[Total care for patients with metabolic syndrome]

Insulin resistance plays an important role in the pathogenesis of metabolic syndrome and hence an improvement of insulin resistance is important in the treatment of metabolic syndrome. Oral hypoglycemic agents such as thiazolidinediones and biguanides improve glycemic control by reducing insulin resistance. Furthermore, it has been clarified that they also have anti-dyslipidemic, anti-hypertensive and anti-atherosclerotic actions. In addition, such an insulin sensitizing effect has been demonstrated when alpha-glucosidase inhibitors, statins, fibrates and hypotensive agents such as ACE inhibitors, calcium channel blockers and ARBs have been given to patients with insulin resistance. These drugs should be used for each patient on the basis of the underlying diseases, in addition to a lifestyle modification.