BOMA

Metabolic Syndrome

By: Mats Bonnier Physician, Specialist of General Practice, Internal Medicine, Diabetes and Endocrinology.I will post some PMs and guidelines I have used over the years. They must be used for the intended problems and diagnosis.Therefore, all material on this site is used on your own responsibility.

Medical Reflections

Chemists and physiologists studying human diets found that it needed <a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Protein">proteins</a>, <a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Fat">fats</a>, <a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Starch">starches</a> and <a target="_blank" rel="noopener noreferrer nofollow" href="http://sugars.It">sugars.</a>It was also realized that the body needed variety of other necessities.The word vitamins: <a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Casimir_Funk">Casimir Funk</a>, a biochemist born in Poland moved to London in 1910. He was one of many scientists trying to isolating the factor in rice polishings that protected the development of <a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Thiamine_deficiency">beriberi</a>.In the following year, he reported that he had isolated the active factor. This was, in fact, incorrect but he then went on to suggest that this material belonged to the chemical class of “amines. So the name is a combination of Vital and amines, <a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Vitamin">Vitamin</a>.

Discovery of Vitamins

According to Google AI, <a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Hormone">hormones</a> are defined as: -a regulatory substance produced in an organism and transported in tissue fluid such as blood or sap to stimulate specific cells or tissues into action.. The definition I got in medical school: 1. Produced in small amounts in one place. 2. Transported by body fluids. 3. Has effects om most of all body cells. It can also be added: Target cells convey the hormone message by specific <a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Hormone_receptor">hormone receptors</a>. This is very important as there are obviously hormone receptors on body cells for hormones we know very little about, e.g <a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/C-peptide">C-peptide</a>..Most hormones are transported inactive in body fluids by carrier proteins. These proteins are mostly produced in the liver, e.g <a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Sex_hormone-binding_globulin">SHBG</a>, <a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Transcortin">CBG</a>, <a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Thyroxine-binding_globulin">TBG.</a>

Hormones

The adrenal glands Are found above the kidneys and produce a variety of hormones. Each gland has an outer <a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Adrenal_cortex">Cortex</a> which produces <a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Steroid_hormone">Steroid hormones</a> an inner part (<a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Adrenal_medulla">medulla)</a> which secretes <a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Catecholamine">Catecholamines</a> (e.g <a target="_blank" rel="noopener noreferrer nofollow" class="mw-redirect" href="https://en.wikipedia.org/wiki/Epinephrine">adrenaline</a>, <a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Norepinephrine">nor-adrenaline</a> and <a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Dopamine">dopamine</a>).Adrenal Hormones produced by: Cortex (Steroid hormones) <a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Mineralocorticoid">Mineralocorticoids</a> (e.g <a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Aldosterone">aldosterone</a>) help in the regulation of blood pressure and <a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Osmoregulation">electrolyte balance</a>. <a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Glucocorticoid">Glucocorticoids</a> (<a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Cortisol">cortisol</a> and <a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Cortisone">cortisone</a>) functions include regulation of <a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Metabolism">metabolism</a> and <a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Immune_system">immune system</a> suppression. <a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Steroid_hormone">Androgens</a> are converted into fully functional sex hormones in the <a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Gonad">gonads</a> and other target organs. Medulla (Catecholamines) <a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Epinephrine">Adrenaline, </a><a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Norepinephrine">Nor-adrenaline</a> (<a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Stress_hormone">Stress hormones</a>) <a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Dopamine">Dopamine (</a><a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Neurotransmitter">Neurotransmitters</a>)<a target="_blank" rel="noopener noreferrer nofollow" href="https://www.nobelprize.org/prizes/medicine/1937/szent-gyorgyi/facts/">Szent-Gyorgyi </a>was researching the adrenal glands, he discovered an unknown <a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Antioxidant">antioxidant</a> that was released from the adrenal glands and <a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Pituitary_gland">Pituitary gland</a> synchronously with <a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Adrenocorticotropic_hormone">ACTH</a> and <a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Cortisol">cortisol. </a>This antioxidant was later found to be <a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Vitamin_C">Vitamin C</a>.

Title: Kidneys and the adrenal glands Creator: Wetselaar-Whittaker, J Date: 1988-08-31 Providing institution: Universitaire Bibliotheken Leiden Aggregator: Dutch Collections for Europe Providing Country: Netherlands Public Domain Kidneys and the adrenal glands by Wetselaar-Whittaker, J - Leiden University Libraries, Netherlands - Public Domain. https://www.europeana.eu/item/744/item_3462131

Adrenal glands

<a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Insulin">Insulin</a> is produced in the pancreas as inactive <a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Proinsulin">pro-insulin</a>. When it is releases into the blood stream, <a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/C-peptide">C-peptide</a> "cuts off", and it becomes active insulin and free C-peptide.There are very few and small studies of "normal" insulin productions/levels. One from 1960 (1) and a few more (2,3,4)The reason why it is so few studies is because insulin is very short acting compared to "indirect methods". e.g C-peptide, Pro-insulin and more.-so these "normal" insulin levels seem to rest on very fragile basic facts..References 1. Diabetes 1960: <a target="_blank" rel="noopener noreferrer nofollow" href="https://diabetesjournals.org/diabetes/article/9/4/254/16938/Plasma-Insulin-Concentrations-in-Nondiabetic-and">Diabetes Plasma Insulin Concentrations in Nondiabetic and Early Diabetic Subjects</a> 2. Am J Phys 1988: <a target="_blank" rel="noopener noreferrer nofollow" href="https://pubmed.ncbi.nlm.nih.gov/3284381/">Effects of lack of exercise on insulin secretion and action in trained subjects</a> 3.J Clin Invest 1988: <a target="_blank" rel="noopener noreferrer nofollow" href="https://pubmed.ncbi.nlm.nih.gov/3276730/">Twenty-four-hour profiles and pulsatile patterns of insulin secretion in normal and obese subjects</a> 4. N Engl J Med 1988: <a target="_blank" rel="noopener noreferrer nofollow" href="https://pubmed.ncbi.nlm.nih.gov/3283554/">Abnormal patterns of insulin secretion in non-insulin-dependent diabetes mellitus</a>

Insulin

Most common reasons are <a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Thyroid_peroxidase">Thyroid peroxidase (</a>TPO) antibodies-induced <a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Hashimoto%27s_thyroiditis">autoimmune thyroiditism </a>or surgical removed thyroid gland because av some reasons (e.g thyroid cancer and severe <a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Graves%27_disease">Graves disease, </a>especially to limit <a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Exophthalmos">exophthalmos</a> symptoms). Hypothyroidism symptoms: e.g freezes, fatigue, muscle aches, constipation, slow heart rate, depression and weight gain due to <a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Edema">edema</a>.Hormones <a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Thyroid-stimulating_hormone">TSH</a> : is a <a target="_blank" rel="noopener noreferrer nofollow" class="mw-redirect" href="https://en.wikipedia.org/wiki/Pituitary_hormone">pituitary hormone</a> that stimulates the thyroid gland produce thyroid hormones. Thyroid hormones: <a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Thyroxine">T4</a> and <a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Triiodothyronine">T3</a>. T4 is converted to T3 which is the most active hormone that stimulates metabolism.Treatment Hypothyroidism will be treated with T4 (<a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Levothyroxine">levo-thyroxine</a>) which converts to T3. Treatment targets and execution: TSH control every 3th months: -Thyroiditis: A steady state TSH: around 1.0 mIU/L. -Surgical removed thyroid gland: Sub-toxic TSH: around lower normal range, approximately 0,3 mIU/L.It takes 3 months or more until TSH reach steady state but the clinical effects of changes Levo-thyroxine doses comes in a few days..

Hypothyroidism

<a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Physical_activity">Physical activity</a> enhances or maintains fitness and overall health.Physical activity are generally grouped into three types: -<a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Aerobic_exercise">Aerobic exercise</a> as cycling, brisk walking, dancing and more. The goal of aerobic exercise is to increase cardivoascular endurance. -<a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Anaerobic_exercise">Anaerobic exercise</a> is exercise that breaks down glucose without using oxygen as weight training, sprinting, interval training and more. It may be used to help build endurance, muscle strength and power. -<a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Flexibility_(anatomy)">Flexibility exercises</a> stretch and lengthen muscles. The goal is to improve the range of motion which can reduce the chance of injury.Physical activity improve physical and mental health as well as cognitive and cardiovascular health. Physical activity prevent diabetes, <a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Obesity">obesity</a>, <a target="_blank" rel="noopener noreferrer nofollow" href="https://diabetesjournals.org/spectrum/article/38/1/23/157816/The-Interconnected-Complexity-of-Diabetes-and">depression</a> <a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Cardiovascular_disease#Risk_factors">cardiovascular risk factors</a> and <a target="_blank" rel="noopener noreferrer nofollow" href="https://pmc.ncbi.nlm.nih.gov/articles/PMC8616213/">different cancers</a> by improving the <a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/C-reactive_protein#Cardiovascular_disease">inflammatory status</a>, <a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Insulin_resistance">insulin resistance</a> and energy metabolism.

Physical Activity

<a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Health_effects_of_sunlight_exposure">Sunlight (UV-radiation) presents both positive and negative health effects</a>. Acute exposure can lead to painful sunburns and increase the likelihood of developing serious skin conditions later in life. Prolonged exposure is associated with the development of <a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Skin_cancer">skin cancers</a>, premature skin aging and eye diseases like <a target="_blank" rel="noopener noreferrer nofollow" class="mw-redirect" href="https://en.wikipedia.org/wiki/Cataracts">cataracts.</a> On the positive side, sunlight enables the synthesis of <a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Vitamin_D">vitamin D</a> and potentially plays a role in inhibiting certain cancers. Sunlight improves <a target="_blank" rel="noopener noreferrer nofollow" class="mw-redirect" href="https://en.wikipedia.org/wiki/Endorphin">endorphin</a><a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Endorphin"> levels</a>, reduces the risk of seasonal affective disorder, exposure to visible light also supports <a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Melatonin">melatonin synthesis</a> and therefore maintains <a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Circadian_rhythm">circadian rhythms</a>.Time of day, of year, geographic latitude, ground altitude, skin <a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Melanin">melanin</a> content are among the factors that greatly affect <a target="_blank" rel="noopener noreferrer nofollow" class="mw-redirect" href="https://en.wikipedia.org/wiki/UV_Index">UV intensity</a> and vitamin D synthesis. It has been suggested adequate amounts of vitamin D produces with moderate sun exposure to the face, arms and legs 5–30 minutes twice per week without sunscreen. Vitamin D overdose is impossible from UV exposure.

Sunlight and health

A Johnson & Johnson vaccine vial with two syringes.

Diabetes complications

Background facts

Detail of stethoscope. Doctor woman with white coat and stethoscope.

-diabetesbehandling är ett okänt hantverk....

Gallery

Doctor Holding Cell Phone. Cell phones and other kinds of mobile devices and communications technologies are of increasing importance in the delivery of health care. Photographer Daniel Sone  

Stethoscope and Laptop Computer. Laptop computers and other kinds of mobile devices and communications technologies are of increasing importance in the delivery of health care. Photographer Daniel Sone  

Does daily routines matter for our health?

-hyperglycemia should´t be an emergency case, it should be prevented...

A details of a shop inside Mercado de La Boqueria, in Barcelona.

Vitamins

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BOMA provided me with exceptional healthcare services during a challenging time. The staff was highly professional, and the care I received was top-notch.

Reviews

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<ul><li>Diabetes 1960: <a target="_blank" rel="noopener noreferrer nofollow" href="https://diabetesjournals.org/diabetes/article/9/4/254/16938/Plasma-Insulin-Concentrations-in-Nondiabetic-and">Diabetes Plasma Insulin Concentrations in Nondiabetic and Early Diabetic Subjects</a></li><li>Am J Phys 1988: <a target="_blank" rel="noopener noreferrer nofollow" href="https://pubmed.ncbi.nlm.nih.gov/3284381/">Effects of lack of exercise on insulin secretion and action in trained subjects</a></li><li>J Clin Invest 1988: <a target="_blank" rel="noopener noreferrer nofollow" href="https://pubmed.ncbi.nlm.nih.gov/3276730/">Twenty-four-hour profiles and pulsatile patterns of insulin secretion in normal and obese subjects</a></li><li>N Engl J Med 1988: <a target="_blank" rel="noopener noreferrer nofollow" href="https://pubmed.ncbi.nlm.nih.gov/3283554/">Abnormal patterns of insulin secretion in non-insulin-dependent diabetes mellitus</a></li><li>Nobelprize.org: <a target="_blank" rel="noopener noreferrer nofollow" href="https://www.nobelprize.org/prizes/themes/the-nobel-prize-and-the-discovery-of-vitamins/">The Nobel Prize and the discovery of vitamins</a></li><li>Oral Dis 2016: <a target="_blank" rel="noopener noreferrer nofollow" href="https://pubmed.ncbi.nlm.nih.gov/26808119/">Vitamin C: the known and the unknown and Goldilocks</a></li><li>Cancers (Basel). 2021: <a target="_blank" rel="noopener noreferrer nofollow" href="https://pmc.ncbi.nlm.nih.gov/articles/PMC8616213/">Diabetes and Cancer: Risk, Challenges, Management and Outcomes</a></li><li>ADA 2025: <a target="_blank" rel="noopener noreferrer nofollow" href="https://diabetesjournals.org/spectrum/article/38/1/23/157816/The-Interconnected-Complexity-of-Diabetes-and">The Interconnected Complexity of Diabetes and Depression.</a></li><li>Environmental Health Perspectives: <a target="_blank" rel="noopener noreferrer nofollow" href="https://ehp.niehs.nih.gov/doi/10.1289/ehp.116-a160">Benefits of Sunlight: A Bright Spot for Human Health</a></li><li>Cleveland Clinic:<a target="_blank" rel="noopener noreferrer nofollow" href="https://health.clevelandclinic.org/how-much-sunshine-you-need-daily">The Health Benefits of Sunshine (and How Much You Need Per Day)</a></li><li>Cancer Research. 2005 (12): 5470–5479:<a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Health_effects_of_sunlight_exposure#cite_note-2">Sun exposure, vitamin D receptor gene polymorphisms, and risk of advanced prostate cancer</a></li><li>Nutrients. 2019:<a target="_blank" rel="noopener noreferrer nofollow" href="https://pmc.ncbi.nlm.nih.gov/articles/PMC6520689/">The Influence of Meal Frequency and Timing on Health in Humans: The Role of Fasting</a>.</li><li>Nutrients 2023:<a target="_blank" rel="noopener noreferrer nofollow" href="https://www.mdpi.com/2072-6643/15/9/2183">Circadian Clock and Nutrition.</a></li><li>Int J Mol Sci. 2023:<a target="_blank" rel="noopener noreferrer nofollow" href="https://pmc.ncbi.nlm.nih.gov/articles/PMC9916946/">Chrono-Nutrition: Circadian Rhythm and Personalized Nutrition.</a></li><li>J Intern Med2019:<a target="_blank" rel="noopener noreferrer nofollow" href="https://pubmed.ncbi.nlm.nih.gov/31081577/">The Circadian Syndrome: is the Metabolic Syndrome and much more!</a></li><li>Tzu Chi Med J2019:<a target="_blank" rel="noopener noreferrer nofollow" href="https://pubmed.ncbi.nlm.nih.gov/31007484/">Molecular basis for the association between depression and circadian rhythm</a>.</li><li>Diabetes Care:<a target="_blank" rel="noopener noreferrer nofollow" href="https://professional.diabetes.org/standards-of-care">Standards of Medical Care in Diabetes Mellitus</a>.</li><li>American Diabetes Associations: <a target="_blank" rel="noopener noreferrer nofollow" href="https://diabetes.org/about-diabetes/complications">Diabetes Complications</a></li><li>J Diabetes Investig. 2016: <a target="_blank" rel="noopener noreferrer nofollow" href="https://pmc.ncbi.nlm.nih.gov/articles/PMC5009124/">Diabetes and shoulder disorders</a></li><li>J Clin Med. 2022: <a target="_blank" rel="noopener noreferrer nofollow" href="https://pmc.ncbi.nlm.nih.gov/articles/PMC8952414/">Carpal Tunnel Syndrome and Diabetes—A Comprehensive Review</a></li><li>Front Endocrinol (Lausanne). 2024: <a target="_blank" rel="noopener noreferrer nofollow" href="https://pmc.ncbi.nlm.nih.gov/articles/PMC11022848/">The association between diabetes mellitus and musculoskeletal disorders: a systematic review and meta-analysis</a></li><li>Primary Care Diabetes 2022: <a target="_blank" rel="noopener noreferrer nofollow" href="https://www.sciencedirect.com/science/article/pii/S1751991823001419">Diabetes mellitus-related musculoskeletal disorders: Unveiling the cluster of diseases</a></li><li>Front. Physiol. 2018: <a target="_blank" rel="noopener noreferrer nofollow" href="https://www.frontiersin.org/journals/physiology/articles/10.3389/fphys.2018.00112/full">Obesity, Metabolic Syndrome, and Musculoskeletal Disease: Common Inflammatory Pathways Suggest a Central Role for Loss of Muscle Integrity</a></li></ul>

References

Bakgrund <a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Metabolic_syndrome#">Metabola Syndromet</a> anses vara orsaken till,alternativt vara orsakat av, <a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Insulin_resistance">insulinresistens</a> och även vara förstadiet till metabol Diabetes (<a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Prediabetes">pre-diabetes</a>) vilket in sin tur orsakar hjärt-kärlsjukdom. I USA anses ungefär 25% av hela befolkningen lida av det metabola syndromet eller metabol diabetes, (typ 2 diabetes) och ungefär 60% av befolkningen över 50 år. <a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Insulin_resistance">Insulin resistens</a>, <a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Metabolic_syndrome#">metabola syndromet</a> samt <a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Prediabetes">pre-diabetes</a> är i stor sett synonymer men ändå finns en turorning i jnsjuknandet som varierar från individ till individ. Skillnaden mellan typ 2 diabetes och metabola syndromet är blodsocker-förhöjningen (bukspottkörteln orkar helt enkelt inte producera tillräckligt stor mängd insulin för att hålla blodsockret "normalt")och därmed ökar därmed riskerna ytterligare för de metabola komplikationerna. Metabola syndromet är ett kluster av minst tre av följande medicinska symtom: <a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Abdominal_obesity">bukfetma</a>, <a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Hypertension">högt blodtryck</a>, <a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Hyperglycemia">förhöjt blodsocker</a>, <a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Hypertriglyceridemia">höga triglycerider</a>, och/eller lågt <a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/High-density_lipoprotein">HDL-kolesterol</a> där bukfetaman anses vara det centrala.Riskfaktorer för det Metabola Syndromet genetik, <a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Epigenetics">epi-genetik, </a>låg fysisk aktivitet, tobaksbruk, högt intag av så kallad <a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Western_pattern_diet#Diabetes">Western pattern diet</a> och småätande.Komplikationer till det metabola Syndromet Metabola Syndromet har många kända och sannolikt även okända komplikationer så som: <a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Type_2_diabetes">typ-2 diabetes</a>, <a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Cardiovascular_disease">hjärt-kärlsjukdomar</a>, njur- och leversjukdomar samt flera typer av maligniteter (1). <a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Metabolic_dysfunction%E2%80%93associated_steatotic_liver_disease">Metabolic dysfunction–associated steatotic liver disease</a> (MASLD) is a type of chronic liver inflammation that leads to insulin resistance and fatty liver. Insulin resistance contributes to the accumulation of toxic fat in the liver in several ways. Metabolic syndrome and Insulin resistance causes systemic <a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Inflammation">inflammation</a>, including <a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/C-reactive_protein">C-reactive protein</a>, <a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Insulin-like_growth_factor_1">IGF-1</a>, <a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Fibrinogen">fibrinogen</a>, <a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Interleukin_6">interleukin 6</a>, <a target="_blank" rel="noopener noreferrer nofollow" class="mw-redirect" href="https://en.wikipedia.org/wiki/Tumor_necrosis_factor-alpha">tumor necrosis factor-alpha</a>&nbsp;(TNF-α), and others are often increased. This inflammation leading to low levels of <a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Sex_hormone-binding_globulin">Sex Hormone Binding Globulin (SHBG)</a>, which is compensated by the gonads producing less sex hormones, which in turn leads to a normal sex hormone/SHBG ratio. Because these low total levels of sex hormones cause women to have more masculine traits and men to have more feminine traits, because the adrenal glands produce small amounts of all sex hormones. Other associated conditions include <a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Hyperuricemia">hyperuricemia</a>, <a target="_blank" rel="noopener noreferrer nofollow" class="mw-redirect" href="https://en.wikipedia.org/wiki/Polycystic_ovarian_syndrome">polycystic ovarian syndrome</a> and <a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Erectile_dysfunction">erectile dysfunction</a>. It is not uncommon for patients to experience a hormonal imbalance with fibromyalgia-like symptoms and to insist on overdoses of various hormones, such as thyroid hormone and testosterone. A contributing factor to this may be that most hormone carrier proteins (e.g thyroid hormone and <a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Sex_hormone-binding_globulin">SHBG</a>) are formed in the liver and are likely affected by insulin resistance and fatty liver. There is very little research on this and it needs to be investigated further.Treatment of Metabolic Syndrome The aim of such treatment is to achieve permanent weight loss with as few side effects as possible. There are many "miracle cures" for rapid weight loss, but virtually none of them have any long-term follow-up. Various surgical procedures are practically impossible to carry out on a population basis and there is little long-term follow-up. Initially, patients experience significant weight loss and improved risk factors, but also experience various deficiency symptoms fairly immediately. I have had a handful of patients who up to 40 years after such a procedure, still having trouble with postprandial hypoglycemia they have to compensate for with fast carbohydrates. When I have mentioned this to other patients they recognize these symptoms, probably there may be a pretty large hidden number. Far from everyone is satisfied after such a procedure and the result on weight is not impressive either. Those I have met, several years after such procedure, have gone from having a severe obesity to a more mildly obesity. <a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Incretin">Incretins</a> Cause weight loss, but we don't know much about the long-term effects. Many of the "risk factors" for metabolic diseases and for death are improving by both surgical intervention and incretins. But the "risk factors" are not a direct "link" of metabolic diseases and death, but an indication. My opinion is that long-term studies are needed before we can use incretins and surgical intervention as treat and preventions metabolic diseases complication and death.. <a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Metformin">Meformin</a> Is an old diabetes drug that has been used since the 1950s, where many of the "new" diabetes drugs often originate. Metformin is no longer patented, which may be the reason why industry cannot/does not want to research this. Despite this, Metformin is gaining more and more indications. Metformin is nowadays the first-line treatment for type 2 diabetes and gestational diabetes. It is also uses as a complement in the treatment of certain cancers and last but not least, it is also indicated in many countries for weight reduction purposes. The advantage of Metformin is that since it has been used since the 1950s, there is very good knowledge about its long-term effects.Behandling av det Metabola Syndromet Beroende på hur patienten kommer till mig försöker jag designa en behandling för den enskilda patienten. Många är övertygade om att de lider av någon hormon brist. Hos kvinnor ofta sköldkörtelhormon och hos män ofta Testosteron.For these people, I usually do a hormone screening with C-peptide, thyroid hormones, cortisol, growth hormone and testosterone/SHBG. At the next visit we will go over these answers. In women it usually happens that all the tests are good but testosterone/SHBG is elevated. Then I say that everything looks good but you have a little too much testosterone. In men I say that everything looks good but you have a little too little SHBG which is why your testicles compensate by reducing their production of testosterone. Then I go into the fact that the cause is due to fatty liver and insulin resistance and the cure is to reduce insulin resistance.Primary target, Insulin Resistance The best is physical activity which is twice as good as Metformin. Since we took C-peptide at the first visit, we start by recommending physical activity for 20 minutes daily. At the return visit, we check C-peptide again, which has then decreased significantly, which gives positive feedback. We start by recommending a 20-minute walk daily, which some claim they are unable to do due to the strain of their excess weight. The second choice is cycling and/or swimming, as the burden of excess weight becomes significantly less. Even then some claim that it is not possible. My answer then is: -it is very unfortunate if you are not capable of physical activity as the prognosis deteriorates considerably.. what do you think about starting with 10 minutes daily instead? Intake and energy Energy requirements to achieve a normal weight when working in a low energy consumption environment: A woman about 1600 kcal/day and a man about 1800 kcal/day. Under that energy restriction, you should get all the nutrients you need. It's not that easy... My strategies Self-care 1. Regular physical exercise as described in the "Background facts". Before starting the regular physical activity I normally use to take a test, or some tests, of the insulin resistance/productions e.g: <a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/C-peptide">C-peptide</a> and/ or <a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Insulin-like_growth_factor_1">IGF-1</a>. At the return visit, for an initial positive feedback, these samples are checked again which has decreased significantly.2.Regular meal schedule as described in the "Background facts": with 2-3 meals/day and long fasting periods in between. 2. Beverage: water, possibly flavored with a slice of orange or lemon. 3. No sweets or snacking between meals and a long overnight fast. Medical treatment Since <a target="_blank" rel="noopener noreferrer nofollow" href="https://en.wikipedia.org/wiki/Metabolic_syndrome">Metabolic syndrome</a>, or as it is also called pre-diabetes, is a "light variant" of Type 2 diabetes, the main target is obesity/overweight. If self-care does not have sufficient effects, I usually start with a cautious introduction of Metformin 500 mg at a time, which is increased by 500 mg/month up to the full dose. If the overweight is significant, GLP-1 analogues can be used in combination with metformin on obesity indications. I have never, so far, prescribed surgical procedures to anyone, but have had (more than one patient) with poor long-term outcomes. I have not yet seen any studies on what effect it has on long-term complications and death.<ul><li>Experimental Gerontology: <a target="_blank" rel="noopener noreferrer nofollow" href="https://www.sciencedirect.com/science/article/pii/S0531556525001317">Metabolic syndrome and cancer risk: A bidirectional two-sample Mendelian randomization study</a></li><li>BMC Endocr Disord. 2025: <a target="_blank" rel="noopener noreferrer nofollow" href="https://pmc.ncbi.nlm.nih.gov/articles/PMC11951830/">Relationship between tobacco smoking and metabolic syndrome: a Mendelian randomization analysis</a></li><li>Arch Rheumatol 2020: <a target="_blank" rel="noopener noreferrer nofollow" href="https://pmc.ncbi.nlm.nih.gov/articles/PMC8140867/">Coexistence of fibromyalgia and metabolic syndrome in females: The effects on fatigue, clinical features, pain sensitivity, urinary cortisol and norepinephrine levels: A cross-sectional study</a><a target="_blank" rel="noopener noreferrer nofollow" href="https://pmc.ncbi.nlm.nih.gov/articles/PMC11951830/"> </a></li></ul>