Nutrition in the metabolic syndrome: Pharmacological treatment

SummaryThe metabolic syndrome is a strong predictor of the development of both of diabetes and cardiovascular disease, so reducing these risks should be the main goal of treatment. Today, dietary and lifestyle changes are the cornerstones of “pathophysiological” treatment for the MetS. Nevertheless, maintaining a healthy lifestyle is not easy for most patients. Evidence suggests drug treatments are able to improve some of the metabolic aspects related to the MetS, such as the progression rate towards the development of type 2 diabetes or cardiovascular risk. After diet and lifestyle changes, antiobesity drugs should be considered when weight loss is recommended. Insulin sensitizers (metformin and glitazones) are a possibility in diabetic individuals with the metabolic syndrome and perhaps in people with impaired glucose tolerance, although controversy exists about their role in cardiovascular risk. There is no evidence for using them in MetS with normal glucose metabolism. Conventional cardiovascular risk factors such as lipids, blood pressure or prothrombotic state should also be treated.