A WORKING DRAFT ON - Diabetes India



FROM ACADEMIC GUIDELINES TO CLINICAL CARE

A WORKING DRAFT ON

“ PRACTICAL GUIDELINES FOR THE MANAGEMENT OF THE

METABOLIC SYNDROME: AN INDIAN SCENARIO”

Section 1

DIAGNOSIS

The Metabolic Syndrome is a cluster or collection of risk factors which predispose a person to Type 2 diabetes mellitus (T2DM) and/or cardiovascular disease (ASCVD).

The clinical utility of the syndrome for risk assessment lies in its ability to readily identify individuals who are at a relatively high, long-term risk for both ASCVD and T2DM. All such individuals should undergo absolute risk assessment to determine whether they are candidates for preventive drug therapies. But once found to have the metabolic syndrome, they deserve more intensive intervention with lifestyle approaches even in the absence of pharmaceutical interventions.

There are two sets of diagnostic criteria which are in general use: the International Diabetes Federation (IDF) criteria and the American heart Association (AHA)/ National Heart, Lung, and Blood Institute (NHLBI) (updated ATP-III) definition.

|IDF clinical criteria for metabolic syndrome |

|[pic] |

|AHA/NHLBI diagnostic criteria for metabolic syndrome |

|[pic] |

| |

|Measure (central obesity sine qua non plus any two of four other criteria constitute a diagnosis of metabolic syndrome) |

|Categorical cut points |

|Measure (any three of the five criteria below constitute a diagnosis of metabolic syndrome) |

|Categorical cut points |

| |

|[pic] |

| |

|Central obesity |

|Waist circumference ethnic specific |

|([pic]90 cm for men and [pic]80 cm for women) for Indian subjects |

|Elevated waist circumference |

|General U.S. population: [pic]102 cm ([pic]40 in) in men, [pic]88 cm ([pic]35 in) in women; lower cut points for insulin-resistant |

|individuals or ethnic groups (based on clinical judgment) |

| |

|Raised triglycerides |

|>150 mg/dl (1.7 mmol/l) or on specific treatment for this lipid disorder |

|Elevated triglycerides |

|[pic]150 mg/dl (1.7 mmol/l) or on drug treatment for elevated triglycerides |

| |

|Reduced HDL cholesterol |

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