by Steve Christensen

Created on: January 12, 2010

An upsurge in the incidence of diabetes is arguably the most compelling issue currently facing American health experts. It is feared that the expected increase in diabetic complications (blindness, amputations, strokes, infections, and heart disease) will consume an inordinate proportion of medical resources and overwhelm the U.S. healthcare budget.

Preventing this increasingly common disease is of paramount importance if such dire predictions are to be forestalled. The notion of using medications as part of a preventive strategy is gaining ground; some drugs that are already on the market show promise in this regard.

Metabolic Syndrome – the Precursor to Type 2 Diabetes

Most people are aware that genetics, obesity, and sedentary lifestyles play key roles in the development of diabetes; scientists have taken a closer look at other common attributes that are shared by people who already have diabetes and, perhaps more importantly, by individuals who are at risk for diabetes due to lifestyle or family history.      

Over the past decade or so, a great deal has been learned about the underlying physical traits that such people share. Specifically, a large amount of research has been dedicated to defining the characteristics of “metabolic syndrome,” a constellation of physiologic traits that greatly enhance one’s chances of developing type 2 diabetes mellitus.

The main features of metabolic syndrome are:

1. Insulin resistance: insulin, a hormone produced by the pancreas, normally drives glucose into cells, where it can be stored or burned for fuel. The cells in people with metabolic syndrome are less responsive to insulin, so larger amounts of insulin must be produced by the pancreas in order to keep glucose levels within a normal range. Insulin resistance, then, leads to a reduced ability to metabolize a given amount of sugar in a meal – a condition called “glucose intolerance.”

2. Hypertension: insulin does more than push glucose into cells. As a metabolically active hormone, insulin stimulates the sympathetic nervous system and increases one’s blood pressure. The higher one's insulin level is, the higher the blood pressure tends to be.

3. Dyslipidemia: the same physiologic derangements that cause insulin resistance also interfere with the storage and burning of other fuels, such as fats. Thus, people with metabolic syndrome tend to have high total cholesterol, low HDL, high LDL, or high

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