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Post by goyocafe on Dec 17, 2018 19:01:17 GMT -5
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 ?? Clearly pointing out anything but the requisite excitement risks my long standing reputation on this board, but you asked. Here’s the same example I posted earlier. PHARMACOLOGIC THERAPY FOR TYPE 1 DIABETES Recommendations 9.1 Most people with type 1 diabetes should be treated with multiple daily injections of prandial and basal insulin, or continuous subcutaneous insulin infusion. If today I had read this instead 9.1 Most people with type 1 diabetes should be treated with multiple daily injections of prandial, or inhaled prandial insulin, and basal insulin, or continuous subcutaneous insulin infusion. I would be jumping up and down with the rest of you. perhaps if they alluded to inhaled insulin in the graphics, as well. Other than its own section, every other mention of prandial insulin in the entire document refers only to injected insulin and injected analogs. I would not consider that a fair play for an organization that supposedly has the patients’ best interest in mind.
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Post by mango on Dec 17, 2018 19:02:32 GMT -5
I am trilled to say the least. I will look over the 2019 SoC more closely later.
What I particularly like seeing is the new referenced studies:
82. Akturk HK, Snell-Bergeon JK, Rewers A, et al. Improved postprandial glucose with inhaled technosphere insulin compared with insulin as- part in patients with type 1 diabetes on multiple daily injections: the STAT study. Diabetes Technol Ther 2018;20:639–647
20. Bode BW, McGill JB, Lorber DL, Gross JL, Chang PC, Bregman DB; Affinity 1 Study Group. Inhaled technosphere insulin compared with injected prandial insulin in type 1 diabetes: a randomized 24-week trial. Diabetes Care 2015;38:2266–2273
Sorry in advance if they're already on the 2018 SoC, but for some reason I didn't think they were.
What I do not like seeing is Afrezza being, once again, incorrectly placed under Rapid-acting analogs, like that in the chart on S97. That needs to be corrected.
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Post by rockstarrick on Dec 17, 2018 19:06:33 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. Goya, the fact that PWD can target lower a1c’s without increased risk of Hypoglycemia is huge. here is the meat, and this isn’t selective posting to try and make this look fabulous, I’m sharing this for you, so you can re-read what was written. (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 Though the difference in wording may be subtle to you, to a PWD who is battling post Prandial glucose spikes, or their Physician, this is an Inhaled option that wasn’t there until now. And just so you know, im good with your opinion, you’re not getting blocked. ✌🏻😎
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Post by rockstarrick on Dec 17, 2018 19:13:51 GMT -5
It is listed exactly where it should be, under “Prandial Insulin”. Where would you list it ?? Clearly pointing out anything but the requisite excitement risks my long standing reputation on this board, but you asked. Here’s the same example I posted earlier. PHARMACOLOGIC THERAPY FOR TYPE 1 DIABETES Recommendations 9.1 Most people with type 1 diabetes should be treated with multiple daily injections of prandial and basal insulin, or continuous subcutaneous insulin infusion. If today I had read this instead 9.1 Most people with type 1 diabetes should be treated with multiple daily injections of prandial, or inhaled prandial insulin, and basal insulin, or continuous subcutaneous insulin infusion. I would be jumping up and down with the rest of you. perhaps if they alluded to inhaled insulin in the graphics, as well. Other than its own section, every other mention of prandial insulin in the entire document refers only to injected insulin and injected analogs. I would not consider that a fair play for an organization that supposedly has the patients’ best interest in mind. “compared with injectable rapid-acting insulin” Now that’s selective posting 😎
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Post by letitride on Dec 17, 2018 19:47:18 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. Thats Huge!
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Post by sayhey24 on Dec 17, 2018 20:08:39 GMT -5
Joey - my hope is the tipping point comes sooner than later. Dr. Kendall is clearly having an impact on the community and while we can all agree we want more changes sooner than later what we got was a start.
A start is good. Its a start and just starting to change the discussion with these so called experts is a major victory.
"Rapid-acting inhaled insulin to be used before meals is now available and may reduce rates of hypoglycemia in patients with type 1 diabetes"
Whats the single biggest worry of PWDs? Now we have something which "may reduce the rates"! Thats huge news. That should be headlining every 6pm newscast in the country.
But what about A1c? "Supplemental doses of inhaled insulin taken based on postprandial glucose levels may improve blood glucose management without additional hypoglycemia or weight gain" Thats beyond huge!
Is the SOC now saying this inhaled insulin can reduce hypoglycemia and improve glucose management? It sure seems it is.
Mike now needs to get some money and do the big daddy study even though everyone already knows the answer, use the afrezza, sleep soundly at night not worrying about hypo's and if you try just a little you will get better A1c.
Mike also needs to put some new marketing hand-outs together for his sales guys.
Dr Kendall needs to start focusing on the T2s. Remember, few ever thought afrezza would be approved for T1s. Everyone knows its a T2 med and the huge market is T2s. All T2s should be put on afrezza day one and the ADA can take and throw out their current Treat to Failure standard. Its 2019 and they are still using the equivalent of leeches to treat diabetes. How many toes and feet will be lost and heart attacks will the PWDs have this year because of this standard of care. Its an embarrassment and they should be ashamed of themselves.
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Post by mnholdem on Dec 17, 2018 20:39:47 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? It’s a 2-Page chart. Look for the arrow by Page 1 of 2.
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Post by peppy on Dec 17, 2018 21:03:53 GMT -5
It is listed exactly where it should be, under “Prandial Insulin”. Where would you list it ?? Clearly pointing out anything but the requisite excitement risks my long standing reputation on this board, but you asked. Here’s the same example I posted earlier. PHARMACOLOGIC THERAPY FOR TYPE 1 DIABETES Recommendations 9.1 Most people with type 1 diabetes should be treated with multiple daily injections of prandial and basal insulin, or continuous subcutaneous insulin infusion. If today I had read this instead 9.1 Most people with type 1 diabetes should be treated with multiple daily injections of prandial, or inhaled prandial insulin, and basal insulin, or continuous subcutaneous insulin infusion. I would be jumping up and down with the rest of you. perhaps if they alluded to inhaled insulin in the graphics, as well. Other than its own section, every other mention of prandial insulin in the entire document refers only to injected insulin and injected analogs. I would not consider that a fair play for an organization that supposedly has the patients’ best interest in mind.
That is the lip service we are given. The ADA works for the pharmaceutical companies.
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Post by traderdennis on Dec 17, 2018 21:08:32 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. Merry Christmas to you! If the company does not come out with a PR this is all just a nothing burger.
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Post by brotherm1 on Dec 17, 2018 21:12:42 GMT -5
not true. The word is already out and will spread like a California wildfire. You should go long now.
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Post by awesomo on Dec 17, 2018 22:03:47 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. Merry Christmas to you! If the company does not come out with a PR this is all just a nothing burger. This is BS. If they did release a PR, shorts would be all over them saying that it is nothing but a fluff piece and “nothing material has changed”.
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Post by brotherm1 on Dec 17, 2018 22:59:24 GMT -5
I share those thoughts precisely. Smart money and institutions will be in he know, start buying, gradually increase and solidify the share price. I think we saw some of that today already.
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Post by bones1026 on Dec 17, 2018 23:08:55 GMT -5
Joey - my hope is the tipping point comes sooner than later. Dr. Kendall is clearly having an impact on the community and while we can all agree we want more changes sooner than later what we got was a start. A start is good. Its a start and just starting to change the discussion with these so called experts is a major victory. "Rapid-acting inhaled insulin to be used before meals is now available and may reduce rates of hypoglycemia in patients with type 1 diabetes" Whats the single biggest worry of PWDs? Now we have something which "may reduce the rates"! Thats huge news. That should be headlining every 6pm newscast in the country. But what about A1c? "Supplemental doses of inhaled insulin taken based on postprandial glucose levels may improve blood glucose management without additional hypoglycemia or weight gain" Thats beyond huge! Is the SOC now saying this inhaled insulin can reduce hypoglycemia and improve glucose management? It sure seems it is. Mike now needs to get some money and do the big daddy study even though everyone already knows the answer, use the afrezza, sleep soundly at night not worrying about hypo's and if you try just a little you will get better A1c. Mike also needs to put some new marketing hand-outs together for his sales guys. Dr Kendall needs to start focusing on the T2s. Remember, few ever thought afrezza would be approved for T1s. Everyone knows its a T2 med and the huge market is T2s. All T2s should be put on afrezza day one and the ADA can take and throw out their current Treat to Failure standard. Its 2019 and they are still using the equivalent of leeches to treat diabetes. How many toes and feet will be lost and heart attacks will the PWDs have this year because of this standard of care. Its an embarrassment and they should be ashamed of themselves. Sayhey-wanted to let you know, as much as the science behind my investment allows me to remain calm about all the money(in since pre approval) I’m down...having you on my side, and reading your extremely informative posts..enables me to not feel so regretful on this LONG journey 🍻
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Post by winstonsmith on Dec 17, 2018 23:45:32 GMT -5
Yup, I'm a Type 2 that really needs Afrezza and won't do without it.
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Post by boytroy88 on Dec 18, 2018 1:01:11 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. No PR so guess they didn't think it was that impactful....unless they are waiting for PM to make the announcement....
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