Endocrine Abstracts

Studies in the general population have shown a prevalence of the metabolic syndrome of 17-25%. We have studied the prevalence of the metabolic syndrome in patients with diabetes mellitus (DM). A total of 150 consecutive patients with type 1 (21%) or type 2 DM (79%), mean age 59.1y (28-85), attending for annual review were studied to determine if they satisfy (ATP III) diagnostic criteria for the metabolic syndrome. Fasting plasma glucose, triglycerides, HDL cholesterol, blood pressure and waist circumference were measured. Taking treatment for hypertension as indicating blood pressure > 130/85, and as all patients satisfied the glycemic criterion by virtue of having DM, a total of 91 (60%) of subjects had the metabolic syndrome. Of these 94.5 % had type 2 diabetes and 5.5 % had type 1. The prevalence of the metabolic syndrome in patients with type 1 and type diabetes was 16% and 72% respectively. Despite treatment for DM (100%), hypertension (64.6%) and dyslipidemia (44%), 69 patients (46%) of whom 65 (94.2%) had type 2 DM, still met diagnostic criteria for the metabolic syndrome. Other than the glycemic criterion, the commonest feature of the metabolic syndrome was hypertension (86.8%), with waist circumference (> 102 cm in males, > 88 cm in females), triglyceride (> 1.7 mmol/L) and HDL cholesterol criteria (<1.04 in males. < 1.29 in females) being present in 79.1%, 52.7% and 56% of subjects respectively. We conclude that the metabolic syndrome is present in most patients with type 2 DM but is uncommon in subjects with type 1 DM. Despite treatment of cardiovascular risk factors, almost half of patients still meet the criteria for the metabolic syndrome. Even more aggressive treatment of risk factors, particularly blood pressure is required if cardiovascular risk is to be reduced in patients with DM.