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Post by uvula on Dec 17, 2018 17:55:53 GMT -5
Is the colorful poster the streamlined version of SOC for type 2? If so basil insulin is the last option and I didn't see prandial insulin mentioned anywhere. How will Afrezza ever become the first line of defense that many of us believe would be the best approach? Will we need large scale trials before we make progress with T2Ds?
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Post by uvula on Dec 17, 2018 17:58:58 GMT -5
I wonder how long it will take aged or traderdennis to chime in with some negative shit on this fabulous update. Merry Christmas. It seemed fabulous because of selective editing. It is progress but only baby steps.
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Post by rockstarrick on Dec 17, 2018 17:59:03 GMT -5
Thanks for posting that, but I would personally encourage everyone to look at the full document for themselves. Download the complete pdf and search for inhaled insulin. The second change you noted above is correct, but incomplete. They also added in the next paragraph: "Inhaled insulin is contraindicated in patients with chronic lung disease, such as asthma and chronic obstructive pulmonary disease, and is not recommended in patients who smoke or who recently stopped smoking. All patients require spirometry (FEV1) testing to identify potential lung disease prior to and after starting inhaled insulin therapy." Sorry if this sounds negative, but I don't see the overall fantastic improvements others do. The language was cleaned up a bit, some new information was added. But we're talking a handful of lines in a 204 page document. Will many prescribers really notice? Or even spot the minor changes? And it's not like the remainder of the document (describing other options) remained static. I suspect several of them also scored some improved language. The Improvement would be that it is mentioned. One of the biggest complaints was nobody knew Afrezza,(Inhaled Insulin), was even an option. You know, when Sanofi, or somebody working for them, was telling Drs that Afrezza was discontinued. And all the reports from patients claiming their Dr didn’t even know of Afrezza. Now, every Physician who actually reads the SOC updates, will know about Afrezza, and those patients wanting to try it out, or just keep their Prescription, will have this to help battle the forces against us. Whoever they may be. Its a good thing, actually, it’s a great way to start 2019, at least I think it is. ✌🏻😎
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Post by joeypotsandpans on Dec 17, 2018 18:08:23 GMT -5
There is no prandial insulin that comes close to Afrezza, been taking it for a year now, and actually I was one of the scripts in the last report. Had my appt. with endo on the 6th and he sent the script into Express Scripts, same 60/60/60 ct. Happily rec'd at my doorstep last Tues. Talk about holiday cheer 😁 EOM.
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Post by rockstarrick on Dec 17, 2018 18:11:25 GMT -5
I wonder how long it will take aged or traderdennis to chime in with some negative shit on this fabulous update. Merry Christmas. It seemed fabulous because of selective editing. It is progress but only baby steps. Right out of the “Prandial Insulin” section in the 2019 Guidelines. Inhaled Insulin Inhaled insulin is available for prandial use with a limited dosing range; studies in people with type 1 diabetes suggest rapid pharmacokinetics (20). A pilot study found evidence that compared with injectable rapid-acting insulin, supplemental doses of inhaled insulin taken based on postprandial glucose levels may improve blood glucose management without additional hypoglycemia or weight gain, although results from a larger study are needed for confirmation (82). Inhaled insulin is contraindicated in patients with chronic lung disease, such as asthma and chronic obstructive pulmonary disease, and is not recommended in patients who smoke or who recently stopped smoking. All patients require spirometry (FEV1) testing to identify potential lung disease prior to and after starting inhaled insulin therapy. Baby step ?? can you imagine if the new SOC Guidelines came out with no mention of Inhaled Insulin ? This is Fabulous news, In more ways than one. 😎
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Post by goyocafe on Dec 17, 2018 18:12:09 GMT -5
Thanks for posting that, but I would personally encourage everyone to look at the full document for themselves. Download the complete pdf and search for inhaled insulin. The second change you noted above is correct, but incomplete. They also added in the next paragraph: "Inhaled insulin is contraindicated in patients with chronic lung disease, such as asthma and chronic obstructive pulmonary disease, and is not recommended in patients who smoke or who recently stopped smoking. All patients require spirometry (FEV1) testing to identify potential lung disease prior to and after starting inhaled insulin therapy." Sorry if this sounds negative, but I don't see the overall fantastic improvements others do. The language was cleaned up a bit, some new information was added. But we're talking a handful of lines in a 204 page document. Will many prescribers really notice? Or even spot the minor changes? And it's not like the remainder of the document (describing other options) remained static. I suspect several of them also scored some improved language. The Improvement would be that it is mentioned. One of the biggest complaints was nobody knew Afrezza,(Inhaled Insulin), was even an option. You know, when Sanofi, or somebody working for them, was telling Drs that Afrezza was discontinued. And all the reports from patients claiming their Dr didn’t even know of Afrezza. Now, every Physician who actually reads the SOC updates, will know about Afrezza, and those patients wanting to try it out, or just keep their Prescription, will have this to help battle the forces against us. Whoever they may be. Its a good thing, actually, it’s a great way to start 2019, at least I think it is. ✌🏻😎 It was listed in much the same way for 2018 as 2019. The updated language is noted above. care.diabetesjournals.org/content/diacare/suppl/2017/12/08/41.Supplement_1.DC1/DC_41_S1_Combined.pdfGo to page 91.
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Post by centralcoastinvestor on Dec 17, 2018 18:12:37 GMT -5
Thanks for posting that, but I would personally encourage everyone to look at the full document for themselves. Download the complete pdf and search for inhaled insulin. The second change you noted above is correct, but incomplete. They also added in the next paragraph: "Inhaled insulin is contraindicated in patients with chronic lung disease, such as asthma and chronic obstructive pulmonary disease, and is not recommended in patients who smoke or who recently stopped smoking. All patients require spirometry (FEV1) testing to identify potential lung disease prior to and after starting inhaled insulin therapy." Sorry if this sounds negative, but I don't see the overall fantastic improvements others do. The language was cleaned up a bit, some new information was added. But we're talking a handful of lines in a 204 page document. Will many prescribers really notice? Or even spot the minor changes? And it's not like the remainder of the document (describing other options) remained static. I suspect several of them also scored some improved language. The Improvement would be that it is mentioned. One of the biggest complaints was nobody knew Afrezza,(Inhaled Insulin), was even an option. You know, when Sanofi, or somebody working for them, was telling Drs that Afrezza was discontinued. And all the reports from patients claiming their Dr didn’t even know of Afrezza. Now, every Physician who actually reads the SOC updates, will know about Afrezza, and those patients wanting to try it out, or just keep their Prescription, will have this to help battle the forces against us. Whoever they may be. Its a good thing, actually, it’s a great way to start 2019, at least I think it is. ✌🏻😎 Sing it brother! I am thinking the same as you. Coming from a more rural upbringing, the new SOC changes are “better than a poke in the eye with a sharp stick.”
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Post by goyocafe on Dec 17, 2018 18:18:55 GMT -5
The Improvement would be that it is mentioned. One of the biggest complaints was nobody knew Afrezza,(Inhaled Insulin), was even an option. You know, when Sanofi, or somebody working for them, was telling Drs that Afrezza was discontinued. And all the reports from patients claiming their Dr didn’t even know of Afrezza. Now, every Physician who actually reads the SOC updates, will know about Afrezza, and those patients wanting to try it out, or just keep their Prescription, will have this to help battle the forces against us. Whoever they may be. Its a good thing, actually, it’s a great way to start 2019, at least I think it is. ✌🏻😎 Sing it brother! I am thinking the same as you. Coming from a more rural upbringing, the new SOC changes are “better than a poke in the eye with a sharp stick.” I know everyone is excited to see real change in the adoption rate for Afrezza, but please read the SOC for 2018. The mention of Afrezza was in last year’s SOC. The only thing that has changed is the verbiage in the same sections as mentioned last year. care.diabetesjournals.org/content/diacare/suppl/2017/12/08/41.Supplement_1.DC1/DC_41_S1_Combined.pdf (Pag 91) I don’t like raining on anyone’s parade, but the euphoria coming from today’s release is misguided IMO. The only thing that changed from last year to this coming year are noted in the above post mnkd.proboards.com/post/164145Sorry to be the bearer of the news.
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Post by mannmade on Dec 17, 2018 18:32:05 GMT -5
Goya what I think you are missing is that the new language reflects the stat study results which says the ada is listening to Dr. K.
Also this will give docs who read it a reason to prescribe. Key is that Afrezza may lead to less hypos w no additional weight gain.
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Post by porkini on Dec 17, 2018 18:40:21 GMT -5
And goyo like dt and ah is now blockity blocked. 1 post more than sufficient, yet 3 posts in a little over an hour to SAY THE SAME THING. Excessive to say the least. D'OH!
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Post by goyocafe on Dec 17, 2018 18:43:59 GMT -5
Goya what I think you are missing is that the new language reflects the stat study results which says the ada is listening to Dr. K. Also this will give docs who read it a reason to prescribe. Key is that Afrezza may lead to less hypos w no additional weight gain. If they were really listening, wouldn’t they actually list a non-inferior insulin treatment, i.e. Afrezza in the SOC along with all other insulin treatments? They treat it as an afterthought, listed below bariatric surgery, and that is what ticks me off. Block me one one and all.
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Post by compound26 on Dec 17, 2018 18:44:17 GMT -5
Goya what I think you are missing is that the new language reflects the stat study results which says the ada is listening to Dr. K. Also this will give docs who read it a reason to prescribe. Key is that Afrezza may lead to less hypos w no additional weight gain. Agree. Definitely a substantial improvement to mention the STAT result in the SoC. As to how impactful this will be, we will have to wait and see.
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Post by tiberious on Dec 17, 2018 18:45:06 GMT -5
Goya what I think you are missing is that the new language reflects the stat study results which says the ada is listening to Dr. K. Also this will give docs who read it a reason to prescribe. Key is that Afrezza may lead to less hypos w no additional weight gain. Goya (selectively) misses that the changes are quite positive and show increased focus on reduced hypos and rapid PK. Another point is that chart for type 2's...looking at this leaves chart little doubt as to why so many PWD are out of range with this kind of triple therapy "stab" in the dark routine. Its sad that the ADA puts this out as a standard given the side effect profiles of some of these drugs on their own however when you throw this cumulative witches brew cocktail (of potential side effects) at people (with little benefit) how can they not see this at best irresponsible?
Afrezza should be at the TOP of this byzantine chart of failure.
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Post by rockstarrick on Dec 17, 2018 18:48:25 GMT -5
Goya what I think you are missing is that the new language reflects the stat study results which says the ada is listening to Dr. K. Also this will give docs who read it a reason to prescribe. Key is that Afrezza may lead to less hypos w no additional weight gain. If they were really listening, wouldn’t they actually list a non-inferior insulin treatment, i.e. Afrezza in the SOC along with all other insulin treatments? They treat it as an afterthought, listed below bariatric surgery, and that is what ticks me off. Block me one one and all. It is listed exactly where it should be, under “Prandial Insulin”. Where would you list it ??
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Post by joeypotsandpans on Dec 17, 2018 18:58:46 GMT -5
Goya what I think you are missing is that the new language reflects the stat study results which says the ada is listening to Dr. K. Also this will give docs who read it a reason to prescribe. Key is that Afrezza may lead to less hypos w no additional weight gain. If they were really listening, wouldn’t they actually list a non-inferior insulin treatment, i.e. Afrezza in the SOC along with all other insulin treatments? They treat it as an afterthought, listed below bariatric surgery, and that is what ticks me off. Block me one one and all. Goyo... I empathize with your frustration regarding "SOC", take some solace in knowing it's my SOC, let the delusional naysayers continue to spew their hot air for they know not nor can see their own ignorance. Those that use it can understand why it becomes their SOC and their writers will continue to get it as well, the results of continued improvement in the long term BG numbers and corresponding improved health cannot/will not be denied...the numbers will continue to grow, Sayhey will have his day of reckoning with his exhaustive efforts to educate the ignorant as well, he knows what I mean by that statement, there will be a tipping point 😉
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