|
Post by agedhippie on Feb 4, 2019 10:49:44 GMT -5
quote from above, stevil said, "An even bigger problem I’ve been seeing is that insulin is really getting blacklisted now with all the various other options. Treatment is heavily shifting towards GLP-1s, DPP-4s, SGLT2s, and the like since they’ve come out with various other benefits related to CVD and overall mortality. (And I’ve run out of stamina to argue them, so anyone- sayhey, mango, etc- go look them up for yourselves. I didn’t make up the data so i don’t want to defend it. It is what it is) Big pharma paid for those results. They compared them against insulin, so it will take a complete re-education of Afrezza insulin to prove why it’s different. This is where I think overwhelming data is needed. But that all takes a long time to test, compile, then publish. I’ve been waiting with bated breath for Dr. Kendall to show us something we haven’t seen yet, but he’s been eerily absent." reply: Stevil, type one diabetes, Insulin is not optional is my understanding. Have things changed? How about LADA, any new orals or injectables for LADA? Type two's need to change the food attached to their fork. Any mention of that in medical school? eh? Type 1 and LADA will always need insulin because there is an absolute insulin deficiency. However, there is a growing trend to add other drugs as well although this is not widespread at the moment and the results have not been good in terms of HbA1c reduction. The pattern seems to be using the drugs off-label, then running trials, then approving them. This is now happening with SGLT2 according to Dr Buse who says he is prescribing SGLT2 off-label to some of his Type 1s. The DEPICT-1 trial is providing the data to drive the SGLT2 change.
|
|
|
Post by peppy on Feb 4, 2019 11:00:18 GMT -5
quote from above, stevil said, "An even bigger problem I’ve been seeing is that insulin is really getting blacklisted now with all the various other options. Treatment is heavily shifting towards GLP-1s, DPP-4s, SGLT2s, and the like since they’ve come out with various other benefits related to CVD and overall mortality. (And I’ve run out of stamina to argue them, so anyone- sayhey, mango, etc- go look them up for yourselves. I didn’t make up the data so i don’t want to defend it. It is what it is) Big pharma paid for those results. They compared them against insulin, so it will take a complete re-education of Afrezza insulin to prove why it’s different. This is where I think overwhelming data is needed. But that all takes a long time to test, compile, then publish. I’ve been waiting with bated breath for Dr. Kendall to show us something we haven’t seen yet, but he’s been eerily absent." reply: Stevil, type one diabetes, Insulin is not optional is my understanding. Have things changed? How about LADA, any new orals or injectables for LADA? Type two's need to change the food attached to their fork. Any mention of that in medical school? eh? Type 1 and LADA will always need insulin because there is an absolute insulin deficiency. However, there is a growing trend to add other drugs as well although this is not widespread at the moment and the results have not been good in terms of HbA1c reduction. The pattern seems to be using the drugs off-label, then running trials, then approving them. This is now happening with SGLT2 according to Dr Buse who says he is prescribing SGLT2 off-label to some of his Type 1s. The DEPICT-1 trial is providing the data to drive the SGLT2 change.wow, our physicians are so smart...... I thought diabetes already put a strain on the kidneys? If you have diabetes, your blood glucose, or blood sugar, levels are too high. Over time, this can damage your kidneys. ... If they are damaged, waste and fluids build up in your blood instead of leaving your body. Kidney damage from diabetes is called diabetic nephropathy. Doesn't save any money. I wonder if they feel better? So aged, are you going to try it? Adding SGLT2 to your regime?
|
|
|
Post by agedhippie on Feb 4, 2019 11:17:15 GMT -5
... Doesn't save any money. I wonder if they feel better? So aged, are you going to try it? Adding SGLT2 to your regime? No. Until they can fix the DKA and the infection risk I am not interested. A marginally quantifiable DKA risk is a deal breaker for me.
|
|
|
Post by peppy on Feb 4, 2019 11:24:13 GMT -5
... Doesn't save any money. I wonder if they feel better? So aged, are you going to try it? Adding SGLT2 to your regime? No. Until they can fix the DKA and the infection risk I am not interested. A marginally quantifiable DKA risk is a deal breaker for me. uh huh, heh. I knew that. fix amputation risk as well? Hard for me to believe.... any physician would put a type one on SGLT2. Buse currently serves as the Director of the Diabetes Care Center at UNC. Buse attended high school at Porter-Gaud School[2] School in Charleston, South Carolina, SC. He went on to receive his Bachelor's degree in Biochemistry from Dartmouth College and his Medical and Doctoral degrees from Duke University. He completed his internship and residency in internal medicine and his fellowship in endocrinology at the University of Chicago.
|
|
|
Post by mango on Feb 4, 2019 11:32:27 GMT -5
No. Until they can fix the DKA and the infection risk I am not interested. A marginally quantifiable DKA risk is a deal breaker for me. uh huh, heh. I knew that. fix amputation risk as well? Hard for me to believe.... any physician would put a type one on SGLT2. Buse currently serves as the Director of the Diabetes Care Center at UNC. Buse attended high school at Porter-Gaud School[2] School in Charleston, South Carolina, SC. He went on to receive his Bachelor's degree in Biochemistry from Dartmouth College and his Medical and Doctoral degrees from Duke University. He completed his internship and residency in internal medicine and his fellowship in endocrinology at the University of Chicago. You know what they're doing pep. These trials are deceptive and cleverly designed to provide favorably [misleading] results. So one thing they did was say that the despite despite "tight glucose control" and A1c lowering, CV improvement was independent of that? Disinformation is sometimes necessary? So they created diversion and distortion for their new cash cows. Milk the cow, have you seen the SoC for T2D? A1c lowers when glucose is excreted in urine. CV = osmotic diuresis? Have these trials used CGMs? Can you claim tight glucose control based on finger sticks and glucose dumping? ACCORD? What is glucose homeostasis?
|
|
|
Post by stevil on Feb 4, 2019 13:04:37 GMT -5
reply: Stevil, type one diabetes, Insulin is not optional is my understanding. Have things changed? How about LADA, any new orals or injectables for LADA? Type two's need to change the food attached to their fork. Any mention of that in medical school? eh? There seems to be plenty of people using fast acting insulin. 27 Apr 2018 Afrezza----495 $632k 277 $380k Apidra----6520 $4.95m 2254 $1.77m Novalog--137k $132m 56.0k $57.8m Humalog-151k $139m 60.3k $58.0m Humalin--37.4k $20.5m 14.9k $8.0m 1:06 PM - 11 May 2018 Type 1s need insulin, yes, but they make up less than 20% of the total diabetes market, and shrinking. If you’re mannkind, it’s certainly a good group to go after, but you really want to hone in on the type 2s. I sometimes get PTSD thinking about anything pre-step 1, but I’m pretty sure I posted on the board when I was learning about diabetes 1st year that diet and exercise is by far the best first step for type 2s. Problem is that poor diets and lack of exercise is what gave most people the disease in the first place so it’s hard to change bad habits. Some people are able to, most are not. Im not saying insulin is going away, by any means. Time in range, as has been talked about, is gaining in momentum. I simply meant that the bridge to insulin is getting longer in a sense in those who stay below 7 A1c. Current guidelines do not suggest starting insulin until 7 and I have seen resistance as high as 8 from doctors. I don’t think I can convince anyone on here about this, but I’ve said in the past that the best treatment isn’t always the best treatment. Sometimes you need to tailor it to the individual. If compliance is an issue, you don’t want someone on a medication 3-6 times a day. For those who are motivated (which type 2s are notorious for not being), you can give them Afrezza. Otherwise, it’s much easier for patients and physicians to take a pill 1-2 times daily or a shot once weekly or surgery. Insulin, currently, is losing favor as more options arise. It’s purely seen as the last resort. Afrezza is not going to change that stigma anytime soon, again, pending unforeseen circumstances. I’m not dismissing its potential to by any means, just the timeline that some on here think it will happen in.
|
|
|
Post by peppy on Feb 4, 2019 13:21:19 GMT -5
type one is our market. I have heard this chit about type two for years. they will cut their stomachs out. we can't hone in on type twos for the reasons you have laid out. on the down low, for you stevil.... I have come to see the truth in this. www.screencast.com/t/eqw5x3lTULU1Any mention of this in medical school?
|
|
|
Post by stevil on Feb 4, 2019 13:49:57 GMT -5
type one is our market. I have heard this chit about type two for years. they will cut their stomachs out. we can't hone in on type twos for the reasons you have laid out. on the down low, for you stevil.... I have come to see the truth in this. www.screencast.com/t/eqw5x3lTULU1Any mention of this in medical school? Not sure if you’re asking about insulin storing glucose as fat or the documentary. The volume of information medical students need to learn doesn’t lend much time to pseudoscience or unproven science, unless the professor is personally involved in active research, either themselves or in a particular field. So the answer to the first is yes, to the second, no.
|
|
|
Post by peppy on Feb 4, 2019 13:57:37 GMT -5
type one is our market. I have heard this chit about type two for years. they will cut their stomachs out. we can't hone in on type twos for the reasons you have laid out. on the down low, for you stevil.... I have come to see the truth in this. www.screencast.com/t/eqw5x3lTULU1Any mention of this in medical school? Not sure if you’re asking about insulin storing glucose as fat or the documentary. The volume of information medical students need to learn doesn’t lend much time to pseudoscience or unproven science, unless the professor is personally involved in active research, either themselves or in a particular field. So the answer to the first is yes, to the second, no. Quote: Not sure if you’re asking Reply; I am asking, was it ever presented you as a medical school student, that insulin resistance is caused by too much fat in the cell? secondary to that was it ever discussed that, if you get rid of the fat in the cell, you get rid of the dis ease.? A two part question. now not on the down low, the for all to see,
|
|
|
Post by stevil on Feb 4, 2019 14:03:40 GMT -5
Not sure if you’re asking about insulin storing glucose as fat or the documentary. The volume of information medical students need to learn doesn’t lend much time to pseudoscience or unproven science, unless the professor is personally involved in active research, either themselves or in a particular field. So the answer to the first is yes, to the second, no. Quote: Not sure if you’re asking Reply; I am asking, was it ever presented you as a medical school student, that insulin resistance is caused by too much fat in the cell? secondary to that was it ever discussed that, if you get rid of the fat in the cell, you get rid of the dis ease.? A two part question. now not on the down low, the for all to see, Yes, it was taught that way. I’m not sure if this is a trick question or not because it’s been a well-documented fact for a long time. Obesity has been linked to diabetes for a long time. If you measure someone’s blood insulin levels (before beta cell failure) they produce far more insulin than the “normal” population. It’s why the prevailing hypothesis is that beta cell exhaustion leads to progression of the disease and ultimate failure to produce insulin in late stages of the disease.
|
|