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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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Embarking on a keto journey can be a challenging yet rewarding experience. Many individuals struggle with staying committed to the strict dietary requirements of the ketogenic diet, resulting in frustration and limited progress. However, with the help of supplements like VitalCare Nutrition Keto Gummies, navigating the ups and downs of keto can become much more manageable. These gummies are designed to enhance your keto journey by providing essential nutrients and support to help you achieve your health and wellness goals.

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VitalCare Nutrition Keto Gummies are a convenient and delicious way to supplement your ketogenic diet. These gummies are formulated with high-quality ingredients that are specifically chosen to support ketosis, a metabolic state where the body burns fat for energy instead of carbohydrates. Each gummy is packed with essential nutrients such as BHB (Beta-Hydroxybutyrate) salts, MCT (Medium-Chain Triglycerides) oil, and vitamins to help boost energy levels, enhance mental clarity, and promote overall well-being.

These gummies are free from artificial colors, flavors, and sweeteners, making them a clean and healthy option for those following a keto lifestyle. They are also gluten-free, dairy-free, and soy-free, making them suitable for a wide range of dietary needs. Whether you are new to keto or a seasoned pro, VitalCare Nutrition Keto Gummies can be a valuable addition to your daily routine.

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VitalCare Nutrition Keto Gummies work by providing your body with exogenous ketones, such as BHB salts, that can help jumpstart ketosis and keep you in a fat-burning state. Additionally, the MCT oil in these gummies can provide a quick source of energy for both your body and brain, helping you feel more alert and focused throughout the day. By incorporating these gummies into your daily routine, you can support your keto journey and optimize your results.

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There are numerous benefits to incorporating VitalCare Nutrition Keto Gummies into your keto lifestyle. Some of the key advantages of these gummies include:

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2. Stay hydrated throughout the day to support proper hydration and help the gummies work more efficiently in your body.

3. Combine the gummies with a balanced ketogenic diet and regular exercise for optimal results in achieving your health and wellness goals.

Frequently Asked Questions about VitalCare Nutrition Keto Gummies

1. Are VitalCare Nutrition Keto Gummies safe to use?Costco Mounjaro Update Weight Loss Journey Mounjaro

Yes, VitalCare Nutrition Keto Gummies are made with high-quality ingredients and are safe for daily consumption. However, it is always recommended to consult with your healthcare provider before starting any new supplement regimen.

2. Can I take VitalCare Nutrition Keto Gummies if I am not following a keto diet?

While these gummies are specifically designed to support a ketogenic lifestyle, they can still be beneficial for individuals looking to boost their energy levels and mental clarity. However, for optimal results, it is recommended to follow a low-carb, high-fat diet while using these gummies.

3. How soon can I expect to see results from taking VitalCare Nutrition Keto Gummies?

Individual results may vary, but many users report feeling increased energy and focus within the first few days of incorporating these gummies into their routine. For best results, it is recommended to use the gummies consistently and in conjunction with a healthy diet and exercise plan.

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