'TLC' for better health

Posted Tuesday, July 8, 2003 - 7:09 pm

By Mike Foley STAFF WRITER
mfoley~greenvillenews.com

link to article

It was a brief mention on television, but it got Connie Geter's attention. Now she hopes it changes her life.

Robyn Zimmerman, spokeswoman for the Greenville Hospital System, was onscreen for a "Medical Minute" session on Metabolic Syndrome, a cluster of health disorders that predicts a person will get Type II diabetes and likely heart disease.

"I always listen to those," Geter said about the GHS commercials. "And I already was a little concerned about my health. When I saw that on TV, it was like a signal, like a witness, to go ahead and get something done."

The Greenville resident needed to lose weight. So she made an appointment with the Metabolic Syndrome Program and became its first patient.

Dr. Sloan Martin, co-director of the Metabolic Syndrome Program at GHS, said giving people "TLC" — therapeutic lifestyle changes — which include losing weight by eating right and exercising, is key to preventing people from future disease.

"If someone has this Metabolic Syndrome, and they will get their weight down, you can very effectively treat these folks and prevent the onset of diabetes, or at least delay it considerably," Martin said.

Syndrome X

As early as age 30, many people begin to feel sluggish — physically and mentally — after they eat and at other times during the day. As the years go by, they gain weight and have a harder time losing it. Their blood pressure creeps up and cholesterol, triglycerides and blood sugar levels increase, too.

They might just figure they're getting old.

A little more than a decade ago, a group of researchers at Stanford University called this cluster of symptoms Syndrome X. They found the symptoms appeared together in many individuals and increased their risk for diabetes and heart disease.

Other physicians and researchers began studying the syndrome, now commonly dubbed Metabolic Syndrome, and found the nation as a whole in dire risk.

"This is one of the biggest topics in the country, even all over the world," Martin said. "This is the coming wave."

The national Centers for Disease Control in Atlanta says 47 million American adults may already have Metabolic Syndrome, making huge numbers of them likely to succumb to heart disease and Type II diabetes, and eventually die from complications.

Lee Rice, a registered nurse and clinical coordinator at GHS Metabolic Syndrome Program, said the idea is to catch those who are in "pre-diabetes" to try and help them avoid it.

Geter, at age 48, said she didn't know anything about Metabolic Syndrome. She just didn't feel good.

"My blood pressure is high, I have a distended abdomen, I carry almost all my weight there," she said. "My cholesterol, one of them was good, one was bad. I wasn't sure about my triglycerides, I hadn't had them done in about two years.

"I recognized the signals. I know my body and I know me, and I don't like the way I feel right now."

Getting help

The key to reducing the likelihood of Type II diabetes and heart disease due to Metabolic Syndrome is often as simple as losing a few pounds, or in some case, more than a few.

"We talk about a 5 to 10 percent weight loss," Rice said. "You've got to go in doable, baby steps. Many people, their goals are so lofty and so unattainable, that they just give up.

"We want to rein in expectations, let them have little goals, because nothing succeeds like success."

Most people have to go on a diet, Martin said, but nothing strict like the Atkins diet.

"What we're trying to do is reduce the amount of simple carbohydrates and sugars in the diet," he said.

Individuals meet with Sloan and Rice to review their medical history. Then they meet with a dietitian to establish a sane eating plan. And they schedule time with an exercise physiologist to learn how to burn off calories.

They're also invited to attend any of nine monthly classes on nutrition, stress, exercise and health taught at GHS.

"It's nothing but common sense," Martin said about the program.

But there are difficulties. Hispanics, African Americans and Native Americans have a higher genetic likelihood of getting Metabolic Syndrome.

Martin said in some Native American tribes, the prevalence of diabetes is not a question of if someone will get it, but when.

Other cultural differences, such as the way many Southerners are used to eating, is another challenge.

"I grew up eating fried chicken, country ham, red-eye gravy, the whole bit," Martin said. "So, I understand that," he said. "That's what makes this a difficult challenge."

Time to change

Both Martin and Rice say there is little choice for Americans, South Carolinians, Greenvillians but to start doing what is good for them. And they are insistent that health insurance companies should realize the value of preventive health care.

"An established diabetic, his medical care costs $7,000 to $13,000 a year," Martin said. "You can actually prevent that with just some very simple things."

The 12-week Metabolic Syndrome Program, which can be extended to six months, costs $253.60, Rice said.

"We hope third-party payers will see the value of treating these folks now, rather than waiting until they're spending thousands on health care when they're sick," Rice said. "We'd rather get them on the right track now, for a few hundred dollars, rather than wait."

As for Geter, she said the important thing for her is making sure she heads into the rest of her life as healthy as possible.

"It's up to me this time," she said. "A few years ago I lost 67 pounds, because I was walking five miles a day."

But the weight crept back on. Add that to a family history of heart disease, painful knees and the difficulty she has sleeping at night because of sleep apnea, and she's worried that if something bad happens, surgeons won't be able to operate on her because of her excess weight.

"I've got my mind made up this time," she said. "I'm like, 'OK, Lord, I get your message and I'm ready to try and do something about this.'

"I'm going walking this evening. And I took the stairs into work this morning, and when I leave this afternoon, I'll be taking the stairs again."

Metabolic Syndrome self test

Do you have Metabolic Syndrome? If you exhibit three or more of these traits, you may.

A waist circumference exceeding 40 inches (for men), or 35 inches (for women).

Fasting blood sugar of more than 110 mg/dl.

Elevated blood pressure of more than 130 (Systolic) or 85 (Diastolic).

Elevated serum triglyceride level of more than 150 mg/dl.

A decreased high-density lipoprotein (HDL) cholesterol level of less than 40 mg/dl (for men), or 50 mg/dl (for women).

Only current lab values are considered relevant for this self-test.

Even if you only know your waist size and your current blood pressure (you can use a blood pressure machine at area pharmacies), those two characteristics alone may give you a strong clue that you have Metabolic Syndrome.

If you suspect that you do, visit your doctor for additional bloodwork, or make an appointment with the Metabolic Syndrome Program at Greenville Hospital System by calling 455-5173.

For an online version of this test, visit: www.drugstudy.md

For more information about metabolic syndrome, visit:

www.hopkinsafter50.com

For a sample diet, for those with metabolic syndrome, visit:

www.peanut-institute.org