What Is Metabolic Syndrome?

What Is Metabolic Syndrome? - One Drop

A syndrome is a group of clinical features (symptoms) that share an underlying cause. Metabolic syndrome is a group of metabolic features that often occur together: obesity, high cholesterol, high blood pressure, elevated triglycerides, BMI, and high blood sugar.

Often, these features result in acute illnesses, like diabetes, nonalcoholic fatty liver disease, chronic fatigue syndrome, histamine issues, or any other type of metabolic inflexibility.

The underlying cause? Insulin resistance (IR). ⁣

How this develops is something that is still currently under investigation. The complexities behind these features are deeply intertwined: while these features are caused by IR, they also each cause IR in a vicious cycle.

The cycle itself can be difficult to break, especially since lots of other endocrine hormones get dysregulated along the way and during these viscous continuums (this is why metabolic syndrome has also been associated with other diseases like PCOS and dementia). ⁣

Insulin Resistance in Type 1 and Type 2 Diabetes

But wait! That doesn’t make sense -- this sounds like a strictly type 2 diabetes issue. High blood sugars caused by insulin resistance is by definition type 2 diabetes.

If a person has type 1 diabetes or another type of illness but not type 2 diabetes, they can’t have insulin resistance or metabolic syndrome, right? ⁣

Wrong. ⁣

Particularly for people with type 1 diabetes.

It is estimated that roughly 40% of people with type 1 diabetes also have metabolic syndrome (50% of people with type 1 diabetes are overweight or obese, more than the general population), which increases risk for both microvascular (eye, kidney, nerve) and macrovascular (heart disease, stroke) complications.

Metabolic syndrome specific to people with type 1 diabetes is related to age, BMI, and glycemic control. ⁣⁣

Metabolic Syndrome Is A Lifestyle 

Metabolic syndrome is caused by many variables. Some of it is genetic predisposition to IR. But even with genetics you won’t get far without an environmental trigger.

In fact, about 75% of our environment -- foods we put into our body, how much we exercise, the way we manage our insulin, how much and how well we sleep at night -- plays into our health outcomes. That’s in comparison to 25% of those genetic factors. Environment is the driver.

In type 1 diabetes, there are some super common pitfalls when it comes to management (blood sugar rollercoasters, feeding your insulin, the idea that “I can eat anything as long as I give insulin for it”) that can frequently lead to weight gain and IR (and IR and weight gain is its own very vicious, very dangerous cycle), and all the morbidity and mortality associated with metabolic syndrome. ⁣

These Standard American Diseases are, for the most part, directly influenced by the Standard American Diet and Lifestyle.

The difference in underlying metabolic factors between people with type 1 diabetes and people with type 2 diabetes is getting smaller every day.

But perhaps what’s even more alarming is that more and more people in the general population (people who do have no diabetes type) are also showing signs and features of metabolic syndrome. Everyone -- not just people with diabetes -- should be striving to avoid or reverse these disease processes. 


Those of us living with diabetes are granted a unique perspective into the impact all of this can have on our health. Robust health is not a given. It is earned, and rent is due every day, with every bite, every sleep -- and we see this daily with our blood sugars.

If we continue to listen and learn from our bodies, we can choose to make the right social and environmental factors that will ensure rich, long lives.

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Jordan Hoese, MD, MPH
Jul 07, 2020

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