Type 2 Diabetes and Metabolic Syndrome

It’s the month of November and we are shining the PLMI spotlight on a worldwide epidemic — type 2 diabetes and metabolic syndrome. There is probably no better condition that warrants a personalized approach than metabolic syndrome, which has a multitude of presentations of at least three of these five criteria including: high triglycerides, high blood sugar, increased waist circumference, low HDL, and elevated blood pressure. An individual could have the first three, the last three, or all of them, and still have metabolic syndrome. Thus, the diagnosis is highly personalized, as is an individual’s lifestyle. It has been said that metabolic syndrome is a gene-environment mismatch – our genes haven’t changed, but the environment they are in makes them express in such a way to present with a metabolic disturbance which sets the stage for a multitude of chronic conditions including cardiovascular disease, dementia, and cancer, to name a few.
So what can personalized lifestyle medicine do to help?
We certainly know that lifestyle intervention can be helpful to those with metabolic dysfunction. In a New England Journal of Medicine study published in 2002, 3234 nondiabetic persons with elevated fasting and post-load plasma glucose concentrations were randomized to placebo, metformin, or a lifestyle-modification program. The authors concluded that “the lifestyle intervention was more effective than metformin.” That’s right – lifestyle reduced incidence of diabetes by 58% and metformin by 31% compared with placebo. A very promising study.
If we think of personalized lifestyle modification as including diet, nutritional supplements, stress reduction, and reduction of toxin load, there are many findings that relate to metabolic syndrome and Type 2 diabetes. For many years, we have been talking of the necessity of a personalized diet. Fortunately, the American Diabetes Association just published their therapeutic nutritional recommendations in October stating that there is no “one-size-fits-all” approach to diabetes. Of course, we were happy to hear that this opinion leader organization has recognized the value of individualization.

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