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The video version of this podcast can be found here: https://youtu.be/W0LL-1BwV3w?si=OT-GNCXaHoA7dcbs This podcast makes reference to guidelines produced by the "National Institute for Health and Care Excellence" in the UK, also referred to as "NICE". Please note that the content on this channel reflects my professional interpretation/summary of the guidance and that I am in no way affiliated with, employed by or funded/sponsored by NICE. My name is Fernando Florido and I am a General Practitioner in the United Kingdom. In this video I will go through a National Patient Safety Alert released on 3.1.2024 by the Department of Health and NHS England on the shortage of GLP1 receptor agonists, touching on sections of the NICE guideline on type 2 diabetes as well as relevant pharmaceutical information, always focusing on what is relevant in Primary Care only. I am not giving medical advice; this video is intended for health care professionals; it is only my summary and my interpretation of the guidelines and you must use your clinical judgement. There is a podcast version of this and other videos that you can access here: Primary Care guidelines podcast: · Redcircle: https://redcircle.com/shows/primary-care-guidelines · Spotify: https://open.spotify.com/show/5BmqS0Ol16oQ7Kr1WYzupK · Apple podcasts: https://podcasts.apple.com/gb/podcast/primary-care-guidelines/id1608821148 There is a YouTube version of this and other videos that you can access here: • The Practical GP YouTube Channel: https://youtube.com/@practicalgp?si=ecJGF5QCuMLQ6hrk The PDF document related to the safety alert on GLP- RA shortage can be found here: · https://www.cas.mhra.gov.uk/ViewandAcknowledgment/ViewAttachment.aspx?Attachment_id=104161 The safety alert on GLP- RA shortage can be found here: · https://www.cas.mhra.gov.uk/ViewandAcknowledgment/ViewAlert.aspx?AlertID=103245 The Central Alerting System Homepage can be found here: · https://www.cas.mhra.gov.uk/Home.aspx Intro / outro music: Track: Halfway Through — Broke In Summer [Audio Library Release] • Music provided by Audio Library Plus • Watch: https://youtu.be/aBGk6aJM3IU (https://www.youtube.com/watch?t=0s&v=aBGk6aJM3IU) • Free Download / Stream: https://alplus.io/halfway-through (https://www.youtube.com/redirect?event=video_description&q=https%3A%2F%2Falplus.io%2Fhalfway-through&redir_token=QUFFLUhqbVNpZlBNM0lCeDIxQzRkU29qUnJGQy15WEtTQXxBQ3Jtc0tuUUFSMkZwSEVuaHdUTWlYV21fZmpjWS1WRXI3R0hZU056MkpmRFpKdXdGYm1La3BlazhUemZ5SkVMTFdaWWRvSG9Ucy1neWpudTJ0MUIxNnl2NmhvR0lmdzduWXEwUUg0alduYkRNdjlWWTNsMnhzaw&v=aBGk6aJM3IU) Transcript If you are listening to this podcast on YouTube, for a better experience, switch to the video version. The link is in the top right corner of the video and in the episode description. Hello and welcome, I am Fernando, a GP in the UK. In this episode I will go through a National Patient Safety Alert released on 3.1.2023 by the Department of Health and NHS England on the shortage of GLP1 receptor agonists, touching on sections of the NICE guideline on type 2 diabetes as well as relevant pharmaceutical information, always focusing on what is relevant in Primary Care only. If you want to access the safety alert website or the associated PDF document, the link is in the episode description. Right, let’s jump into it. You are probably aware that the supply of GLP-1 receptor agonists continues to be limited, with supplies not expected to return to normal until at least the end of 2024. The supply issues have been caused by an increase in demand for these products for licensed and off-label indications. The situation at the moment is that exenatide as Byetta® will be discontinued in March 2024. In addition, liraglutide as Victoza® continues to be out of stock and further stock is not expected until end of 2024. The supply of other agents such as injectable semaglutide as Ozempic® and Dulaglutide as Trulicity® may be unreliable and the shortages may cause significant issues. So, what is the solution? Well, oral semaglutide has come to the rescue. Semaglutide as Rybelsus® tablets are now available in sufficient quantities to support initiation of GLP-1 RA for type 2 diabetes in line with NICE guidance. So let’s remind ourselves of what NICE recommends for type 2 diabetes. NICE says that if triple therapy with metformin and 2 other oral drugs is not effective, not tolerated or contraindicated, we can consider triple therapy by switching one drug for a GLP‑1 receptor agonist if: · The BMI is 35 or higher and there are psychological or medical problems associated with obesity. We will adjust the BMI to 32.5 for people from Black, Asian and other minority ethnic groups or · For lower BMIs if: o insulin would have occupational implications or o weight loss would benefit other significant comorbidities. NICE also says that we should only ...
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In recent years, the ketogenic diet has gained widespread popularity for its potential health benefits, including weight loss, improved mental clarity, and increased energy levels. One of the challenges often faced by individuals following the keto diet is finding convenient and delicious ways to stay in ketosis. This is where Keto Life Gummies come in. These gummies are specially formulated to help individuals maintain ketosis while satisfying their sweet cravings. The success of Keto Life Gummies on Shark Tank has brought them into the spotlight, with many success stories emerging from users who have experienced the benefits of these tasty treats.
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Keto Life Gummies first caught the attention of the sharks on Shark Tank with their innovative approach to supporting the ketogenic lifestyle. The founders shared their own struggles with staying in ketosis and how they developed these gummies as a solution to make the keto diet more enjoyable and sustainable. The sharks were impressed not only by the delicious taste of the gummies but also by the science-backed ingredients that help individuals reach and maintain ketosis more effectively.
After securing a deal on Shark Tank, Keto Life Gummies experienced a surge in demand as word spread about their unique product. People who had struggled to stick to the keto diet found that incorporating these gummies into their daily routine made it easier to stay on track. Success stories began pouring in from users who noticed improved energy levels, enhanced focus, and, of course, weight loss thanks to these tasty treats.
As more and more people discovered the benefits of Keto Life Gummies, the company expanded its product line to include different flavors and variations to cater to a wider audience. Whether you prefer fruity flavors or chocolatey indulgence, there is a Keto Life Gummy for everyone. The success of these gummies has inspired many to embrace the keto lifestyle and take charge of their health and wellness.
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One of the most inspiring aspects of Keto Life Gummies is the way they have transformed the lives of their users. Many people who had struggled with weight loss for years found success with the keto diet, thanks in part to these gummies. By making it easier to stay in ketosis, users have reported significant weight loss, improved self-confidence, and a renewed sense of vitality.
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Keto Life Gummies come in a variety of flavors, including fruity options like strawberry and raspberry, as well as chocolatey varieties like peanut butter cup and coconut almond. Users have praised the delicious taste of these gummies, making them a delightful treat for those following the keto diet.
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One user, Sarah, shared her experience with keto gummies, emphasizing their convenience and taste. According to Sarah, having a pack of keto gummies on hand helps her stay on track with her macros while providing a guilt-free treat. She mentioned that the gummies taste surprisingly similar to traditional gummy candies, making them an excellent substitute for sugary snacks.
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