title: An overview of the identification and management of the metabolic syndrome in chiropractic practice.
abstract: OBJECTIVE
  This article presents an overview of metabolic syndrome (MetS), which is a collection of risk factors that can lead to diabetes, stroke, and heart disease. The purposes of this article are to describe the current literature on the etiology and pathophysiology of insulin resistance as it relates to MetS and to suggest strategies for dietary and supplemental management in chiropractic practice.
  
  
  METHODS
  The literature was searched in PubMed, Google Scholar, and the Web site of the American Heart Association, from the earliest date possible to May 2014. Review articles were identified that outlined pathophysiology of MetS and type 2 diabetes mellitus (T2DM) and relationships among diet, supplements, and glycemic regulation, MetS, T2DM, and musculoskeletal pain.
  
  
  RESULTS
  Metabolic syndrome has been linked to increased risk of developing T2DM and cardiovascular disease and increased risk of stroke and myocardial infarction. Insulin resistance is linked to musculoskeletal complaints both through chronic inflammation and the effects of advanced glycosylation end products. Although diabetes and cardiovascular disease are the most well-known diseases that can result from MetS, an emerging body of evidence demonstrates that common musculoskeletal pain syndromes can be caused by MetS.
  
  
  CONCLUSIONS
  This article provides an overview of lifestyle management of MetS that can be undertaken by doctors of chiropractic by means of dietary modification and nutritional support to promote blood sugar regulation.
authors.affiliation: Professor, Department of Clinical Sciences, National University of Health Sciences, Pinellas Park, FL.
authors.forename: David R
authors.initials: DR
authors.lastname: Seaman
authors.affiliation: Private Chiropractic Practice, Newburyport, MA.
authors.forename: Adam D
authors.initials: AD
authors.lastname: Palombo
keywords: Hyperglycemia; Inflammation; Insulin resistance; Metabolic syndrome X; Weight loss