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St. Luke's Tackles Metabolic Syndrome in Population Health

By Dr. David C. Pate, News and Community
September 3, 2013

As an accountable care organization, St. Luke’s aims to promote better health of our communities, improve care for our patients, and lower the costs for those we serve. 

A key competency for accountable care organizations is the ability to help at-risk and high-risk patients eliminate as many risk factors as possible and achieve better control of their health conditions. This is part of population health management

One such condition that threatens the lives and health of many Idahoans is metabolic syndrome, and many with this condition do not know they have it.

What is metabolic syndrome?

If you have any three of the following, your physician or nurse practitioner may diagnose metabolic syndrome:

  • Central obesity as determined by waist circumference. You can measure this with a tape measure around your waist so that the tape is parallel to the floor and touches the top of your pelvic bones on the sides. This criteria is met:
    • In men when the measure is 40 inches or more, or 35 inches for Asian American men.
    • In women when the measure is 35 inches or more, or 31 inches for Asian American women.
    • When there is a fasting triglyceride blood level of 150 or higher.
    • When there is a level of HDL cholesterol:
      • In men, of less than 40.
      • In women, of less than 50.
    • When there is blood pressure of 130 or higher for the top number or 85 or higher for the bottom number.
    • When there is fasting blood sugar of 100 or greater.
If you are already on medications for high triglycerides, low HDL cholesterol, high blood pressure, and/or diabetes, you also may meet some of these criteria. Check with your doctor or nurse practitioner.

How big a problem is this and what are the consequences?

Twenty percent to 30 percent of American adults have metabolic syndrome. The reason this is so serious is that people with metabolic syndrome have:

  • a five-fold increased risk of developing diabetes.
  • double the risk of having or developing coronary artery disease.
  • double the risk of an earlier death compared with someone of their same gender and age without metabolic syndrome.
  • higher risks for asthma, gallstones, breathing disorders while sleeping, and some forms of cancer.
What is St. Luke’s doing about metabolic syndrome?

First of all, we want to educate people and encourage everyone who is overweight (statistically, that’s two out of every three people reading this blog) to get screened. 

The other thing we are doing is opening a St. Luke’s Metabolic Syndrome Clinic at our St. Luke’s Heart Health and Rehabilitation Clinic site in Meridian. 

We are creating a 12-week program for people who meet the criteria above, in keeping with St. Luke’s commitment to team-based care – a physician, registered dietitian, social worker, and exercise physiologist all working together to improve the health of people in our region.  

The program demonstrates our commitment to evidence-based medicine, and will include supervised exercise (and we know how to make exercise fun!), extensive education (a well-informed patient and family help to ensure that our care is patient-centered), medical treatment and management of the risk factors identified, psychosocial support (the resources and encouragement for lifestyle changes that will stick), and nutritional counseling.

We are starting the pilot this fall with St. Luke’s employees. We know that we have to take care of our caregivers so that they can continue to provide the exceptional care to our patients that St. Luke’s is known for. 

Further, any change has to start with us. We are not going to ask our patients to do things we don’t expect of ourselves. We will report back on our progress and results from this pilot and then prepare to open this program to the public. 

Our metabolic clinic is just one more example of how we Take Care Forward!

About The Author

David C. Pate, M.D., J.D., is president and CEO of St. Luke's Health System, based in Boise, Idaho. Dr. Pate joined the System in 2009. He received his medical degree from Baylor College of Medicine in Houston and his law degree from the University of Houston Law Center.