Metabolic Syndrome Screening Protocol Medical Volunteer Qualifications MD, DO, NP, PA, CNS, RN, Certified Diabetes Educator (CDE) who has knowledge related to the disease processes that make up Metabolic Syndrome. Students in the above programs may perform this screening under the direct supervision of a Clinical Instructor/Preceptor. One screener can screen approximately twenty-five (25) participants per hour. One screener can educate approximately ten (10) participants per hour. Screeners may not solicit for clientele or promote their business. Non-Medical Volunteer Qualifications One volunteer per 25 participants. Overview Each participant will complete a Metabolic Syndrome Questionnaire. It is recommended that participants have their blood drawn at the 9HealthFair to obtain cholesterol, triglyceride, hemoglobin A1c (HgA1c) and glucose levels. Participants should share their results with their healthcare provider, who can determine their Metabolic Syndrome risk factors. Explain that the purpose of the Metabolic Syndrome screening is to teach participants the importance of recognizing risk factors for developing Metabolic Syndrome and methods by which they can be prevented and/or treated. Preparation and Maintenance of Equipment Place this screening in close proximity to Height, Weight, and BMI Screening. This screening should be done in an area that affords privacy for participants. Place scales on hard, flat surface. Weigh participant if they have not been weighed at Height/Weight Station. Affix height measurement ruler to wall at correct level to use in case participant has not had height checked at Height/Weight Station. Set up privacy screens. Measure participant s waist circumference in this area. Have blood pressure equipment available in case participant has not had blood pressure checked prior to this screening. Procedure Ask participant to remove shoes. Place fresh paper towel on scale platform for each participant. If using a balance beam scale to measure height, ask participant to stand on scale facing away from the scale. Bar should touch top of head and not just brush hair. If balance beam scale is not used, measure participant against wall using height measurement ruler. Measure height in inches. Consult height conversion chart (located in the Standard Screenings - Medical section of this Resource Guide) and record result in feet and inches in space provided on the Metabolic Syndrome Questionnaire. Measure weight and record result in space provided on the Metabolic Syndrome Questionnaire. 1
In a private area measure participant s waist circumference. Make sure the tape is in a horizontal plane and is snug but not compressing the skin. Use the posterior iliac spine as a landmark. Have the participant take a deep breath and let it out. At this time measure waist circumference in inches. Record the waist circumference on the Metabolic Syndrome Questionnaire and on the yellow copy of the Participant Form. Ensure that Height, Weight, Waist Circumference, and Blood Pressure have all been recorded on the Metabolic Syndrome Questionnaire as well as the yellow copy of the Participant Form. This will be given to the participant to share with his/her healthcare provider. Record results on Participant Form in the Participant Data section, page 3. Circle: Normal (N) = 2 or less risk factors Further Evaluation (FE) = 3 or more risk factors. Refer the participant to their own healthcare provider for follow-up or to the Ask a Medical Questionnaire/Get a Referral station. Additional educational materials about Diabetes and the Diabetes Prevention Program (DPP) can be located through the American Diabetes Association (ADA) at 1-800-DIABETES or (1-800-342-2383). The ADA Colorado Chapter website is www.diabetes.org/colorado NOTE: This is a screening only. Diagnoses are not permitted. Screeners may only contact 9HealthFair participants after the Fair, if the participant is positive for cognitive impairment and needs follow up. There can be absolutely no commercial activities by 9HealthFair volunteers. WAIST CIRCUMFERENCE CHART (IN INCHES) Gender Health Risk Rating Low Medium High Male < 37 37 39.9 40 Female < 32 32 34.9 35 Protocol Hand sanitizer METABOLIC SYNDROME SCREENING SUPPLIES 9Health Fair Provides: Blood Pressure equipment Tape measure (12 ft. for measuring height) Station sign: Metabolic Syndrome Screening Copies of Protocol Site Provides: Black or blue ball point pens Chairs Tape measure (6 ft. for waist circumference) Paper towels Copies of Metabolic Syndrome Questionnaire English and Spanish Small table or clipboard Scales Wastebasket(s) 2
Copy of Screener Tally Sheet for each screener PARTICIPANT COPY METABOLIC SYNDROME QUESTIONNAIRE Metabolic Syndrome is defined as a condition in which a person has any 3 or more of the following indicators: Increased waist size (greater than 40 inches in men, greater than 35 inches in women) High fasting blood glucose (greater than 100 mg/dl) High blood pressure (greater than 130/85 mmhg) High serum triglycerides (greater than 150 mg/dl) Low HDL cholesterol (less than 40 mg/dl) Increased HgA1c (5.7 6.4) If you answer YES to 1 or more of the following you may be at risk for developing Metabolic Syndrome: Do you have a personal or family history of diabetes? Do you have a personal or family history of high blood pressure? Do you have a personal or family history of abnormal cholesterol or triglycerides? Do you have a personal or family history of heart disease? Metabolic Syndrome is important to recognize because people with this condition have a significantly increased long-term risk of developing cardiovascular disease (heart attack, congestive heart failure, and stroke). Furthermore, people who have Metabolic Syndrome (without having high fasting blood glucose or diabetes) have a very high risk of developing Type 2 Diabetes Mellitus within the next 5-10 years. Metabolic Syndrome is NOT a medical emergency since it is not an acutely life threatening situation, but you should discuss/determine your Metabolic risk factors with your healthcare provider once you receive your blood results from 9Health Fair. Effective therapy for Metabolic Syndrome is available - diet, exercise, weight loss, diabetes medications, blood pressure medications, lipid lowering medications, and weight loss medications. If you have further questions about this screening please go to the Ask a Medical Question/Get a Referral Station at your 9Health Fair for further education and resources. Screeners: Please record all available information in the space below and on the yellow copy of the Participant Form (as participants will need this information to share with their provider). Metabolic Syndrome Results: Height: Weight: Waist Circumference: Blood Pressure: Fasting Glucose, Serum Triglycerides, HDL Cholesterol, HgA1c. 3 Related to Metabolic Syndrome: TSH: Total Cholesterol: LDL Cholesterol: Please note that you will need to wait for your final blood test results which will arrive via mail within 4 weeks. Please share your results with your provider to determine your Metabolic risk.
COPIA PARA EL PARTICIPANTE Your Metabolic risk (to be determined with your provider): One risk factor = LOW Two risk factors = MEDIUM Three or more risk factors = HIGH CUESTIONARIO SOBRE EL SÍNDROME METABÓLICO El Síndrome Metabólico se define como un trastorno en el que la persona presenta cualesquiera 3 o más de los siguientes indicadores: Aumento del tamaño de la cintura (mayor a 40 pulgadas en los hombres, mayor a 35 pulgadas en las mujeres) Valores altos de la glucemia en ayunas (más de 100 mg/dl) Presión arterial alta (mayor a 130/85 mmhg) Valores altos de triglicéridos en suero (mayores a 150 mg/dl) Bajos niveles de colesterol HDL (menos de 40 mg/dl) La prueba hemoglobin A1c ( 5.7 6.4) Si contesta SI a 1 o más de las preguntas siguientes, usted puede correr riesgo de padecer Síndrome Metabólico: Tiene antecedentes personales o familiares de diabetes? Tiene antecedentes personales o familiares de presión arterial alta? Tiene antecedentes personales o familiares de valores fuera de lo normal de colesterol o triglicéridos? Tiene antecedentes personales o familiares de cardiopatías? Es importante reconocer el Síndrome Metabólico pues las personas con este trastorno sufren un aumento significativo del riesgo a largo plazo de contraer enfermedades cardiovasculares (infarto de miocardio, insuficiencia cardíaca congestiva y apoplejía). Además, las personas que padecen el Síndrome Metabólico (aun sin tener valores altos de glucemia en ayunas o diabetes), corren un riesgo muy alto de padecer diabetes mellitus tipo 2 en los 5 a 10 años siguientes. El Síndrome Metabólico NO constituye una emergencia médica ya que no se trata de una situación potencialmente mortal, pero usted debería conversar y determinar sus factores de riesgo Metabólicos con su profesional médico una vez que reciba por correo los resultados de su análisis de sangre. Se dispone de tratamiento eficaz para el Síndrome Metabólico: dieta, ejercicio, pérdida de peso, medicamentos para la diabetes, medicamentos para la presión arterial, medicamentos hipolipemiantes y medicamentos para fomentar la pérdida de peso. Si usted tiene más preguntas sobre este examen, diríjase a la estación Hable con un Profesional Médico en su 9HealthFair, quien le brindará más información y recursos. Examinadores: Registre la presión arterial y la circunferencia de la cintura en el espacio a continuación y en la copia amarilla del formulario de participación (ya que los participantes necesitarán esta información para compartirla con su médico). Resultados del Síndrome Metabólico: Estatura: Peso: Circunferencia de la cintura, Presión arterial, Glucemia en ayunas, Triglicéridos en suero, Colesterol HD, HgA1c. Relacionados con el Síndrome Metabólico: TSH: Colesterol total: Colesterol LDL: Tenga en cuenta que deberá esperar los resultados finales de su análisis de sangre, que llegarán por correo en el plazo de 4 semanas. Comparta sus resultados con su médico para determinar su riesgo Metabólico. Su riesgo Metabólico (a determinar con su médico): 4
Un factor de riesgo = BAJO Dos factores de riesgo = MEDIO Tres o más factores de riesgo = ALTO TALLY SHEET FOR SCREENERS METABOLIC SYNDROME Site Name: Site#: Instructions: As an educator/consultant at this station you will provide each participant with education or advice either concerning a screening finding or a participant s question. If you agree with the need for further evaluation FE and/or refer the participant to their own healthcare professional or provide the participant with one or more clinic referrals, mark this form as follows: Further Evaluation/Follow-Up (FE) If there is no need for any follow-up or further evaluation, mark this form as follows: Normal Evaluation or No Further Follow-Up (N) Mark the next available number with an "X" in the appropriate section below -- according to the evaluation. Please mark one of the boxes below for each participant. This is the only way to track the number of people who participate in this station. We will use this data to help plan the number of screeners needed for next year. THANKS!!! Normal Evaluation (N) Further Evaluation (FE) 1 26 51 76 101 126 151 176 1 26 51 76 101 126 151 2 27 52 77 102 127 152 177 2 27 52 77 102 127 152 3 28 53 78 103 128 153 178 3 28 53 78 103 128 153 4 29 54 79 104 129 154 179 4 29 54 79 104 129 154 5 30 55 80 105 130 155 180 5 30 55 80 105 130 155 6 31 56 81 106 131 156 181 6 31 56 81 106 131 156 7 32 57 82 107 132 157 182 7 32 57 82 107 132 157 8 33 58 83 108 133 158 183 8 33 58 83 108 133 158 9 34 59 84 109 134 159 184 9 34 59 84 109 134 159 10 35 60 85 110 135 160 185 10 35 60 85 110 135 160 11 36 61 86 111 136 161 186 11 36 61 86 111 136 161 12 37 62 87 112 137 162 187 12 37 62 87 112 137 162 13 38 63 88 113 138 163 188 13 38 63 88 113 138 163 14 39 64 89 114 139 164 189 14 39 64 89 114 139 164 15 40 65 90 115 140 165 190 15 40 65 90 115 140 165 16 41 66 91 116 141 166 191 16 41 66 91 116 141 166 17 42 67 92 117 142 167 192 17 42 67 92 117 142 167 18 43 68 93 118 143 168 193 18 43 68 93 118 143 168 19 44 69 94 119 144 169 194 19 44 69 94 119 144 169 20 45 70 95 120 145 170 195 20 45 70 95 120 145 170 21 46 71 96 121 146 171 196 21 46 71 96 121 146 171 22 47 72 97 122 147 172 197 22 47 72 97 122 147 172 23 48 73 98 123 148 173 198 23 48 73 98 123 148 173 24 49 74 99 124 149 174 199 24 49 74 99 124 149 174 25 50 75 100 125 150 175 200 25 50 75 100 125 150 175 When you reach the end of either box, start a new sheet. 5
At the end of the fair please place all tally sheets in the envelope marked Tally Sheets and return to the 9Health Fair Site Medical Coordinator or a 9Health Fair site leader. 6