Dr. Karen Dwyer - 'SGLT2 Inhibitors - Optimising Their Use'
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- เผยแพร่เมื่อ 22 ธ.ค. 2023
- Dr. Karen Dwyer graduated from The University of Melbourne in 1994 and completed physician training in Nephrology in 2001. She completed her PhD in 2004 through the University of Melbourne and then spent two years in Boston, USA.
As a nephrologist and transplant physician, Dr. Dwyer has a keen interest in metabolic health. In 2020 she became a fellow of the Australasian Society of Lifestyle Medicine and is undertaking training through the Society of Metabolic Health Practitioners. Karen is passionate about improving the health and well-being of the community taking a holistic and integrated approach with an emphasis on lifestyle management.
Until recently, Dr. Dwyer was Clinical Director at Kidney Health Australia and Professor of Medicine at Deakin University. Karen has published over 100 peer review articles with her research interest being adnosine signalling in kidney transplantation. In 2021 she was presented the inaugural Burnstock Lecture for her contribution to the field.
The highlight of Karen's clinical career was as the lead physician for Australia's first hand transplant in 2011 which was recognised with Quality Award by St. Vincent's Health Australia. Karen has served on the council and executive of the Transplantation Society of Australia and New Zealand and is currently the Oceania representative on council for the International Transplant Society. In 2018 Karen was awarded the Leader in Transplantation Award for gender equity advocacy.
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Cardiologists also use this type of med for heart failure. All they need to recommend is to stop ingesting carbs in the first place.
There is an example patient mentioned in the video.
Agreed but it is more nuanced than that
All they need is to recommend low carb, and have a patient that will accept that recommendation
@@David-hp9tr yes nuanced because of all those carbs and seed based oils, and other lifestyle and bad habits over a lifetime, all culminating into inflammation and at its core mitochondrial damage
Hmmm another doctor are evil, stupid, drug pusher .....etc
1. Patients have variable attitude....some pt are slob, some are snob (won't change their perspective) and some are very reasonable and curious...God knows when and if ever they change at all..... I'm sure before u go low carb you also one of those people..
2. Low carb is effective but it is not the only way...there are HUMAN RANDOMIZED CONTROLLED TRIALS showed benefits of other diet as well especially if they controlled for total calories.. ...and not all people can tolerate low carb lifestyle for what ever reason.....
3. You have a med that works and while the pt decide to change the lifestyle or not it is reasonable to start and can always off it later..
4. Diet such as low carb exist bcos the pioneers are open minded enuff and not being dogmatic of the conventional way......so keeping an open mind is important otherwise low carb community just become another diet zealot that we criticize so much....one day if suddenly it is proven low carb are harmful or dangerous then we also need to abandon it .... we may laugh and ridicule at the vegan zealot but some of us might turn into one albeit in the different camp.
People on carnivore diets and sometime on keto diets, often show a low egfr number, which is very misleading and can make a doctor think you have early or some form of kidney disease. This is why cystatin c is much more accurate and will invariably show that your kidneys are in much better shape.
Egfr is one marker, but a much better one is cystatin c, which many drs dont know about or test for..far better and less influenced by muscle mass.
Taurine found in animal foods and in particular in seafood is a safer inhibitor of SGLT.
Best to supplement with taurine and avoid the blood sugar lowering meds.
Safety tip: if you are on blood pressure (in particular calcium channel blockers, because taurine is a natural calcium channel blocker and regulator of minerals in the body) or blood sugar lowering meds, because taurine lowers both, you need to start of with very low dosing of 500mg a day and slowly increase upto 6g a day (2g per meal), while getting your meds adjusted to a lower dose, by the 3g stage you should be off your meds.
What about just reducing carbs overall, Harry? Would it not have a far more immediate affect on lowering blood glucose than increasing taurine. Eventhough there are added benefits for the inclusion of taurine in our diet through supplementation.
@@dombarton2483 yes, I agree, eliminating carbs should be the main message.
I'm on a carnivore diet and don't take taurine for blood pressure or blood sugar, but as a biohack for other purposes (increase brain stem cells, lower fibrosis, improve protein folding, increase melatonin synthesis in the mitochondria all day long to improve mitochondrial function and get better ATP production etc).
My initial comment was in regards to meds being promoted by her for non low carb people.
Good to know about taurine, but giving dosage advice is not wise when you don't know the individual health and medication status of readers. Too much of a good thing can be harmful for some people, especially when taken as supplements rather than in the diet.
@@dombarton2483I think most people have very sick mitochondria and supplement helps speed up recovery.
What supplemends? @@TheShumoby
Insulin resistance is highly governed and influenced by environmental and lifestyle factors. Saying its genetic is a cop out. Mum and Dad were just carb, seed oil addicts, and so was that lady. Its an epidemic worldwide and the solution is very simple indeed. A carnivore diet. In nature there has never ever been a documented case of heart disease. Inflammation at every angle and mitochondrial damage is at its core. When will people get it, when?
Forget low carb, no carb is the way to go. That lady turned carnivore this year! The damage was already done by carbs.
I eat mostly meat and cheese, but I still enjoy salad, nuts and coffee, so I'll stick with keto, thanks.
SGLT-2 inhibitors also dump sodium (dehydration) and increase risk of UTI (bacteria feeds on glucose)
Appreciating the comments on this talk
Retired GP/Diabetes lead here. I have seen a case of DKA with blood sugar of 12 mM in a patient on one of these drugs. They had their place, after 1/3 had voted with their feet, and stopped them because of uti or genital thrush. Also some got unacceptable postural hypotension.
I have my own theory about HBP and kidney disease. It's not that high blood pressure damages the kidneys, but rather the kidneys help regulate BP which they do, and because the kidneys are not getting adequate blood flow they cause the higher pressure to increase the flow.
As an adjunct I have been stage 3 for about 20 years caused by using too many pain killers and or urine retention not diabetes. Since discarding most medical advice I have become borderline stage 2. Not only advice but BP and Statins which were prescribed.
Insulin resistance is a concept or construct but not a disease. Its an adaptation to constantly high glucose levels in the blood and chronic ingestion of seed based oils, among other things, even beta blockers can increase it.
Insulin resistance is a cause of metabolic disease.
Fun fact: in the US we have a sugar substitute called allulose that lowers blood glucose by a similar mechanism.
Are there any international, bilingual doctors in the LCDU group? I want to know so I can find their contents and spread the words world wide.
Is high LDL like with LMHR people dangerous for CKD ? Very important !!
Sugar is dangerous for CKD.
I am a bit concerned about SGLT drugs and low carb. Having suffered from it, the risk of ketoacidosis is way too risky to me.
Just do a carnivore diet.
My family are dying of from diseases caused carbs, sugars and bad medicines. They trust their doctors, even when all syptoms are worsening.
So sad to see. Another Friend was diagnosed with prediabetes the other day. Doctor told him to reduce his fats and increase fruit and vegetables. What can you say I’m an ex ICU R.N. So might have a tiny bit of medical knowledge , but these people just believe their doctors lock stock and barrel and have no clue that their doctor has no clue.
There’s no free lunches