What are the nursing issues for metabolic syndrome?

Poor intervention compliance caused by patients' insufficient cognition, omissions in multi-indicator linkage monitoring, and emotional internal friction hidden behind the indicators that are easily overlooked.

Last week, I met a 42-year-old Internet company executive. His body fat rate was 34%, his fasting blood sugar was borderline, his blood pressure fluctuated around 140/90 all year round, and his triglycerides exceeded the standard twice as fast. After the diagnosis, he was given a plan of fat control + sugar control + gradual weight loss. He turned around and said to me, "I just stay up late recently. I just need to take a vacation. There is no need to bother like this" - this In fact, it is the most common problem. Many people do not regard metabolic syndrome as a "disease" at all. They either think that it is sub-healthy and just take a two-day rest, or they think that taking antihypertensive drugs will be all right. They do not realize that the indicators of blood sugar, blood lipids, blood pressure, and weight are like grasshoppers tied on a string. If one goes wrong, the rest will explode sooner or later. It is useless to control one alone.

In addition to patients’ misunderstandings, it is also easy for us on the nursing side to fall into the trap of “looking at indicators alone”. A while ago, there was a 62-year-old aunt who came to the community to have her blood pressure measured every week and her blood pressure was stable at 130/80. She happily said she was fine every time. After measuring her blood pressure last week, I asked her, "Are you always thirsty lately? I see you bring a big water bottle every time you come here." She just said that she drank a lot and peeed a lot in the past two months, and lost almost 5 pounds in weight. She quickly measured her fasting blood sugar on her fingertips, and it went straight to 7.3. If she only looked at the normal blood pressure value she reported every time, she might not be able to find the problem until her blood sugar was much higher.

When it comes to specific intervention care, there are actually different opinions in the industry. It was popular for a while to let patients with metabolic syndrome directly use the ketogenic diet to quickly reduce body fat. Indeed, some patients lost 8 points of body fat in 3 months and their blood sugar returned to the normal range. However, there are also many cases where they could not bear it after two months. They ate staple foods in retaliation, regained their weight even higher than before, and even had high uric acid. For a patient, taking ketogenic medicine for more than half a month directly induced gout, so now we don’t just give the patient the so-called “standard answer”. We first find out his usual eating habits and whether he has any underlying diseases. If he likes rice, he should start with white rice mixed with 1/3 of grains. If he likes to drink, he should start by drinking less than 2 times a week. On the contrary, it will last much longer than strict requirements that he cannot eat this or touch that.

Another point that is easily overlooked is the emotional problems of patients with metabolic syndrome. Last year, there was a 50-year-old menopausal aunt. After being diagnosed, she went home for a long-term check-up. She was told that the disease is prone to myocardial infarction and cerebral infarction, and she will have to take medication for the rest of her life. She was so anxious that she couldn't sleep all night long. Her blood pressure, which was originally critical, rose to 150. /100, her blood sugar also fluctuated high and low. Later, we chatted with her for an extra 10 minutes every time we tested her indicators, and asked her to do aerobics with the chronically ill patients in the community. Gradually, her mood stabilized, and her blood pressure and blood sugar stabilized without increasing the dosage of medication.

In fact, in the final analysis, the care of metabolic syndrome has never been a matter of checking the guidelines one by one. Each patient's living environment and personality are different, and the hidden problems are also different. Only by calming down and following the patient's actual situation can the problem be truly solved.