Which specialist consultations are beneficial to patients with metabolic syndrome?

Updated: Oct 17, 2019
  • Author: Stanley S Wang, JD, MD, MPH; Chief Editor: Yasmine S Ali, MD, FACC, FACP, MSCI  more...
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Answer

Patients with diabetes should be referred to a diabetic nutritionist, if not an endocrinologist. Patients with cardiac symptoms (chest pain, shortness of breath, palpitations) or an abnormal stress test may merit referral to a cardiologist. Consider referral to a preventive cardiologist for primary or secondary prevention of cardiovascular disease in these high-risk patients. Consultation with a sleep specialist is indicated if there are symptoms suggestive of sleep apnea, such as excessive fatigue or daytime somnolence, a history of snoring and witnessed apneas, or physical signs of untreated apnea such as resistant hypertension.

Patients who are at high risk for obesity-associated morbidity and mortality with a BMI greater than 40 kg/m2 or with a BMI greater than 35 kg/m2 plus 1 or more significant comorbid conditions may be referred for consideration of bariatric surgery when less invasive methods of weight loss have failed.

Some advocate using the 130/80 mm Hg goal in all patients with metabolic syndrome, as well as using angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) rather than diuretics or beta blockers when medication is indicated. [92]


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