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Post by shawnonafrezza on Sept 3, 2019 14:23:33 GMT -5
The insulin that goes into Afrezza is made from GMO ecoli bacteria. Is exactly the same insulin as Humulin from years ago... just different delivery mechanism. So question would be what value it would have drawing a distinction at the molecular level between it and RAA. I think that distinction would be lost on a vast majority of consumers. Most patients go on basal insulin first, which is modified to slow absorption, so the concept of tweaking the molecule to alter timing is something that is pretty well accepted as useful. However, as long as Mannkind stuck within the verified facts, it would likely be allowed by FDA. Just curious, are you equally opposed to long acting basal insulins? no one uses Humulin subq anymore. However hospitals still may use it IV. You know that ktim. P.S. leave sweedee alone, she was trying to help me and my thinking. I'll stop thinking.... I do... I said so in my first post in this thread. I know MANY who do. Theres a very famous book (The Diabetes Solution) and group of people (Type1Grit) who do. How famous is this group? Well they got the ADA to embrace low carb for diabetes because of their results.
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Post by ktim on Sept 3, 2019 14:30:51 GMT -5
no one uses Humulin subq anymore. However hospitals still may use it IV. You know that ktim. P.S. leave sweedee alone, she was trying to help me and my thinking. I'll stop thinking.... I do... I said so in my first post in this thread. I know MANY who do. Theres a very famous book (The Diabetes Solution) and group of people (Type1Grit) who do. How famous is this group? Well they got the ADA to embrace low carb for diabetes because of their results. Kaiser in Southern CA seems to push Humulin as their SOC. Not that I think they are always correct in their "evidence based" approach, but they've done some benefit vs cost analysis that has led them to that practice. Whenever cost gets mixed into the equation things get murky pretty quick. Curious (and sorry if you've answered before and I don't recall), why do you choose Humulin over RAA?
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Post by peppy on Sept 3, 2019 14:31:29 GMT -5
no one uses Humulin subq anymore. However hospitals still may use it IV. You know that ktim. P.S. leave sweedee alone, she was trying to help me and my thinking. I'll stop thinking.... I do... I said so in my first post in this thread. I know MANY who do. Theres a very famous book (The Diabetes Solution) and group of people (Type1Grit) who do. How famous is this group? Well they got the ADA to embrace low carb for diabetes because of their results. oh. thanks for tell me, or pointing it out again. The management you are using. so Shawn, your take, your results, you are happy with it? was the Humilin even longer to peak and longer tail? added: Are you eating to the curves of the insulin, eating just before the peak and eating on the tail? ww4.mgh.org/Physicians/Formulary%20Documents/Insulin%20Comparison%20Chart.pdfR U-100 is a polypeptide hormone structurally identical to human insulin synthesized through rDNA technology in a special non-disease-producing laboratory strain of Escherichia coli bacteria. Humulin R U-100 has the empirical formula C257H383N65O77S6 and a molecular weight of 5808. Humulin R U-100 is a sterile, clear, aqueous, and colorless solution that contains human insulin (rDNA origin) 100 units/mL, glycerin 16 mg/mL and metacresol 2.5 mg/mL, endogenous zinc (approximately 0.015 mg/100 units) and water for injection. The pH is 7.0 to 7.8. Sodium hydroxide and/or hydrochloric acid may be added during manufacture to adjust the pH.
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paul
Researcher
Posts: 134
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Post by paul on Sept 3, 2019 16:08:38 GMT -5
The insulin that goes into Afrezza is made from GMO ecoli bacteria. Is exactly the same insulin as Humulin from years ago... just different delivery mechanism. So question would be what value it would have drawing a distinction at the molecular level between it and RAA. I think that distinction would be lost on a vast majority of consumers. Most patients go on basal insulin first, which is modified to slow absorption, so the concept of tweaking the molecule to alter timing is something that is pretty well accepted as useful. However, as long as Mannkind stuck within the verified facts, it would likely be allowed by FDA. Just curious, are you equally opposed to long acting basal insulins? no one uses Humulin subq anymore. However hospitals still may use it IV. You know that ktim. P.S. leave sweedee alone, she was trying to help me and my thinking. I'll stop thinking.... I don't know how accurate his numbers are, but "otherottawaguy" in the scripts section reported almost 80,000 humulin/novolin scripts a week. That suggests quite a few still use it.
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Post by shawnonafrezza on Sept 3, 2019 16:24:50 GMT -5
no one uses Humulin subq anymore. However hospitals still may use it IV. You know that ktim. P.S. leave sweedee alone, she was trying to help me and my thinking. I'll stop thinking.... I don't know how accurate his numbers are, but "otherottawaguy" in the scripts section reported almost 80,000 humulin/novolin scripts a week. That suggests quite a few still use it. And that's just scripts. You can get it OTC like I do because I don't want to bother my endo with it.
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Post by peppy on Sept 3, 2019 16:25:41 GMT -5
no one uses Humulin subq anymore. However hospitals still may use it IV. You know that ktim. P.S. leave sweedee alone, she was trying to help me and my thinking. I'll stop thinking.... I don't know how accurate his numbers are, but "otherottawaguy" in the scripts section reported almost 80,000 humulin/novolin scripts a week. That suggests quite a few still use it. hospitals use it IV. shawnonafrezzaShawn, you use Humulin by pump? And a basil? Additionally now you are using afrezza? to answer your question Paul two hours to peak seems difficult to manage. I see where an all meat high fat diet would be the way to manage that insulin. 8 hour tail.
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Post by shawnonafrezza on Sept 3, 2019 16:31:31 GMT -5
I do... I said so in my first post in this thread. I know MANY who do. Theres a very famous book (The Diabetes Solution) and group of people (Type1Grit) who do. How famous is this group? Well they got the ADA to embrace low carb for diabetes because of their results. Kaiser in Southern CA seems to push Humulin as their SOC. Not that I think they are always correct in their "evidence based" approach, but they've done some benefit vs cost analysis that has led them to that practice. Whenever cost gets mixed into the equation things get murky pretty quick. Curious (and sorry if you've answered before and I don't recall), why do you choose Humulin over RAA? They push Humalog. I do... I said so in my first post in this thread. I know MANY who do. Theres a very famous book (The Diabetes Solution) and group of people (Type1Grit) who do. How famous is this group? Well they got the ADA to embrace low carb for diabetes because of their results. oh. thanks for tell me, or pointing it out again. The management you are using. so Shawn, your take, your results, you are happy with it? was the Humilin even longer to peak and longer tail? added: Are you eating to the curves of the insulin, eating just before the peak and eating on the tail? ww4.mgh.org/Physicians/Formulary%20Documents/Insulin%20Comparison%20Chart.pdfR U-100 is a polypeptide hormone structurally identical to human insulin synthesized through rDNA technology in a special non-disease-producing laboratory strain of Escherichia coli bacteria. Humulin R U-100 has the empirical formula C257H383N65O77S6 and a molecular weight of 5808. Humulin R U-100 is a sterile, clear, aqueous, and colorless solution that contains human insulin (rDNA origin) 100 units/mL, glycerin 16 mg/mL and metacresol 2.5 mg/mL, endogenous zinc (approximately 0.015 mg/100 units) and water for injection. The pH is 7.0 to 7.8. Sodium hydroxide and/or hydrochloric acid may be added during manufacture to adjust the pH. Humalin lasts 7-8 hours over the 4-6 of RAA. I like it because it better matches the rise of gluconeogenesis which since I eat lower carb is what I really need. So for both of you, my "protocol" is this (which I outlined in the fb groups so others can follow this and I'm probably the only one doing it). Tresiba 2x a day. I get a noticeable rise over night so I split 66% AM 33 PM. R dosed conservative AT mealtime, no pre bolus. If I think I'll need 2U I might dose 1.5U. This is to mitigate lows because of... Afrezza POST meal and maybe 1x follow up 4 hours later if the conservative R was actually conservative and not "correct". Afrezza is for the 10ish carbs per meal, R is more accurately dosed for protein/fat. R is very gentle and IMO far more predictable than RAA. It peaks the same every time, its tail is consistent, it doesn't crash. I've been off my closed loop (called Loop on Iphone which I used with Humalog) for 16 days now (three omnipod failures in a row left me enraged) and I'd say I've got my Tresiba dose dialed in and this protocol more figured out. My reporting says the last week would yield an a1c of 5.2, average bgl of 104, and a standard deviation of 26. I want to get that more dialed in but not going to lie, the level of effort right now and fault tolerance is nice.
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Post by peppy on Sept 3, 2019 16:58:19 GMT -5
Kaiser in Southern CA seems to push Humulin as their SOC. Not that I think they are always correct in their "evidence based" approach, but they've done some benefit vs cost analysis that has led them to that practice. Whenever cost gets mixed into the equation things get murky pretty quick. Curious (and sorry if you've answered before and I don't recall), why do you choose Humulin over RAA? They push Humalog. oh. thanks for tell me, or pointing it out again. The management you are using. so Shawn, your take, your results, you are happy with it? was the Humilin even longer to peak and longer tail? added: Are you eating to the curves of the insulin, eating just before the peak and eating on the tail? ww4.mgh.org/Physicians/Formulary%20Documents/Insulin%20Comparison%20Chart.pdfR U-100 is a polypeptide hormone structurally identical to human insulin synthesized through rDNA technology in a special non-disease-producing laboratory strain of Escherichia coli bacteria. Humulin R U-100 has the empirical formula C257H383N65O77S6 and a molecular weight of 5808. Humulin R U-100 is a sterile, clear, aqueous, and colorless solution that contains human insulin (rDNA origin) 100 units/mL, glycerin 16 mg/mL and metacresol 2.5 mg/mL, endogenous zinc (approximately 0.015 mg/100 units) and water for injection. The pH is 7.0 to 7.8. Sodium hydroxide and/or hydrochloric acid may be added during manufacture to adjust the pH. Humalin lasts 7-8 hours over the 4-6 of RAA. I like it because it better matches the rise of gluconeogenesis which since I eat lower carb is what I really need. So for both of you, my "protocol" is this (which I outlined in the fb groups so others can follow this and I'm probably the only one doing it). Tresiba 2x a day. I get a noticeable rise over night so I split 66% AM 33 PM. R dosed conservative AT mealtime, no pre bolus. If I think I'll need 2U I might dose 1.5U. This is to mitigate lows because of... Afrezza POST meal and maybe 1x follow up 4 hours later if the conservative R was actually conservative and not "correct".
Afrezza is for the 10ish carbs per meal, R is more accurately dosed for protein/fat. R is very gentle and IMO far more predictable than RAA. It peaks the same every time, its tail is consistent, it doesn't crash.
I've been off my closed loop (called Loop on Iphone which I used with Humalog) for 16 days now (three omnipod failures in a row left me enraged) and I'd say I've got my Tresiba dose dialed in and this protocol more figured out. My reporting says the last week would yield an a1c of 5.2, average bgl of 104, and a standard deviation of 26. I want to get that more dialed in but not going to lie, the level of effort right now and fault tolerance is nice. Very nice. you are running a fine concert maestro.
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