Metabolic syndrome is a cluster of interrelated risk factors that significantly increase the likelihood of developing cardiovascular disease and type 2 diabetes. It is typically defined by the presence of at least three of the following: abdominal obesity, elevated blood pressure, high fasting blood glucose or insulin resistance, high triglycerides, and low HDL cholesterol. Metabolic syndrome reflects underlying metabolic and inflammatory processes that accelerate atherosclerosis and organ damage. Lifestyle factors such as poor diet, physical inactivity, and genetic predisposition contribute to its development. For insurers, metabolic syndrome is a key underwriting concern because it signals increased long-term mortality and morbidity, even before full diabetes or coronary artery disease is diagnosed. Underwriting manuals often address metabolic syndrome indirectly through separate criteria for build, blood pressure, cholesterol, and glucose control, but recognition of the combined pattern has grown in importance for risk assessment.

In real-world underwriting, metabolic syndrome may not always be labeled explicitly in medical records, but its components appear throughout attending physician statements and lab reports. Underwriters look at body mass index or waist circumference, blood pressure readings, lipid panels, and fasting glucose or A1C levels to assess whether a client effectively meets metabolic syndrome criteria. Advisors often see this pattern in clients who are overweight, on multiple medications for hypertension and cholesterol, and have borderline or elevated blood sugar. Carriers may respond with table ratings or more conservative offers even in the absence of diagnosed coronary disease. Producers can add value by encouraging clients to pursue lifestyle changes, obtain updated labs showing improvement, and share favorable physician comments before or during underwriting. Over time, successful management of metabolic syndrome components can lead to better offers at policy review, reconsideration, or when applying for new coverage.