Transcript Keto Diet Success Shark Tank Amazon Finds That Actually Work Introduction The ketogenic diet, commonly known as keto, has gained immense popularity in recent years due to its remarkable weight loss benefits and potential health improvements. It is a high-fat, low-carbohydrate eating plan that encourages your body to enter a state of ketosis, where it burns fat for fuel instead of carbohydrates. This dietary shift can lead to rapid weight loss, reduced hunger, and improved mental clarity. However, when dining out or attending social gatherings, sticking to the ketogenic lifestyle can become challenging, especially in cuisines that are rich in carbs, such as Mexican food. The upcoming 7-Day Keto Challenge is designed to empower you with strategies and tips to maintain ketosis while enjoying delicious meals at a Mexican restaurant. Mexican cuisine is deeply engrained in many cultures, often filled with vibrant flavors, fresh ingredients, and a myriad of options that can derail your keto goals if you’re not mindful of what you order. Traditional meals often include rice, beans, tortillas, and sweet desserts that are typically loaded with carbohydrates. Nevertheless, with a little knowledge and planning, you can enjoy a variety of flavorful dishes that align with your ketogenic lifestyle. This article will guide you through the nuances of navigating the Mexican menu while staying committed to your diet. You’ll learn how to identify the best options, make substitutions, and even create some keto-friendly favorites at home. Staying keto at a Mexican restaurant requires both preparation and adaptation. This article breaks down the process into five distinct sections, exploring the essentials of choosing the right dishes, understanding what ingredients to avoid, and offering practical tips to ensure that you remain in ketosis while savoring the rich flavors of Mexico. Each of these components will serve to enhance your dining experience without compromising your dietary choices. As you embark on this 7-Day Keto Challenge, you will develop an understanding of how to navigate both traditional and contemporary offerings that Mexican cuisine provides, making it easier to remain on track with your health goals while enjoying dining out. Understanding Ketosis and Its Importance To successfully engage in the 7-Day Keto Challenge, it’s crucial to understand what ketosis is and why it matters. Ketosis is a metabolic state where the body shifts from burning glucose as its main source of energy to burning fat. This occurs when carbohydrate intake is limited to a few grams per day, generally around 20 to 50 grams, encouraging the liver to produce ketones from fatty acids. These ketones then serve as an alternative energy source for various bodily functions, including brain activity and physical exertion. By reducing carb intake and increasing healthy fats, your body initiates this remarkable process. Understanding the mechanics of ketosis empowers you with the knowledge needed to make informed choices at any restaurant. This understanding is particularly vital when deciding what to order at a Mexican restaurant. Traditional dining options often feature carbohydrate-rich ingredients, which can easily knock you out of ketosis. Familiarizing yourself with the science behind ketosis aids in recognizing what constitutes acceptable food items. This prepares you to look beyond typical menu items and creatively brainstorm keto-friendly alternatives. For instance, while a traditional burrito wrapped in a flour tortilla may be carb-heavy, exploding with flavor, you can still enjoy the filling components like grilled meats, guacamole, and salsa without the tortilla. Emphasizing fats and protein empowers you to navigate the menu without falling prey to deceptively carb-laden dishes. Moreover, being informed about your own body’s response to ketogenic foods is just as important. Each person’s body reacts differently to certain food types, and it’s essential to track how your individual intake can influence your ketosis. Gastrointestinal comfort, energy levels, and even mental clarity can be affected by your choices. By understanding your personal responses, you can tweak your dining choices to remain in ketosis while maintaining overall well-being and enjoyment from your meals. This foundation creates a personalized strategy that aligns with your unique lifestyle and preferences—making the 7-Day Keto Challenge not just manageable, but enjoyable. Deciphering the Mexican Menu: Smart Selections When you’re faced with the tantalizing offerings of a Mexican restaurant, knowing how to choose wisely can significantly affect your success during the 7-Day Keto Challenge. The menu is often overflowing with choices, so understanding which options align with your dietary goals is crucial. Start by seeking out dishes centered on proteins such as grilled meats, seafood, or poultry. Tacos, enchiladas, and fajitas can often be adapted by substituting the starchy tortillas with lettuce wraps or simply opting for the ingredients served on a plate without the carbs. Encourage the restaurant to hold the rice and beans, instead asking for additional grilled vegetables or extra guacamole—both rich in healthy fats and low in carbs. Another important component in deciphering the menu is recognizing the various sauces and salsas that can either boost your dish or detract from it. Many sauces, such as those made with cream or butter, can add flavor without adding carbs, making them perfect additions to your ketogenic plate. Opt for salsas made from fresh vegetables or herbs, as these typically have fewer carbs compared to sweeter sauces. Additionally, cheese is a staple in Mexican cuisine, and it not only enhances the flavor but also fulfills your fat intake goals—just be cautious of quantities, as some cheeses can be calorie-dense. Seeking out appetizers is another clever way to stay ketogenic at a Mexican restaurant. Guacamole is a fantastic choice, loaded with healthy fats and fiber while being naturally low in carbohydrates. Pick jalapeño poppers stuffed with cream cheese, ensuring that any breading is removed, or enjoy shrimp ceviche for a refreshing option. The key lies in being proactive about your choices and not hesitating to customize your dishes. Most restaurants are more than willing to accommodate dietary restrictions; you just need to ask. Your ability to articulate your keto-friendly desires can turn meals into satisfying experiences without compromising your goals, making the 7-Day Keto Challenge a stepping stone to a long-term lifestyle. Common Ingredients: What to Avoid As you navigate your dining experience during the 7-Day Keto Challenge, knowledge about common ingredients to avoid is essential. Understanding what items typically present a carb risk enables you to steer clear of potential pitfalls. At Mexican restaurants, staple items such as rice and beans sit high on the list of ingredients to watch out for. These elements are delicious and often served as side dishes, but they contribute a significant number of carbohydrates that can derail your diet. It’s critical to be mindful when ordering to bypass these staples entirely and request alternatives such as sautéed vegetables or a simple salad. Tortillas are another culprit that can obliterate your keto plans. This includes not just flour tortillas, which are incredibly high in carbohydrates, but even corn tortillas, which can still add up in carb counts. Understanding the tortilla’s carbohydrate content is essential. Doing so will empower you to request menu items without these additions or suggest lettuce wraps as a substitute. Communicating with your server about your dietary choices can lead to creative solutions that ensure you still enjoy the flavors of your preferred dishes without sacrificing your keto objectives. Striking a balance between a fulfilling meal and remaining in ketosis is also about knowing how certain ingredients may be hidden. For example, many salsas may contain added sugars, making them a deceptive choice while appearing healthy. Likewise, sauces such as mole can be delicious but are sometimes high in sugars and other carbs. It’s essential to approach these condiments with caution and inquire about the ingredients or opt for simpler, fresher versions. Being knowledgeable about both visible and hidden ingredients ensures you’ll remain committed to your dietary goals while enjoying everything that a Mexican dining experience has to offer. Crafting Your Own Keto Mexican Dishes at Home If you find it challenging to stick to your goals when dining at a restaurant, consider translating the spirit of Mexican cuisine into your own kitchen. Crafting keto-friendly Mexican dishes can keep your dietary intentions in check while allowing you to explore flavors without the worry of hidden carbs. Start by experimenting with zucchini or bell pepper “tortillas” for tacos. Simply slice these vegetables, sauté them briefly, and stuff them with your favorite fillings. Toppings can include seasoned grilled meat, fresh guacamole, and a sprinkle of cheese, all while keeping carbohydrates at bay. Another wonderful dish to try making at home is a delicious keto enchilada. By opting for shredded chicken or beef, you can skip traditional tortillas and instead use thinly-sliced cabbage or eggplant, filling them with protein-rich options and a low-carb enchilada sauce. Top with cheese, bake until bubbly, and voilà! You can enjoy an authentic tasting meal without worrying about the carbs. Pair it with a fresh salad or some avocado slices for a complete and hearty meal. Don’t forget the importance of snacks and sides! Preparing your own jalapeño poppers, made with cream cheese and wrapped in bacon, can satisfy your craving for a crunchy appetizer while keeping carb counts low. Additionally, whip up recipes for flavorful salsas or dips using fresh herbs, tomatoes, and avocados to keep your meals vibrant and fulfilling. Engaging in homemade preparations fosters creativity while solidifying your dedication to the ketogenic lifestyle, ensuring that when you step out for the 7-Day Keto Challenge, you’re always set up for success. Frequently Asked Questions The journey through the 7-Day Keto Challenge, especially with an emphasis on Mexican dining, raises numerous questions as many enthusiasts seek to achieve successful outcomes. A common query revolves around whether enjoying traditional ingredients in moderation can still fit within a ketogenic framework. The answer lies in your personal carbohydrate limits and food choices. While indulging in small portions of higher-carb foods can work for some, many find it beneficial to completely abstain to regulate their state of ketosis effectively. Keeping note of your total daily carbohydrate intake is crucial in determining what is feasible for your body. Another frequently asked question centers around dining out: “Should one alert the staff about dietary restrictions?” Absolutely, yes! Many restaurants are accustomed to accommodating low-carb or keto diets. Explaining your needs will allow your server to help guide you through the menu and offer substitutions or adjustments. The willingness of the associate reflects the restaurant’s commitment to providing a positive experience for their guests. By making your desires clear, you’re more likely to receive a plate that meets your dietary preferences without compromising the overall dining experience. Lastly, individuals often worry about staying in ketosis while attempting to enjoy a meal at a restaurant. The most effective approach to combating this uncertainty is preparation. Researching the restaurant’s menu beforehand, selecting keto-friendly items, and knowing what to ask for when you arrive can empower you to make better choices. Building a strategy in advance equips you with the tools to avoid potential pitfalls while enjoying your meal. Balancing a lifestyle change with dining experiences can be challenging, but employing a proactive approach ensures you will savor the flavors of Mexican cuisine while maintaining your ketogenic goals. 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Most people think of the best supplements for weight loss to be those that increase the heat in their body (thermogenic) or that speed them up. But I haven't found those to have a long-term healthy effect. The supplement I have found to be very effective at weight loss AND extremely healthy long-term are Perfect Aminos by BodyHealth. PerfectAmino® is comprised of pure Essential Amino Acids in an exact ratio that is 99% utilized to build new protein and collagen in the body – without the calories. If you are trying to lose weight, PerfectAmino can help in two ways: First, it can help build lean muscle, which in turn burns fat. The more muscle you have on your body, the more fat it will burn to feed this muscle. Amino acids are also necessary to make Thyroid, Lipase, Glucogen and HGH, which each have a role in fat-burning. The second way is by replacing low-utilization protein powders with PerfectAmino. Over 80% of protein powders are converted to sugar in the body, not protein. This sugar triggers a hormone called insulin to shuttle the sugar to the cells for energy production. But when there is more sugar than the body needs, the insulin converts the sugar into body fat (energy for later). Intermittent Fasting & Ketosis using PerfectAmino: With the Keto diet many people have trouble taking away their body’s accustomed energy source (sugar) without, at the same time, giving it what it actually needed in the first place: usuable amino acids to build the body’s structure. When adding in PerfectAmino, most people who had trouble with their Keto diet or the “Keto Flu”, now find they are able to follow through with it. And adding in PerfectAmino will not add calories onto this or take them out of Ketosis, it will only enhance their gains. With Intermittent Fasting we are trying to do something very similar to Keto. We are trying to remove sugar from the bloodstream long enough to lower Insulin levels and turn back on Lipase for fat burning. 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For many it is about calories, but what I explain in this short video is that calorie counting is a waste of time and it really comes down to 3 things Reduce your stress Eat quality nutrition and eat frequently Add muscle using functional strength training techniques If you do these 3 things and in this order you will achieve optimal health, happiness and lose fat without losing muscle. This is without doubt the most frustrating thing I have come across in my career as a Personal Trainer in Melbourne. The client who absolutely hammers themselves with all types of exercise, but has poor nutrition habits and wonders why they don't lose the belly fat! A classic case of the gym junkie who is ignorant to the two biggest factors regarding weight loss, STRESS and NUTRITION. In fact it is also safe to say that most personal trainers are ignorant to the first factor too! What you’ll see here is two things happening. Firstly whenever cortisol levels (your stress hormones) are chronically high, it suppresses your androgens (growth hormones), so things like testosterone and growth hormone are suppressed, which is not good if you are trying to add muscle to get stronger and fitter. You need more muscle to speed up your metabolism so you are already off to a bad start. In addition to testosterone decreasing, your gluco-corticoids or your stress hormones are elevated. One of the first reactions is that the body thinks that it’s going to have a long-term energy crisis, if we repeatedly stress out our hormonal system. So what normally happens is most bodies will start accumulating fat right around the belly button, and this is your signal that this is a chronic stress related problem. Make sure you watch this video to fully understand What Stress Is and Where Does it come from. So what do most people do to get rid of the gut? They start doing heaps of ab exercises, do more boxing classes or run more, and start starving themselves or cutting fat out and sorts of other crazy and ineffective ideas. This is the go hard go home mentality that does not work, and will only set you up for a lifetime of chronic problems. By the way calorie restriction never works either in case you were thinking of doing that too. Another philosophy of most personal trainers and diet books that just sets people up for....... you guessed it, more STRESS! What you need to do is, Eat high quality meals balanced for your Metabolic Type, Reduce your stress. Watch the video on Reducing Stress for ideas on how to do this Lastly NEVER skip meals or go longer than 4 hours without eating and you’ll see that that fat around the belly button will start to metabolize and disappear which makes everybody happy. Include a good Strength training program 3-4 times per week. (If you need help designing a program go to our Personal Training page and fill in a consult form and I will get in touch with you within 24 hours) If you live in Melbourne make sure you go to our website and fill in a contact form to book a free health and fitness consultation. https://www.noregretspt.com.au/index.php/specialised-programs/weight-loss-plansHow To Take Your Bariatric Wls Vitamins Barimelts Wlsjourney Vsgjourney Vitamins WeightlossDiscover why Goli Apple Cider Vinegar Gummies are a game-changer for your daily wellness routine. In this video, we break down the key ingredients and the powerful benefits—without the harsh taste of traditional vinegar. From digestion to immune support, Goli Gummies make it easy to prioritize your health. 🎯 Get yours with exclusive discounts at the link in the comments. 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You can find a list of international crisis lines here: https://blog.opencounseling.com/suicide-hotlines/ Disclaimer: All of the information on this channel is for educational purposes only and not intended to be specific/personal medical advice or substitute for diagnosis and treatment of any conditions discussed herein. Furthermore, watching these videos or getting answers to comments/questions, does not establish a provider-patient relationship. Please consult with your own healthcare provider for proper diagnosis and treatment. Note: This video is not sponsored. Some of the links provided are affiliate links, meaning I may earn a small commission from purchases made through those links.Quick And Simple Keto Recipes For Busy Weeknightsweightlossketodietshorts The ketogenic diet, commonly known as “keto,” has taken the weight loss world by storm in recent years. This high-fat, low-carb diet has been praised for its ability to help individuals shed pounds quickly and effectively. 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Born in Ireland, Coughlan gained prominence through her role as Penelope Featherington in the Netflix series “Bridgerton,” where her character serves as both a comedic relief and a central figure in the show’s romantic entanglements. Yet, Coughlan is much more than just her role; she embodies a strong advocate for body positivity and self-love. As she navigates both her professional and personal life, she manages to project an image that is unfiltered and inspiring, conveying the importance of acceptance in a world often shrouded by unrealistic beauty standards. Coughlan, like many actresses, has faced scrutiny over her physical appearance. The entertainment industry can be ruthless, and actors often find themselves at the mercy of public opinion. However, rather than succumbing to pressures to conform to a particular ideal, Coughlan has opted to celebrate her own unique body. The contrast between her charismatic public persona and the oftentimes harsh reality of societal expectations can serve as a poignant reminder of the importance of self-acceptance. This dynamic is especially highlighted in Coughlan’s social media presence, where she frequently shares candid images that celebrate her body just as it is. Through these platforms, she directly challenges the notion that a woman’s worth is determined by her size or shape. Moreover, Coughlan’s journey speaks not only to the challenges women face in self-acceptance but also emphasizes the importance of mental health. The pressure to look a certain way can lead to significant psychological struggles, yet Coughlan’s openness about her experiences resonates deeply with many of her fans. By discussing the intersection of body image and mental health, Coughlan highlights the psychological impact of societal pressure, encouraging others to embrace their bodies. The realities surrounding weight and body image are complex and deeply ingrained in cultural perceptions. As such, Coughlan’s testament of loving oneself despite societal pressures stands as a beacon of hope for many who deal with similar struggles. Challenging the Norms of Beauty Standards In her role on “Bridgerton,” Coughlan’s character, Penelope, is a testament to the idea that beauty comes in all forms. The show, set in the regency era, is known for its visually stunning cast and intricate costumes, which may reinforce traditional perceptions of beauty. However, Coughlan’s portrayal of Penelope infuses a sense of authenticity that resonates with viewers. By showcasing an individual who possesses both intelligence and charm, Coughlan defies the stereotype that beauty alone determines worth. This nuanced depiction allows audiences to transcend narrow definitions of beauty, recognizing the diverse forms it can take. Coughlan’s willingness to address her own body image issues encompasses a broader discussion about societal beauty standards. In interviews, she often shares how the industry pressures actors to meet specific physical criteria that may not be achievable for everyone. Instead of succumbing to those pressures, she embraces her figure and encourages others to do the same. Her commitment to challenging these outdated norms encourages a global conversation surrounding representation and acceptance. In an industry that is often rigid in its definitions of beauty, Coughlan’s authenticity helps pave the way for future generations of performers. Additionally, Coughlan’s advocacy extends beyond her on-screen roles, as she participates in campaigns aimed at promoting body positivity. Her influence encourages young people to embrace their unique qualities and recognize that they are beautiful just as they are. By challenging beauty norms, Coughlan participates in an essential movement that prioritizes diversity and individuality over conformity. Her prominent public presence serves as a reminder that change is gradual but necessary; it calls for a collective effort among entertainers and audiences alike to reshape societal expectations. The Intersection of Weight and Mental Health Awareness The relationship between body image and mental health is a critical aspect of Nicola Coughlan’s narrative. Many individuals struggle with how they perceive themselves and how they think others perceive them. Coughlan candidly discusses her experiences with anxiety and how they intersect with her body image, emphasizing that mental health encompasses far more than physical appearance. Her transparency about these challenges is not just revealing; it also encourages her fans to understand that it is okay to have insecurities and that acknowledging them is the first step toward healing. Moreover, Coughlan’s openness about her mental health issues resonates with many who face similar battles. By sharing her story, she normalizes discussions around anxiety, self-doubt, and societal pressures. The entertainment industry often perpetuates the myth that happiness is linked to achieving a particular appearance, yet Coughlan’s narrative emphasizes that true contentment stems from embracing one’s identity, imperfections, and all. Her journey proves that mental well-being is not only attainable but also a valid pursuit alongside the struggles tied to body image. In raising awareness about mental health, Coughlan acknowledges the need for society to foster environments where open discussions can thrive. The stigma surrounding mental health often leads individuals to suffer in silence. Recognizing the connection between mental health and body image issues can serve as a pivotal step toward greater understanding and support. By continuing this dialogue, Coughlan advocates for more inclusive conversations about how we, as a society, can redefine our understanding of beauty and self-worth. Empowering Others Through Social Media Social media can serve as a double-edged sword, often magnifying both body image issues and positive reinforcement. For Nicola Coughlan, her social media platforms have become an empowering tool for self-love and acceptance. Through her posts, she celebrates her individuality and shares messages that challenge the status quo, emphasizing that everyone has the right to feel comfortable in their skin. Coughlan’s use of social media not only highlights her journey but also embodies the spirit of connecting with a community of supportive individuals. In today’s digitally driven world, social media can be rife with unrealistic portrayals of beauty. Coughlan takes a deliberate stand against this trend by posting unfiltered moments, showcasing herself without the gloss of over-editing and filters. This authenticity invites her followers to embrace their imperfections and love themselves as they are. By fostering a culture of transparency, Coughlan encourages her audience to engage in conversations surrounding body positivity, reshaping their narratives and understanding that beauty is multi-faceted beyond societal pressures. Additionally, Coughlan leverages her platform to advocate for representation in media, promoting diversity in body types and narratives. Highlighting representation, she emphasizes that everyone deserves to see themselves reflected on screen and in various art forms. By bringing attention to this crucial matter, Coughlan motivates others to speak up about their experiences and challenges the entertainment industry to broaden its scope of what is deemed beautiful. Her social media presence not only empowers her followers but also sets a new standard for individuals in the industry to embrace diversity. A Legacy of Self-Acceptance and Body Positivity Nicola Coughlan’s journey within the entertainment industry is a powerful reminder of the ongoing fight for body positivity and self-acceptance. She symbolizes courageous resistance against the norms dictated by society and the media while embracing her unique identity. Her impact extends beyond her acting career, serving as a figure of hope and inspiration for countless individuals struggling with self-acceptance. Through her roles, interviews, and social media presence, Coughlan showcases that beauty come in various forms, emphasizing that self-love is an ongoing journey. Coughlan’s advocacy for body positivity transcends personal narratives, encouraging a broader cultural shift towards acceptance. By addressing the intricacies surrounding body image, her work ignites discussions and motivates change within the industry. Notably, she emphasizes that representation matters, pushing for more diverse character portrayals in film and television. With significant milestones yet to achieve, Coughlan’s voice contributes to the larger conversation about how we perceive ourselves and each other. Ultimately, Nicola Coughlan’s impact reaches far beyond her weight or body type; it lies in the principles of self-acceptance and the celebration of individuality. Her candidness serves as a catalyst for change in the entertainment world and inspires audiences to value themselves beyond preconceived notions of beauty. By continuing to challenge societal norms, Coughlan shapes a culture that embraces diversity, resilience, and authenticity. Common Questions About Nicola Coughlan’s Journey Nicola Coughlan has emerged not only as a talented actress but also as a voice for body positivity and mental health awareness. Given her influence, many fans and followers may have questions regarding her journey and the principles she advocates. One common question is how Coughlan handles scrutiny regarding her appearance. Beyond her resilience, she draws strength from her commitment to self-love, emphasizing the importance of surrounding herself with positive influences. Coughlan’s journey reflects her belief that everyone is deserving of love, regardless of their size or shape. Another frequently asked question involves how Coughlan prioritizes her mental health amidst industry pressures. Coughlan emphasizes the importance of listening to oneself and recognizing when to step back. She advocates for open conversations about mental health vulnerabilities, encouraging individuals to seek help when needed and to embrace their struggles as a part of their unique journey. Coughlan’s willingness to share her challenges invites her audience to reflect on their own mental well-being and the importance of self-care. Lastly, many individuals are curious about Coughlan’s perspective on beauty standards and representation. Coughlan remains vocal about the need for diversity in media, advocating for stories that resonate with different body types and experiences. As she continues to expand her platform, she emphasizes the significance of redefining beauty as inclusive and multi-dimensional. By promoting narratives that empower everyone, Coughlan pushes for a future where acceptance and diversity are prioritized over conformity, ultimately fostering a culture of body positivity that uplifts and inspires. 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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. 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