Recognition and management of this metabolic disorder in primary care

Article Abstract:

Recognition of syndrome X and appropriate treatment can avoid the onset of Type II diabetes. Syndrome X is characterized by insulin resistance and may associate with hypertension, atherosclerosis, microvascular angina, dyslipidemia, polycystic ovary syndrome, obesity, especially centrally distributed adiposity, and benign acanthosis nigricans. Screening measures include plasma glucose evaluations and measurement of HbA1c. Treatment addresses diet and exercise and may include medications for glycemic control, antihypertensives and antilipidemics, and the avoidance of medications that decrease glucose tolerance.

Prevention

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Advances in assessment and management of HIV/AIDS-associated wasting syndrome

Article Abstract:

Protein energy malnutrition (PEM) or progressive protein wasting can develop in patients with HIV infection or AIDS. Pathophysiological mechanisms that may be involved in the development of HIV/AIDS-associated PEM include inadequate caloric intake, malabsorption of nutrients, metabolic dysfunctions, and abnormal cytokine activity. An individualized intervention strategy should be devised based on body composition analysis. Treatments may include total parenteral nutrition, treatment for diarrhea, and use of anabolic agents or agents to reduce cytokine activity.

Wasting syndrome, AIDS (Disease), Malnutrition

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Primary care provider's role in health promotion and disease prevention

Article Abstract:

Nurse practitioners (NPs) can use their unique skills at education and preventative care to avert the onset of Type II diabetes in patients with syndrome X. Symptoms of syndrome X are abdominal weight gain, decreased activity, hyperinsulinemia, insulin resistance, elevated triglycerides, and reduced high density lipoprotein cholesterol. NPs can identify at-risk individuals and help them reduce their risk with diet and exercise. NPs can also advocate for the availability of cost-effective primary care in community based settings.

Development and progression, Insulin resistance

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