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Antihyperglycemic Therapy In Type 2 Diabetes General Recommendations

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Donate on Patreon: https://www.patreon.com/hasfit Shop HASfit Tribe store: https://hasfit.myshopify.com/ Coach Kozak's 15 minute senior workout is great for senior strength and will get your heart rate up at the same time. The total body exercise for elderly doesn't require any equipment, but you may choose to use some light weights or a couple water bottles. Senior exercises for elderly are low impact and safe on the joints. Visit http://hasfit.com for the seniors workouts instructions, more videos, free meal plans, and other health tips. http://hasfit.com for the best free workout and senior aerobic exercise routines for men and women at home or in gym. Download the HASfit app: Android http://goo.gl/q1rpi0 -- iPhone http://goo.gl/6N3gfS Start a Free Fitness Program Calendar: Which program is right for me? http://goo.gl/bvRcjV Foundation (beginner) - https://goo.gl/Ay3m3t Motive: (intermediate thru advanced) - https://goo.gl/qH3aSF Classic Programs: 30 Day Challenge to Get in Shape (beginner intermediate): http://goo.gl/YtALOu Warrior 90 HIIT (intermediate): http://goo.gl/NxwO5u Hero 90 (advanced): http://goo.gl/a8BYTk 30 Day Ab Plan (intermediate): http://goo.gl/hVsttG 30 Day Low Impact Program (beginner): http://goo.gl/yH99lZ Get our Diet Guide: Eating For Life https://goo.gl/7qnHn4 Personal Training Services: http://hasfitpersonaltrainer.com Follow us for more! Facebook: https://www.facebook.com/HASFitness/ Instagram: https://www.instagram.com/hasfit_offi... Snapchat: @hasfit Twitter: https://twitter.com/HeartSoulFit Disclaimer: You should consult your physician or other health care professional before starting a HASfit program or any other fitness program to determine if it is right for your needs. This is particularly true if you (or your family) have a history of high blood pressure or heart disease, or if you have ever experienced chest pain when exercising or have experienced chest pain in the past month when not engaged in physical activity, smoke, have high cholesterol, are obese, or have a bone or joint problem that could be made worse by a change in physical activity. Do not start this fitness program if your physician or health care provider advises against it. If you experience faintness, dizziness, pain or shortness of breath at any time while exercising you should stop immediately. HASfit offers health, fitness and nutritional information and is designed for educational purposes only. You should not rely on this information as a substitute for, nor does it replace, professional medical advice, diagnosis, or treatment. If you have any concerns or questions about your health, you should always consult with a physician or other health-care professional. Do not disregard, avoid or delay obtaining medical or health related advice from your health-care professional because of something you may have read on this site. The use of any information provided on this site is solely at your own risk. HASfit makes no warrants, promises, or claims regarding accuracy of the calories burned estimate. It is provided only as a general reference and each person should use an indirect calorimetry system for a more accurate estimate. Developments in medical research may impact the health, fitness and nutritional advice that appears here. No assurance can be given that the advice contained on HASfit will always include the most recent findings or developments with respect to the particular material. exercise for elderly,senior exercise,exercise for seniors,exercises for elderly,senior exercises,exercises for seniors,seniors workouts,senior workout,fitness for seniors,senior work out,low impact workout,low impact exercises,low impact workouts,low impact exercise,senior strength,senior aerobic,senior aerobics,fitnessblender,senior workout routines,senior workout video,senior workout cardio

Antihyperglycemic Therapy In Elderly Diabetics

Antihyperglycemic Therapy in Elderly Diabetics Adopting an individualized approach is the cornerstone of much of modern medicine, and nowhere is that more true than in the care of older patients with type 2 diabetes (T2DM).1 Older patients represent a highly variable population. Some may have no health problems other than T2DM, while others may suffer from multiple health issues that complicate treatment. Longstanding diabetes increases the risk for microvascular and macrovascular complications, yet those with well controlled disease may need a different treatment approach than those whose disease has been difficult to manage. Patients who are newly diagnosed later in life with T2DM may need yet another strategy. In recent years, guidelines have recognized the variability in this age group by emphasizing the importance of balancing the risks of hypoglycemia vs the benefits of adequate glucose control. Although guidelines differ, in general they recommend less intensive treatment and more relaxed HbA1c targets in certain circumstances, especially for frail patients and those with cardiovascular disease. These guidelines follow on the heels of research suggesting the existence of a Continue reading >>

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Popular Questions

  1. Caz

    What can I do to help before I start?
    If you start to reduce your carb intake and increase your water intake prior to starting on packs, then it will make it an easier transition onto the packs and into ketosis - i.e. for your body to start burning it's own fat for fuel, instead of waiting for you to feed it.
    Take some 'before' pictures, whole body and face, and perhaps side on as well. You may hate doing this bit, and may do it yourself with a camera in the mirror if you don't want anyone else to do it / see it. However, it is really helpful to have these to compare too as you go on this journey. Because the weight loss can be very quick, it's sometimes hard for our heads to realise that we've changed shape, and these pictures are really useful to help our brain keep up!
    Measure yourself, there's a little chart in your Exante booklet. It's really motivating to see how your body has changed - and the tape measure will help you to believe it! I've lost 5 stone now, and sometimes when I look in the mirror I don't see how I've changed. Looking at the pictures and the measure tape, is helping it to sink into my slow brain!
    Work out what your goals are, perhaps write yourself what it will mean to you to have lost the weight. I find it helpful to focus on the things I will be doing / able to do when I've achieved my goals - to help spur you on through the next steps on your journey.
    Here's a link to a 100 day chart, to help keep you focused, give you something to mark off as you progress.
    I'm not sure if I'll like the packs
    You can always order just a few packs, or a week's worth to try it before buying a month's bumper pack. This will let you find out if you prefer shakes or soups, and if there's any that you can't stand! (Everyone's tastes are different, and all of us have different favourites)
    What's it like when I start?
    The first few days can be interesting, as your body has to adjust to a totally new way of feeding - getting used to the packs and coming off conventional food. It normally takes 2-3 days, possibly up to 5 for your body to get into ketosis.
    In these first few days you may feel headachey and tired and you will probably feel quite hungry - your body will still be expecting food. Keep drinking the water to help your hydration, and find things to do to distract yourself - take a long bath, go to bed early with a good book, paint your nails (OK, perhaps this one isn't such a good one for the chaps!) If you're finding it too hard, then you can supplement with some lean meat, to help this change but try and resist if you can!
    How will I know when I'm in ketosis?
    If you want to, you can buy ketostix (pee sticks) from the chemist so that you can check. However, once you're in ketosis, your hunger is likely to reduce, you may get a metallic taste in your mouth, your kids may tell you that you have dog breath, you may start to feel a lot colder. All lovely things (However, remember, this is what's helping you to achieve your goal!)
    How much weight will I lose?
    All we can do is give you some guide weights, as it's different for each person. In your first week, if you've been eating normal food, you will most likely experience a larger loss - your body will first burn up all it's glycogen stores, and you'll likely lose some water - typically 4-14lbs in the first week - and men, you lucky things - are likely to lose more quickly than women of the same weight on this diet. Once you're following the plans, Exante suggest that Total Solution will give you losses of 14lbs a month and Working Solution roughly 10lbs a month. It will vary person to person, and you'll see from the site that some people lose considerably more than that. I've been on this diet 16 weeks so far, and have lost 5 stone, doing a mixture of Total and Working Solution.
    What can I drink?
    Water, water and more water - you need to drink 2-4 litres a day (Some people fill up enough 1litre or 500ml bottles at the start of the day, and just make sure they've drunk them all by the end, rather than trying to count cups / glasses through the day - little and often makes it easier to get through it all in the day.)
    Coffee (black)
    Tea (black)
    Peppermint tea
    Green Tea
    Bouillon (There are vegetarian ones available and reduced salt options)
    You can add tablet sweetener to drinks as well
    There are a few diet drinks that you can have: (You are best sticking to ones that have malic acid, not citric acid. Depending how sensitive you are, citric acid can knock you out of ketosis - so best to stay to the ones that won't!)
    Coke Zero
    Dr Pepper Zero
    Asda Diet Cola
    Asda Diet Cherry Cola
    Tesco strawberry flavoured water
    Sainsburys Strawberry & Kiwi water
    Perfectly Clear - Strawberry & Kiwi
    Other VLCD water flavourings
    (While it's important to drink sufficient water, so that you don't dehydrate, it's dangerous to drink too much water - safest not to go beyond 6l a day, and to spread the water out through the day.)
    Will I be hungry?
    Yes, for the first few days until you're in ketosis.
    No, once you're in ketosis, your hunger will largely go (although some people do still feel hungry at times). You may find that you miss actually eating food, and you may also find that you'll start to spot some of the emotional triggers that used to lead you to food.
    Over the first few weeks you'll probably find a lot of your cravings disappear altogether, or at least get a lot more manageable!
    Some people find that the bars are too much to eat in one go, and split them into two smaller portions to eat. You can do the same with shakes and soups too, if you prefer to have smaller meals more frequently.
    What about the side effects?
    This intended to give you an idea of what you might experience. Of course, if you are worried about anything, or it seems unusual, please talk to your doctor. There are some very rare but serious side effects that you may experience, and it is always best to talk to someone who really knows! Before you start the diet, do check the medical stuff on the Exante website, as this isn't a suitable diet for everyone.
    Tummy Upsets
    You may well find your bowel movements start to change - you are eating totally differently, so there isn't the same stuff for your body to deal with. You will not be getting the same levels of fibre that you are likely to be having with your normal food, this can lead some people get quite constipated (drinking extra water when consuming the packs can help this). There are some remedies from the chemist that you can get to help too. If it gets too bad, you could go to Working Solution and have some of the fibrous low carb vegetables - increasing the fibre may help.
    You may also experience nausea or diarrhoea instead. Make sure you drink plenty of water to keep yourself hydrated, and hopefully as your body adjusts to the diet it will find it's new pattern. If you're experiencing nausea, it could be that you're not having enough water when you have the packs - they are crammed full of vitamins & minerals, so if you don't have water at the same time, to help dilute it, flush it through, it can be a bit of a hit on your body that can make you feel a bit sick!
    Feeling Chilly
    This diet is changing your metabolism, and this can be a totally normal side effect. Wrap up warm, find a blanket, dance and wriggle, this is just temporary and once you return to food, this will sort itself out.
    Dog Breath / Metallic Taste
    One of the less delightful side effects that some people may encounter, usually seems to be worst in the first few days. Keep drinking the water! Brush your teeth, you could also use mouth wash, or a breath freshener spray. There are also some minty fresh strips that dissolve on your tongue. Chewing gum / mints are not recommended while on a VLCD (although I can't remember why!)
    Cramp
    Some people suffer more from cramp on this diet. It's suggested that you drink some more water, or you can also add a little salt into one of your packs or some water.
    Girlie Stuff
    Your periods may change while on this diet too - although it seems to be different for everyone. Mine get lighter and much more regular. Some may find that their fertility changes, and pregnancy may be easier (take precautions if that's not what you want!) (I had to stop Lighter Life abruptly when I found out I was expecting - our beautiful daughter, the most fantastic side effect of a VLCD - we'd struggled with fertility for years prior to this)
    Hair / Skin
    If you stay on this for a while because you have a lot of weight to lose, you may find eventually that your hair growth starts to slow down or your skin may start to get quite dry. You may also find that some of your hair starts to fall out. I've now been on this 16 weeks, and I'm just starting to experience some of the hair loss. Once you return to normal food, this will resolve itself.
    I'm bored of the packs / I don't like them all
    There are some things you can do to add in a bit of variety / adapt the packs to your taste.

    Add some coffee to the shakes, and have them hot (this even works for some people that don't like coffee!)
    Experiment with the amount of water you use in making up the shakes and soups, some use a lot more water, find what suits your taste.
    You can also do some more imaginative things with them, in the microwave - but don't do this to more than 1 pack a day, as it can destroy some of the nutrients. Examples are mixing the chocolate with a little bit of water and microwaving it into a biscuity / cake thing.
    If you find it's the shakes or the soups that you prefer, there are shakes only or soup only options that you can buy for the same price.
    Make up a shake quite thick and then put it in the fridge / freezer to turn it into a mousse.
    Make up the shakes with ice / crushed ice and a blender and turn it into a slushy, or a thick milkshake
    You can also add herbs & spices to the soups (make sure it's not mixes that have carbs in them), typically people add things like salt, pepper, chilli powder, italian seasoning, tabasco, any of the herbs really.

    Add some cinnamon or nutmeg to the shakes
    You may also find, over time, that your tastes change. When I started this I couldn't stand the tomato, but will now eat it! (Caution, you're not allowed to advertise / exchange packs with others on the site, there's a warning about it somewhere)
    I really miss food and want to eat something
    If you find the total food replacement too much, then Working Solution may be the perfect thing for you. You can have your 3 packs a day and add a low carb meal. There's another sticky with the info about ketogenic foods. Just make sure you stick to lean meat, and low carb vegetables & salad, and you will still continue to lose weight. I tend to choose day by day whether I'm going to add a meal in or not. I've also used this to be able to still go out for meals with friends, just sticking to low carb. I find pubs are usually pretty good for this as you can order things like steak & chips, and ask them to swap the chips for a green salad. However some people prefer the Total Solution method, and this is how you will get the quickest weight loss. If you like to push boundaries, then Working Solution is probably not for you either, as you will try and add in more and more things, until you're really on a low calorie diet with packs or just blow it all together.
    What about a night out?
    There are several options here.
    Do something that doesn't involve food - bowling, cinema etc
    Go out and stick to low carb food and water
    If you want to have some alcohol, then it is best to come off plan and eat food as drinking alcohol in ketosis is not safe, particularly when you won't be used to alcohol at the moment.
    If you are doing this every weekend, you will be having a nightmare as you ping in and out of ketosis, and it is unlikely that you will be achieving good weight loss, and are probably better to pick a different diet that suits your lifestyle better.
    I've done another VLCD, how does this one compare?
    Essentially they're all the same - in that you have packs - a mixture of soups, shakes and bars as per most of the other ones. The weight losses are pretty similar between the different diets.
    What's different - well, on this one there's no counselling / counsellor / group involved, or external person that's going to weigh you. If you need this, then Exante may not be the right choice for you, or you could use this forum for support (as the rest of us do!) On Exante you have just 3 packs a day (each one is roughly 200cals), so your total intake will be 600 cals a day if you have 3 (you can have 4 if you need it). On Exante you can have bars from week one (although as with other VLCDs, just one bar per day, as they are higher in carbs) For those that have done CWP or LL, the shakes on this diet are not as sweet, and some mention that these are a bit more powdery. Some will add sweeteners to the Exante shakes. Others say that the Exante packs have a less flavoured, synthetic taste.
    Those changing from Lipotrim, tend to comment that the packs are tastier on Exante than LT.
    The price is the big lure that draws us to this diet though. Because there is no group / counselling etc, you are just paying for the packs. Unfortunately you only get the best price though if you buy the bumper packs (mixed, shakes or soups), if you want to choose just some of the packs, then the price is much more similar to other VLCDs.
    Exercise?
    Yes, yes, yes - exercise will definitely help. If you were exercising before you started this, then you can continue doing what you were doing. If you were doing quite a lot of exercise, you may find you need to have an extra pack on those days, to help sustain you, and keep drinking the water. If you weren't exercising before you started this diet, then you are best to wait for the first 2 weeks and let your body adjust to the packs first, and then start introducing some exercise gradually. Lots of people have had fun at various fitness classes, dance classes and the gym - just do something that appeals to you - but remember, start slowly, as you are only on 600 cals a day and let your body get used to it, and find out what you can do. It is best to consult your GP on this, remember now to do too much.
    Treats!
    Remember to treat yourself / find ways to reward yourself as you achieve your goals. You'll have spotted mine from my picture, I buy a huge number helium balloon each time I achieve my next stone. But there are loads of non-food things you can do. One note of caution, if you have a lot of weight to lose, don't go and splash out on new shoes or rings as early treats, as is quite likely that you will lose weight from your feet and fingers too! When I first lost 5 stone I went from a size 8 to a size 7.
    How long will my packs take to arrive
    If you order before 1pm they'll arrive the next day. However the courier doesnt deliver on a Saturday so if you order on Friday morning it'll be Monday before you get them

  2. kittybling

    This is brilliant, thank you!

  3. Jasmine

    Just to say that you can have Saturday and Sunday deliveries - they're delivered by a different courier and they text or email you with the time they'll deliver.. Slightly more expensive but if you're in a hurry to get going, probably worth it!

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Pharmacologic Therapy For Type 2 Diabetes: Synopsis Of The 2017 American Diabetes Association Standards Of Medical Care In Diabetes Free

Abstract Description: The American Diabetes Association (ADA) annually updates the Standards of Medical Care in Diabetes to provide clinicians, patients, researchers, payers, and other interested parties with evidence-based recommendations for the diagnosis and management of patients with diabetes. Methods: For the 2017 Standards, the ADA Professional Practice Committee updated previous MEDLINE searches performed from 1 January 2016 to November 2016 to add, clarify, or revise recommendations based on new evidence. The committee rates the recommendations as A, B, or C, depending on the quality of evidence, or E for expert consensus or clinical experience. The Standards were reviewed and approved by the Executive Committee of the ADA Board of Directors, which includes health care professionals, scientists, and laypersons. Feedback from the larger clinical community informed revisions. Recommendations: This synopsis focuses on recommendations from the 2017 Standards about pharmacologic approaches to glycemic treatment of type 2 diabetes. The American Diabetes Association (ADA) first released its Standards of Medical Care in Diabetes for health professionals in 1989. These practice gui Continue reading >>

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Popular Questions

  1. Prairie-dawg

    So I went to the pharmacy yesterday to pick up a new scale and some Ketostix. The pharmacist (who works right next door to me and I've become friendly with) asked me if I was "starting some kind of crazy diet." I told him I've started a ketogenic diet and I'm just trying it out to see if it's right for me. He asked me a few questions about it, mostly about macro ratios and if it's been working so far. When I told him about the higher fat ratio (as opposed to high protein) he seemed somewhat intrigued, but still a little skeptical. The other pharmacist who was working with him chimed in at that point. He said apparently in some Scandinavian countries, they've found that a higher fat content and fewer simple carbs in a person's diet is ideal and actually recommended. However, they both agreed that ketosis for an extended period of time can be very hard on the kidneys. I did a little investigating on my own and there's very little info regarding the long-term effects of the high fat/moderate protein/low carb keto diet. So my question is, has anybody experienced any kidney issues on this diet? Has anyone received any similar warnings from their physician?
    TL;DR
    Pharmacist warned about kidney issues caused by long term ketosis. Seeking out facts/sources to prove or disprove this claim.

  2. cloudmind

    When I first started keto I ended up going to hospital because I had severe internal pain that wouldn't go away. Turns out I was eating far too much protein so my kidneys were giving me grief. Fixed it by upping the fat macros in my diet and I went back to being pain free. Hooray for butter and coconut oil!
    Given my experience, I can understand where the pharmacists are coming from since I think there might* have been a spate of people doing atkins-like diets with kidney problems in the past (too much protein, not enough fat).
    *rampant speculation on my part

  3. Prairie-dawg

    I don't blame them for that at all. In fact, before I really started doing my homework on keto, I used to internally roll my eyes when people would talk about low carb dieting. I think there's a lot of risidual negativity held over from the early days of Atkins regarding low carb diets. Fortunately, I'm always happy to have a teaching moment when the chance arises!

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Prevention of microvascular and macrovascular complications rests on timely institution of drug therapy by the prescribing physician, usually a general practitioner (GP), and the patient's compliance with the treatment regimen and willingness to make lifestyle changes. Optimal use of clinical practice guidelines (CPGs) in general practice demands specific implementation strategies aiming at the reduction of barriers to high-quality care. Clinical practice guidelines are potentially useful for health services and health workforce planning, but would be more valuable for this aim if they contained more detail about care protocols and specific skills and competencies especially for general practitioners who would be expected to have reduced capacity for effective high-quality care.Subsequently, many patients will not receive such level of care despite the availability of international treatment guidelines describing the supposed optimal management of patients with diabetes. Hence, a clear understanding on how to overcome this knowledge-action gap in diabetes seems to be lacking, despite previous studies which outlined the obstacles that prevent GPs from following the CPGs. So the only winner in such battle field is the pharmaceutical companies. Because we as healthcare professionals control the market for products that we neither pay for nor consume, and whose unwanted consequences are experienced by patients.

Ada/easd Antihyperglycemic Therapy - General Recommendations1

There have been no clinical studies establishing conclusive evidence of macrovascular risk reduction with TRADJENTA. Nasopharyngitis, hypoglycemia (when used in combination with sulfonylurea) The efficacy of TRADJENTA may be reduced when administered in combination with a strong P-gp or CYP3A4 inducer. Alternative treatments should be used. Use during pregnancy only if clearly needed. Exercise caution when administering to a nursing woman. Please see Prescribing Information and Medication Guide . INDICATION AND IMPORTANT LIMITATIONS OF USE TRADJENTA is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus. TRADJENTA should not be used in patients with type 1 diabetes or for the treatment of diabetic ketoacidosis. TRADJENTA has not been studied in patients with a history of pancreatitis, and it is unknown if using TRADJENTA increases the risk of developing pancreatitis in these patients. TRADJENTA is contraindicated in patients with a history of hypersensitivity reaction to linagliptin, such as anaphylaxis, angioedema, exfoliative skin conditions, urticaria, or bronchial hyperreactivity. Acute pancreatitis, including fatal Continue reading >>

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Popular Questions

  1. View Profile

    late period

    Hi guys, my period is late, only by a couple of days. I took a test, it came back negative. I was wondering would being in ketosis effect the test result? I read not to do atkins if pregnant. Any advice. Xxx

  2. View Profile

    Hey. Erm started my period today, D'oh couple of days late, thought I might of been preggers : 3( There's always next month. If I was to get pregnant would I be able to carry on the woe? X

  3. View Profile

    yeah i guess we are , we are engaged and have been together 7 years, i came off the pill a while ago now so if it happens it happens if i caught i would come out of ketosis, up till then i will continue this woe xxx

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