Anyone with metabolic syndrome should make every attempt to reduce their body weight to within 20% of their "ideal" body weight (calculated for age and height), and to incorporate aerobic exercise (at least 20 minutes) into their daily lifestyle. With vigorous efforts to reduce weight and increase exercise, metabolic syndrome can be reversed, and the risk for cardiovascular complications can be substantially improved.
How to treat metabolic syndrome is controversial. Because there are several potential markers, the public health community has struggled with the decision of how best to define, diagnose and treat it. Nutritional approaches have generally been downplayed in favor of multiple medications that target the individual markers. Conventional recommendations tend to emphasize caloric restriction and reduced fat intake, even though metabolic syndrome can best be described as carbohydrate intolerance. The most effective treatment for metabolic syndrome is to control the intake of carbs, not fat. In fact, restricting dietary fat and replacing it with carbohydrate actually makes many of the problems of metabolic syndrome worse. The metabolic syndrome paradigm has therefore caused a great deal of distress—and pushback—among those advocating low-fat diets. For more on how to prevent metabolic syndrome, see How to Reduce Your Risk for Metabolic Syndrome.
Forouzanfar MH, Alexander L, Anderson HR, et al, for the GBD 2013 Risk Factors Collaborators. Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 188 countries, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2015 Dec 5. 386 (10010):2287-323. [Medline].
Diabetes mellitus is a group of metabolic diseases characterized by high blood sugar (glucose) levels that result from defects in insulin secretion, or its action, or both. Diabetes mellitus, commonly referred to as diabetes (as it will be in this article) was first identified as a disease associated with "sweet urine," and excessive muscle loss in the ancient world. Elevated levels of blood glucose (hyperglycemia) lead to spillage of glucose into the urine, hence the term sweet urine.
Some cases of diabetes are caused by the body's tissue receptors not responding to insulin (even when insulin levels are normal, which is what separates it from type 2 diabetes); this form is very uncommon. Genetic mutations (autosomal or mitochondrial) can lead to defects in beta cell function. Abnormal insulin action may also have been genetically determined in some cases. Any disease that causes extensive damage to the pancreas may lead to diabetes (for example, chronic pancreatitis and cystic fibrosis). Diseases associated with excessive secretion of insulin-antagonistic hormones can cause diabetes (which is typically resolved once the hormone excess is removed). Many drugs impair insulin secretion and some toxins damage pancreatic beta cells. The ICD-10 (1992) diagnostic entity, malnutrition-related diabetes mellitus (MRDM or MMDM, ICD-10 code E12), was deprecated by the World Health Organization (WHO) when the current taxonomy was introduced in 1999.[53]
Diabetes mellitus (DM), commonly referred to as diabetes, is a group of metabolic disorders in which there are high blood sugar levels over a prolonged period.[10] Symptoms of high blood sugar include frequent urination, increased thirst, and increased hunger.[2] If left untreated, diabetes can cause many complications.[2] Acute complications can include diabetic ketoacidosis, hyperosmolar hyperglycemic state, or death.[3] Serious long-term complications include cardiovascular disease, stroke, chronic kidney disease, foot ulcers, and damage to the eyes.[2]
Measuring BP takes into account two pressures, measured in millimeters of mercury (mm Hg). The first, systolic pressure, is the force exerted on the blood vessel walls when the heart is pumping blood. Diastolic pressure reflects the force present when the heart relaxes between beats. They are written as systolic over diastolic pressure. For instance, a blood pressure of 120/80 mm Hg or 120 over 80 corresponds to a systolic pressure of 120 and a diastolic pressure of 80.

These calorie counting fanatics are either unaware, or don’t want you to know about what we call the law of metabolic compensation. This law dictates that your metabolism is not like a calculator at all but more like a thermostat or see-saw. You eat less and exercise more to burn calories, and your body compensates by making you more hungry while at the same time decreasing the amount of calories you burn at rest (resting energy expenditure or REE).
In 1977 and 1978, Gerald B. Phillips developed the concept that risk factors for myocardial infarction concur to form a "constellation of abnormalities" (i.e., glucose intolerance, hyperinsulinemia, hypercholesterolemia, hypertriglyceridemia, and hypertension) associated not only with heart disease, but also with aging, obesity and other clinical states. He suggested there must be an underlying linking factor, the identification of which could lead to the prevention of cardiovascular disease; he hypothesized that this factor was sex hormones.[66][67]
As waistlines expand, so does the epidemic of metabolic syndrome. It’s estimated that nearly one of every four American adults has this condition(1). If you’re one of them, it puts you on the track to developing type 2 diabetes and triples your risk for heart disease down the road. The identification of metabolic syndrome two decades ago(2) is now recognized as a turning point in our understanding of how metabolism can go awry, resulting in obesity, diabetes and cardiovascular disease.
Hypertension is defined as elevated blood pressure and is the leading cause globally of death and disability. It is the major risk factor for heart attack and stroke, and is also a significant risk factor for for chronic kidney disease and chronic heart failure. Because individuals with hypertension usually don’t have any symptoms, it is a disease that is often under-diagnosed. Diagnosis relies upon routine blood pressure screening to monitor and detect affected individuals.
Type 2 diabetes, a form of diabetes mellitus, is likely one of the better-known chronic diseases in the world — and that's no surprise. Data from the Centers for Disease Control and Prevention suggest in the United States alone, 30.3 million people, or 9.4 percent of the U.S. population, has diabetes, and the majority of these people have type 2. (1)

Hypertension may be primary, which may develop as a result of environmental or genetic causes, or secondary, which has multiple etiologies, including renal, vascular, and endocrine causes. Primary or essential hypertension accounts for 90-95% of adult cases, and a small percentage of patients (2-10%) have a secondary cause. Hypertensive emergencies are most often precipitated by inadequate medication or poor compliance.

Anteroposterior x-ray from a 28-year old woman who presented with congestive heart failure secondary to her chronic hypertension, or high blood pressure. The enlarged cardiac silhouette on this image is due to congestive heart failure due to the effects of chronic high blood pressure on the left ventricle. The heart then becomes enlarged, and fluid accumulates in the lungs, known as pulmonary congestion.
Insulin is vital to patients with type 1 diabetes - they cannot live without a source of exogenous insulin. Without insulin, patients with type 1 diabetes develop severely elevated blood sugar levels. This leads to increased urine glucose, which in turn leads to excessive loss of fluid and electrolytes in the urine. Lack of insulin also causes the inability to store fat and protein along with breakdown of existing fat and protein stores. This dysregulation, results in the process of ketosis and the release of ketones into the blood. Ketones turn the blood acidic, a condition called diabetic ketoacidosis (DKA). Symptoms of diabetic ketoacidosis include nausea, vomiting, and abdominal pain. Without prompt medical treatment, patients with diabetic ketoacidosis can rapidly go into shock, coma, and even death may result.