Niflheim Most of the symptoms of metabolic syndrome patients we come into contact with in clinical care are "packaged". The core is abdominal obesity, high blood pressure, and abnormal blood sugar and lipid metabolism. Most of them don't have particularly typical pain in the early stage, and they are easily ignored as tired. By the time they feel obvious discomfort, there are often signs of target organ damage.
Xiao Li, a 38-year-old Internet programmer who was just followed up last month, is a typical example. He is 1.8 meters tall and has a waistline of almost 100 centimeters. His belly is as big as a small rubber ball. Every time he comes, he talks about how he has been feeling muddy recently. He can fall asleep in the middle of a meeting and can only walk two steps after get off work. I had chest tightness and always felt dry and bitter in the mouth. At first, I thought it was due to continuous cooking, but the physical examination showed that the fasting blood sugar was 6.9, the blood pressure was 142/93, and the triglycerides were 1.8 times higher than the normal value, which just met the diagnostic threshold of metabolic syndrome.
In fact, these vague discomforts are all signals from the body, but they are so non-specific that many people don’t take them seriously. There are also many patients who have dark skin on the back of their necks and armpits that cannot be cleaned no matter how much they are rubbed. It looks like it has not been cleaned all year round. This is called acanthosis nigricans sign, which is a typical manifestation of insulin resistance. It is also a sign that we will pay special attention to during nursing evaluation.
There are still differences in the industry on whether to include mood and sleep-related abnormalities in the nursing observation symptoms of metabolic syndrome. Some nursing scholars believe that metabolic disorders will affect neurotransmitter secretion. Nearly 40% of the patients we follow up have difficulty falling asleep and are irritable and irritable. Related studies also say that the risk of anxiety and depression in people with metabolic syndrome is 32% higher than that of ordinary people. Adding one to routine assessment can detect problems earlier.； However, some experts believe that these are accompanying symptoms, not the core manifestations of metabolic syndrome, and there is no need to include them in routine screening. We usually ask a few more questions during practical operations, and there is no harm in doing so.
There are also some symptoms that are hidden deeper. Normally, fasting blood sugar is normal, but blood sugar goes very high after eating something sweet or too much. Occasionally, there will be foam in the urine, or the feet always feel numb and cold when walking. These are actually signs of early kidney damage and peripheral neuropathy. There was a 56-year-old aunt who had no discomfort at all but occasional numbness in her feet. She thought it was due to a problem with her lumbar spine. When we came for a follow-up visit, we measured her blood sugar 2 hours after a meal, and it actually reached 11.2. We also checked the nerve conduction and found early abnormalities. If it were delayed for a few more months, more serious diabetic foot-related problems might occur.
