Management Of Acute Hyperglycemia In Type 2 Diabetes

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Dr. Bernstein discusses how to bring down severe hyperglycemia caused by gastroparesis. Dr. Bernstein's book is available at www.amazon.com/Dr-Bernsteins-Diabetes-Solution-Achieving/dp/0316182699/ This video was produced and edited by Dr. RD Dikeman and David Dikeman of TYPEONEGRIT. For more on Dr. Bernstein's book, Diabetes Solution, go to http://www.diabetes-book.com/ Every month Dr. Bernstein hosts a free teleseminar via http://www.askdrbernstein.net/ where you can ask questions and he will answer them. Also check out http://www.thebernsteinconnection.com/ for the The Bernstein Connection, which is the one and only current and archive website of every Audio Recording, Video, DVD, Transcript, Teleseminar, and more, that Dr. Bernstein has done plus so much more...

Initial Management Of Severe Hyperglycemia In Type 2 Diabetes

Initial Management of Severe Hyperglycemia in Type 2 Diabetes Shauna Runchey, MD and Irl B Hirsch, M.D. Fellow in Metabolism, Endocrinology & Nutrition, University of Washington, Seattle Professor of Metabolism, Endocrinology & Nutrition, University of Washington, Seattle Type 2 diabetes mellitus (DM) is a common disease affecting 26 million people, 8.3% of the US population. Of these, an estimated 7 million people are undiagnosed. Type 2 DM typically has two pathophysiologic defects: an insulin secretory defect and insulin resistance. Symptoms of uncontrolled hyperglycemia include polyuria, polydipsia, blurry vision and possibly dehydration and weight loss. Patients may complain of thirst, sweet cravings, generalized fatigue, abdominal discomfort, and muscle cramps. They may have a history of poor wound healing and/or frequent infections. Basic metabolic laboratory tests may reveal a random blood glucose level over 200 mg/dL [11.1 mmol/L], hyper- or hyponatremia, hypokalemia, metabolic acid-base derangements and acute renal or prerenal insufficiency. Historical clues for the diagnosis of type 2 DM might include pre-existing history of pre-diabetes, a family history of type 2 diab Continue reading >>

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  1. martinus

    Keto Calculator 2.0

    It is a slow and lazy Sunday, so I've tried to make something useful: An online calculator that tries to determine how much of what nutrient you should eat each day. The main reason for this is to have something much more accurate than the typically recommended ratios:
    I'd appreciate any feedback!
    UPDATE: Wow, I did not expect such a big interest! I'm trying to improve the calculator while still keeping it simple, and most importantly as scientific accurate as possible. The latest update now remembers your form data so your data is not lost when you reload the page. If you want something improved, please tell me!
    UPDATE 2: I had a second look at the protein numbers. I am now using the middle way between the suggestions from here, and the book "The Art and Science of Low Carbohydrate Performance". (I used the numbers from the second source earlier). The protein numbers have therefore increased a bit, when you reload the page.
    UPDATE 3: A target caloric goal can be chosen, and percentage for MFP are calculated.
    UPDATE 4: Please see Keto Calculator 2.0
    UPDATE 5: Now it's more flexible. protein intake can be specified, and monthly loss is estimated.
    UPDATE 6: IE support. Lots of minor changes.
    UPDATE 7: Now with fancy estimated weight loss chart
    UPDATE 8: red boxes everywhere (I got complaints that the calculator did not work and the reason was missing data), and some book recommendations
    UPDATE 9: Lower limit of 30g fat for prevention of gallstone formation.
    UPDATE 10: Lots of restructuring, and now you enter target fat instead of target calories.

  2. [deleted]

    easy to use and easy to understand :)

  3. sutrigoo

    Spectacular! This follows the exact procedure in the FAQ, doesn't it? Amazing!

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Date : 9 March 2013 Speaker : Dr.Roy Panusunan Sibarani, SpPD-KEMD Venue : GP Update - Hotel Grand Aston City Hall, Medan

Management Of Hyperglycemia In Type 2 Diabetes: A Consensus Algorithm For The Initiation And Adjustment Of Therapy

Injections, three times/day dosing, frequent GI side effects, expensive, little experience *Severe hypoglycemia is relatively infrequent with sulfonylurea therapy. The longer-acting agents (e.g. chlorpropamide, glyburide [glibenclamide], and sustained-release glipizide) are more likely to cause hypoglycemia than glipizide, glimepiride, and gliclazide. Repaglinide is more effective at lowering A1C than nateglinide. GI, gastrointestinal. 1)Begin with low-dose metformin (500 mg) taken once or twice per day with meals (breakfast and/or dinner). 2)After 57 days, if GI side effects have not occurred, advance dose to 850 or 1,000 mg before breakfast and dinner. 3)If GI side effects appear as doses advanced, can decrease to previous lower dose and try to advance dose at a later time. 4)The maximum effective dose is usually 850 mg twice per day, with modestly greater effectiveness with doses up to 3 g per day. GI side effects may limit the dose that can be used. 5)Based on cost considerations, generic metformin is the first choice of therapy. A longer-acting formulation is available in some countries and can be given once per day. Injections, three times/day dosing, frequent GI side effect Continue reading >>

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  1. Philip Ghezelbash

    This depends on many different factors.
    The main factors contributing to how much weigh someone can lose on a ketogenic diet in one week are:
    The individual person
    The individual’s current weight
    The individual’s current body composition
    The caloric deficit
    The type of food they’re eating

    Water fluctuation.
    Generally a ketogenic diet is going to have someone lose more weight in a week than another diet even if calories are the same.
    This generally comes down to the extra water retention in the body which is flushed out when carbohydrates are restricted to very low levels (typically 5%).
    The final answer is, given a caloric deficit, weight loss will occur.
    Whether this weight loss is tangible and noticeable will depend on all 6 latter points.
    Thanks for reading,

    Philip Ghezelbash ©

  2. Drew Baye

    It would depend on the calorie deficit. Regardless of whether you follow a ketogenic or low fat diet, how much fat you lose over time still depends primarily on your calorie intake (as repeatedly demonstrated in metabolic ward studies comparing the two).

  3. Nathanael Schulte

    That is extremely variable, depending on the person. When I was in my early twenties, I did the Atkins diet for a while, starting out in the 20g of carbs phase, I probably lost 2–5 lbs per week. A few years later, after having come back to it after trying Weight Watchers with my wife, the scale moves much slower, and I’m much more affected by factors like stress, which I have a lot more of these days. I find it very hard to see the scale move at all unless I’m throwing in fasting as well.

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On www.xtalks.com - Data from a recent real-world observational study has found that that Sanofis type 2 diabetes drug, Toujeo (insulin glargine 300 Units/mL), was associated with a lower risk of hypoglycemia, compared to other basal insulins. To read more: http://xtalks.com/Diabetes-Drug-Lower... For more news stories, visit: http://xtalks.com/News.ashx Receive weekly news updates right in your inbox: http://xtalks.com/subscribe.ashx Listen live and interact with featured speakers on our upcoming Life Science webinars: http://xtalks.com/upcoming.ashx

Initial Management Of Severe Hyperglycemia In Patients With Type 2 Diabetes: An Observational Study

Initial Management of Severe Hyperglycemia in Patients with Type 2 Diabetes: an Observational Study University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, CO USA University of Colorado Hospital, Aurora, CO USA Jennifer M. Trujillo, Email: [email protected] . Current guidelines recommend insulin for patients with type 2 diabetes (T2D) and severe hyperglycemia, but this recommendation lacks sufficient evidence and poses practical challenges. It is unclear whether non-insulin treatments are effective in this setting. The objective of this study was to describe treatment strategies of T2D patients with severe hyperglycemia and identify which initial treatments, interventions, or patient characteristics correlated with successful glucose lowering. This was a retrospective cohort study of 114 patients with T2D and a glycosylated hemoglobin (A1C) 12%. Changes in A1C were compared between patients started on non-insulin medications versus insulin-based regimens. Regression analysis was performed to assess predictors of success in achieving A1C 9% within 1year. The main outcomes measures were change in A1C from baseline and predictors of success Continue reading >>

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  1. bundysn

    I have been doing the Keto diet for 2.5 weeks. The first week I lost 4 lbs in 6 days. Then gained a lb and lost .6 now I'm stalled out. Basically losing .2 every few days. I AM in ketosis. I know the metallic taste, the urine smell and I test my urine in the AM before I drink water and it is at the high end of the color spectrum. My macros are 75/20/5. My energy levels are through the roof!! So no complaints there. I feel amazing!! My skin, hair etc looks better but the weight isn't coming off, even though I'm in ketosis.... Can anyone help me with this? I drink massive amounts of water. It's my addiction. At least 200 oz a day.... Always have so that's nothing new. Thanks in advance!
    Female 33

  2. Kathy13118

    Is your doctor advising you about your diet? Being in ketosis, drinking so much water, not losing weight - and continuing with the diet - I would ask your doctor what he or she thinks is going on.

  3. TattooedRN

    Since you are already at a healthy weight for your height I suspect that's why you are not losing large amounts of weight. With that said, a couple of suggestions...
    Are you eating enough fat? It has been shown that higher fat in = higher fat out.
    Also remember you can lose inches without losing pounds, this is normal and happens to everyone. Stalls are normal, they are your body's way of shifting gears and figuring out what changes are happening.
    Again, 5'8 and 149 lbs is a perfectly healthy weight and I can't see it would be very healthy for you to lose much more. Just keep at it, and if you have weight to lose, it will come off, but the less weight you have to lose the slower it will be...if your in the last 5 lbs to lose, i reiterate, it can take some time for that since your body is more likely to hold onto it. Maybe try an Atkins fat fast if that's your goal?
    Good luck!

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