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LIFESTYLE MODIFICATIONS IN METABOLIC SYNDROME Leanne Cutajar, Lilian M. Azzopardi, Anthony Serracino-Inglott Department of Pharmacy, Faculty of Medicine and Surgery, University of Malta, Msida, Malta email: [email protected] DEPARTMENT OF PHARM ACY UNIVERSI TY OF MA LTA Department of Pharmacy INTRODUCTION AIMS Patients suffering from metabolic syndrome have an increased risk for cardiovascular disease and developing 1 type 2 diabetes . With about 40,000 Maltese suffering from diabetes, early identification of patients at risk of developing metabolic syndrome (MS) is essential to minimize the morbidity and mortality associated with the syndrome. To assess the local prevalence of MS METHOD University of Malta To evaluate the significance, if any, of a reinforced lifestyle intervention SETTING Diabetes and Endocrine outpatient clinic at Mater Dei Hospital, Malta RESULTS Hundred type-2 adult diabetics with a BMI>25 were recruited by convenience sampling. Sixty-nine patients (mean age: 61 years) completed the study, of whom 63 suffered from MS at baseline. Of these, 25 patients comprised the intervention group Baseline weight (wt), waist circumference, fasting blood glucose (FBG) level, blood pressure (BP), HDLcholesterol and triglycerides were recorded. with 13 applying for the weight management program and 1 patient completing it entirely. Patients satisfying all five of the MS criteria decreased Intervention group (n=33) Control group (n=67) *Followed up 3 times+ Continue standard care Wt management program Aerobics classes Information leaflets from 17 to 12 for the intervention group and increased from 20 to 23 for the control group over 1 year. A greater decrease in mean weight, FBG level, systolic and diastolic blood pressure readings was observed for the intervention group. The improvement in mean HDL-c (p=0.001) and A questionnaire to assess lifestyle habits and identify any influencing incentives and barriers was conducted with all volunteers. triglycerides (p=0.010) were both significant for the control group. Mean HDL-c improvement for the intervention group was also significant (p=0.025). However, during the study lipid lowering medications Biological markers, any changes in medications or relevant remarks were re-obtained after one year. Figure 1: The 5 most common incentives to achieve a healthier lifestyle (n=69) were increased for 12 control group patients and only 3 intervention group patients. Figure 2: The 5 most common barriers to achieve a healthier lifestyle (n=69) CONCLUSION Most of the patients (91.3%) recruited at baseline suffered from metabolic syndrome. Patients were not keen to follow the weight management programs. Despite this, an improvement was observed in some parameters in the intervention group. The fact that these patients were followed-up 3 times during the study period and given written information may have contributed. A higher number of patients in the control group had their medications increased and this could have influenced the lipid parameter comparison between the groups. Major limitations included the small sample size, lack of motivation from the patients’ end and time-frame. Pharmacists should be proactive in helping patients overcome barriers to achieve healthier lifestyles. Reference: 1 International Diabetes Federation. IDF worldwide definition of the metabolic syndrome *Internet+. 2006 *cited 2013 Jul 20+. Available from: http://www.idf.org/metabolic-syndrome