drugs and ezetimibe. Below are some examples:
- Simvastatin (eg. Zocor, Simvastat, Omistat, Quibus, Setorilin). The active ingredient belongs to the class of statins, drugs widely used for the treatment of high cholesterol. It is recommended to start the treatment for the treatment of hypercholesterolemia in the context of the metabolic syndrome with a dose of drug varying from 10 to 20 mg, to be taken orally, once a day. The maintenance dose is expected to take 5-40 mg of active, once a day, in the evening. Sometimes the drug is associated with other active ingredients, such as sitagliptin (eg Juvisync), useful for combating diabetes in the context of hypercholesterolemia, and ezetimibe (eg Vytorin).
- Gemfibrozil (eg Lopid, Genlip, Gemfibrozil DOC): in general, for the treatment of hypercholesterolemia in the context of the metabolic syndrome, the normally recommended posology is 600 mg of active, to be taken orally, twice a day, preferably 30 minutes before breakfast and dinner.
- Pravastatin (eg. Selectin, Langiprav, Sanaprav). Indicatively, for the treatment of hypercholesterolemia in the context of the metabolic syndrome, take the drug at a dose of 40 mg, orally, once a day. For the maintenance dose, it is possible to take 40-80 mg of the drug a day. Consult your doctor. The drug can also be formulated with other active ingredients, such as acetylsalicylic acid, antiplatelet agent: the two active exercise their therapeutic activity in synergy, both for the treatment of high cholesterol (pravastatin), and for treating and preventing ischemia and myocardial disorders.
For further information: see the article on drugs for the treatment of high cholesterol.
Smoking cessation drugs
It is well known that smoking is a wrong habit; yet, it seems that abandoning this habit is not among the good intentions of hardened smokers. However, the smoker who shows a marked propensity to the metabolic syndrome should stop smoking, since smoking increases the risk of cardiovascular disease. In case the patient is not able to abandon the habit, some drugs can be a valid help:
- Bupropion hydrochloride (eg. Elontril, Wellbutrin, Zyban): start the treatment by taking 150 mg of active oral, once a day. Maintenance dose: the dosage may increase up to 300 mg per day (given in two divided doses during the day), but not before three days from the start of therapy.
- Varenicline (eg Chapmix, 25-28-56 tablets): take 0.5 mg of active per os once a day in the first three days of smoking cessation treatment. From the 4th to the 7th day of therapy, increase the dose to 0.5 mg of active twice daily. From the eighth day on, take 1 mg of active twice a day.
- Nicotine-based smoking cessation patches (eg Nicopatch): generally, apply one patch a day, on dry, cleansed skin; the patch should be applied on the arm, or on an upper part of the body, always trying to position it at a different point, to avoid local irritation.
Anti-obesity drugs : obese patients who are unable to get benefits in reducing their body weight, can find help by taking some drugs. In fact, obesity is one of the risk factors for the metabolic syndrome. Orlistat and acarabose are two drugs particularly indicated to treat obesity in the context of the metabolic syndrome:
- Orlistat (eg Xenical, Alli): the drug (lipase inhibitor) is indicated as an adjunct to low-calorie diets: it is the drug of choice in the treatment of obesity, together with Sibutramine (until a few years ago). Indicatively, the drug should be taken at a dose of 120 mg, orally, three times a day, during the meal or no later than an hour after its end. It is recommended to take a multivitamin supplement (eg. Multicentrum, Supradyn, Be-Total Plus) in combination with orlistat: this drug, in fact, hinders the absorption of some essential nutrients and vitamins for its proper functioning.
- Acarbose (eg Glucobay, Glicobase): approximately, it is recommended to take half a tablet (corresponding to 50 mg) 3 times a day, together with the meal. The dosage should be changed progressively based on the patient's response to treatment. Consult your doctor. This drug is widely used to treat certain disorders of the metabolic syndrome, such as obesity and diabetes.
For further information: read the article on drugs for the treatment of obesity
