Low-Carbohydrate Nutrition Approaches in Patients with Obesity, Prediabetes and Type 2 Diabetes

Low Carb Nutritional Approaches - Guidelines Advisory

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106 Commerce Street, Suite 105 Lake Mary, FL 32746 TEL: 407.878.7606 • FAX: 407.878.7611 Order additional copies at GuidelineCentral.com Copyright © 2019 All rights reserved CARB19108 Disclaimer This pocket guide attempts to define principles of practice that should produce high-quality patient care. It is applicable to specialists, primary care, and providers at all levels. This pocket guide should not be considered exclusive of other methods of care reasonably directed at obtaining the same results. The ultimate judgment concerning the propriety of any course of conduct must be made by the clinician after consideration of each individual patient situation. Abbreviations ACE, angiotensin-converting enzyme; ARB, angiotensin-receptor blocker; ASCVD, atherosclerotic cardiovascular disease; bid, twice a day; BP, blood pressure; CAC, coronary artery calcium; CBC, complete blood count; CGM, continuous glucose monitor; CMP, complete metabolic panel; CVD, cardiovascular disease; GLP-1, glucagon-like peptide-1; GTT, glucose tolerance test; HbA1c, hemoglobin A1c; HDL, high density lipoprotein; hsCRP, high-sensitivity C-reactive protein; LADA, latent autoimmune diabetes in adults; LDL, low density lipoprotein; OTC, over-the-counter; SBP, systolic blood pressure; SGLT-2, sodium-glucose co-transporter-2; TC, total cholesterol; TG/HDL, triglyceride to HDL Table 6. Summary of Common Osmotic Laxatives Type Generic Name Dosage Side Effects/ Problems a Mechanism of Action OTC Products Hyperosmolar agents Sorbitol 15–30 mL daily or bid Sweet taste, transient abdominal cramps, flatulence, bloating Nonabsorbable disaccharides metabolized by colonic bacteria into acetic and short-chain fatty acids, which accelerate colonic transit Lactulose 15–30 mL daily or bid Polyethylene glycol 17 g/d Incontinence due to potency, bloating, abdominal cramps Osmotically ↑ intraluminal fluids Saline laxative Magnesium 15–30 mL daily or bid Magnesium toxicity, dehydration, abdominal cramps, incontinence Fluid osmotically drawn into small- bowel lumen, cholecystokinin stimulated, colon transit time↓ Magnesium citrate 5–10 fl oz (150–300 mL) once Avoid in renal failure a Potentially all laxatives and constipation treatments may cause fecal incontinence.

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