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Post by agusta on Apr 8, 2016 15:25:15 GMT -5
Thank you for the advice and will do. Think I need a new Doc for Diabetes. The Cleveland Clinic is NOT all it is cranked up to be - just super expensive and treated like a number like at your local Deli counter.
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Post by Deleted on Apr 8, 2016 15:37:07 GMT -5
Thank you for the advice and will do. Think I need a new Doc for Diabetes. The Cleveland Clinic is NOT all it is cranked up to be - just super expensive and treated like a number like at your local Deli counter. but you need to educate your current doc too.. may be he will read around and help his next patient - Right thing to do no matter the outcome
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Post by rockstarrick on Apr 9, 2016 0:26:35 GMT -5
First Post, Shareholder, Voyeur of this board and others. Just wanted to share a recent experience. Had my yearly blood work done end of March. Call back from PCP's office (Nurse) message: You have high blood sugar and now are considered Diabetic. Reviewed my blood test results on their "My Chart" online Medical Management Program. Results: Non Fasting Blood Sugar 399. Called back for fasting BS or HbA1c and number was 11.9 Met with my Cleveland Clinic PCP who resides in a large Cleveland Clinic off campus facility in a very large Cleveland suburb. Was given the required speech of what Diabetes is all about and what I need to do. Meeting with Dietician, scheduled for new blood work first of June and placed on 2000 mg of Metformin. Asked my Doctor if he had heard of the new inhaled insulin "Afrezza" he said NO and asked who makes it.... Seeing my appointment was within the time frame of Sanofi handing Afrezza back to MNKD - it was no time to share that information. I just told him there was a new FDA treatment on the market that was inhaled. Fell on DEAF ears. He went on to say that Pfizer had an inhaled insulin that was a big flop and was not an improvement over current insulin therapies. Hence, 2000 mg. of Metformin 1x per day for a grand total with my insurance of $10.00 for 90 Days. Can not be far from the commode room and CAN afford Afrezza. Sucks. (Female- 57yrs. 165lbs. 5'4") Don't give up! I'm sure you'll get a script for Afrezza if you ask for it and your body will be the proof your doc needs! Best of luck to you on your new journey! Hopefully you get back to the point where you don't need insulin. Yes, with an a1c of 11.9 I would be very aggressive on getting that down as soon as possible. I'm no Dr, but if what we are hearing about Afrezza is even close to accurate, (I believe it is) Afrezza is what you need. I wouldn't take no for an answer. Good luck with everything, let us know if you do get Afrezza.
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Post by peppy on Apr 9, 2016 8:52:15 GMT -5
I don't know what is more disturbing... that your doctor gave you monotherapy of Metformin for an A1C of almost 12 or that he works at the Cleveland Clinic. That insulin is not far away from levels that could be dangerous. Granted it was not fasting, but for instance: www.diabetes.org/living-with-diabetes/complications/hyperosmolar-hyperglycemic.html?referrer=https://www.google.com/They use 600 as a cutoff but I have had personal experience with patients in the 400s. Your average blood glucose level for the past 3 months has been around 300. Until you can get back to your doc or see a new one for better treatment, please severely limit your carbohydrate intake of all kinds. Thank you for speaking up. I was surprised. (inappropriate thoughts like, "move out of Cleveland," flashing through)
( I remembered reading how Sam was started on insulin for type one. It went something like this. You are a diabetic, here take insulin. A story from years ago, I was surprised.)
This insulin resistance is amazing to see unfold. pep
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Post by vestful on Apr 9, 2016 13:24:55 GMT -5
First Post, Shareholder, Voyeur of this board and others. Just wanted to share a recent experience. Had my yearly blood work done end of March. Call back from PCP's office (Nurse) message: You have high blood sugar and now are considered Diabetic. Reviewed my blood test results on their "My Chart" online Medical Management Program. Results: Non Fasting Blood Sugar 399. Called back for fasting BS or HbA1c and number was 11.9 Met with my Cleveland Clinic PCP who resides in a large Cleveland Clinic off campus facility in a very large Cleveland suburb. Was given the required speech of what Diabetes is all about and what I need to do. Meeting with Dietician, scheduled for new blood work first of June and placed on 2000 mg of Metformin. Asked my Doctor if he had heard of the new inhaled insulin "Afrezza" he said NO and asked who makes it.... Seeing my appointment was within the time frame of Sanofi handing Afrezza back to MNKD - it was no time to share that information. I just told him there was a new FDA treatment on the market that was inhaled. Fell on DEAF ears. He went on to say that Pfizer had an inhaled insulin that was a big flop and was not an improvement over current insulin therapies. Hence, 2000 mg. of Metformin 1x per day for a grand total with my insurance of $10.00 for 90 Days. Can not be far from the commode room and CAN afford Afrezza. Sucks. (Female- 57yrs. 165lbs. 5'4") Hang in there Agusta. One of my employees had an almost identical response from his Endo in a Columbus suburb last week.I provided some resources. Hopefully Afrezza education improves soon.
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Post by karl on Apr 9, 2016 14:19:43 GMT -5
Find out a prescribing Doc from Sam Finta's list.
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Post by agusta on Apr 9, 2016 17:11:55 GMT -5
Interesting....ONLY 1 Doctor for the state of OHIO prescribing "Afrezza" (on Sam's List) and we have the World Renown Hospital System - Cleveland Clinic??? My experience troubles me with my investment and belief in MNKD. My PCP will not prescribe with only one doctor listed. We need a major education to all PCP's and Endo's, educating them on Afrezza vs the "Other Inhaled Insulin" and overcoming objections. As a patient he will not listen. I have tried.
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Post by kball on Apr 9, 2016 17:39:49 GMT -5
Interesting.... ONLY 1 Doctor for the state of OHIO prescribing "Afrezza" (on Sam's List) and we have the World Renown Hospital System - Cleveland Clinic??? My experience troubles me with my investment and belief in MNKD. My PCP will not prescribe with only one doctor listed. W e need a major education to all PCP's and Endo's, educating them on Afrezza vs the "Other Inhaled Insulin" and overcoming objections. As a patient he will not listen. I have tried. kball the pessimist opines: That's currently high on Mannkind's list of "immediate needs we just don't have the money or manpower for, but trust us...have we let you down before?" business plan
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Post by bioexec25 on Apr 9, 2016 18:17:00 GMT -5
Interesting.... ONLY 1 Doctor for the state of OHIO prescribing "Afrezza" (on Sam's List) and we have the World Renown Hospital System - Cleveland Clinic??? My experience troubles me with my investment and belief in MNKD. My PCP will not prescribe with only one doctor listed. W e need a major education to all PCP's and Endo's, educating them on Afrezza vs the "Other Inhaled Insulin" and overcoming objections. As a patient he will not listen. I have tried. kball the pessimist opines: That's currently high on Mannkind's list of "immediate needs we just don't have the money or manpower for, but trust us...have we let you down before?" business plan Normally being slightly more optimistic K, I wouldn't react. But oddly, I remember nearly 1.5 years ago interacting with a Nurse Prac in Ohio who was hosting an educational dinner on Afrezza. I emailed her as it was fairly close to Indy. She seemed upbeat at the time and it is disturbing that the chapter was somehow optimistic and here we sit, insurance, bribes and dinosaurs notwithstanding.
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Post by nylefty on Apr 9, 2016 18:26:48 GMT -5
Interesting.... ONLY 1 Doctor for the state of OHIO prescribing "Afrezza" (on Sam's List) and we have the World Renown Hospital System - Cleveland Clinic??? My experience troubles me with my investment and belief in MNKD. My PCP will not prescribe with only one doctor listed. We need a major education to all PCP's and Endo's, educating them on Afrezza vs the "Other Inhaled Insulin" and overcoming objections. As a patient he will not listen. I have tried. Your PCP makes his decisions based on Sam's list? In any event, I highly doubt that Sam's list is anywhere close to being complete. How could it be? And remember the pro-Afrezza article posted on the Cleveland Clinic's website last year? From the article: As a nurse and certified diabetes educator who has also lived with diabetes for the past 17 years, I wanted to try this new option. After using it for a few months, I found the inhaled insulin to be effective, easy to use, and a great alternative to an injection when I needed mealtime insulin. It can be used safely with any basal insulin, such as Lantus®, Levemir® or Toujeo®. Anyone who has Type 1 or Type 2 diabetes can benefit from this treatment option.
Inhaler benefits
Here are some of the benefits of the inhaled insulin:
It decreases risk for hypoglycemia. The onset time is 12 to 15 minutes and it is totally out of your system within 180 minutes.
It is painless, convenient and effective. Once inhaled, the insulin gets released into the body through your lungs and released into tiny airways that help move the insulin into the bloodstream quickly.
Color coding makes the dosages easy to identify. The color coding of the blisters are blue for four units, green for eight units and yellow for 12 units of insulin. This color coding decreases the possibility of errors.
The blister and the inhaling device are small and compact. Both can easily fit into a small purse or pant pocket.
The inhaling device is included with the monthly prescription. The device is changed every two weeks and needs no special care. Simply place the cap back on after use.
It is easy to use. To properly use the inhaling unit, you just place the prescribed blister containing a powder form of insulin into the device. Breathe out, place the device in your mouth and take in a deep breath slowly over the course of three to five seconds. Then breathe normally.health.clevelandclinic.org/2015/10/insulin-inhaler-new-option-diabetes/
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Post by Deleted on Apr 9, 2016 19:26:06 GMT -5
Interesting.... ONLY 1 Doctor for the state of OHIO prescribing "Afrezza" (on Sam's List) and we have the World Renown Hospital System - Cleveland Clinic??? My experience troubles me with my investment and belief in MNKD. My PCP will not prescribe with only one doctor listed. We need a major education to all PCP's and Endo's, educating them on Afrezza vs the "Other Inhaled Insulin" and overcoming objections. As a patient he will not listen. I have tried. You need change your pcp because he is not applying his own reasoning to find Afrezza pk pd profile similar to non diabetic and how that can help reach non diabetic sugars . He could wait until other docs start prescribing but your organs wouldn't wait until then with those high levels. I think finally it's up to the patient in this case you to make the decision though as its your health Get on Afrezza .. Send your results in 3 months A1c to the docs office and give him a chance to learn from you
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Post by rvc on Apr 9, 2016 20:07:42 GMT -5
It's ironic, I had almost the same experience with my PCP at the Cleveland Clinic last year(off campus at a Cleveland suburb). The Doc told me I was pre diabetic and he prescribed metformin. I mentioned a newly approved inhaled insulin called afrezza and he blew me off. He said the reason Exubera failed was not because of the bong like size but the fact that it 'didn't work'. He said he hadn't heard about Afrezza and expressed no interest whatsoever in hearing about it. At that point(last summer) I began to have doubts about how hard SNY was pushing Afrezza, and I should have listened to my instincts. Instead, I held on to the stock and the rest is history. Before anyone responds that I should get another doctor, I have to say that his response was probably typical of most PCP's.
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Post by agedhippie on Apr 9, 2016 20:16:04 GMT -5
The PCP (and Cleveland clinic) are following the standard of care. This is exactly what they should be doing. When (if) the metformin doesn't work after a few months then you can get them to give you insulin but they are very unlikely to give you insulin as a first line treatment for Type 2.
I am surprised that they put you on 2000mg immediately as they usually work up to that level. Usually they do this in 500mg steps or maybe 1000mg as it minimizes the side effects. Also make sure they have you on the extended release version and not the old one for the same reason. My endo uses metformin for all his patients including the Type 1s so I find myself on it from time to time. Diabetes aside metformin has a lot of interesting properties and seems to be protective against various cancers.
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Post by straightly on Apr 9, 2016 20:22:30 GMT -5
I believe this is the kind of help MNKD should be focusing on providing: We have a willing patient who want Afrezza and cannot. Think of it: if we get this patient her first prescription, that will be more than 0.5% increate in our prescription count.
The other thing MNKD need to focus on is "Who are likely to be willing patients and how do I get the right words to them."
Is it legal for MNKD to help such as referring her to a doctor who has already prescribe Afrezza before? Is it legal for MNKD to call upon this doctor who did not want to prescribe Afrezza?
Is there anything legal for MNKD to do to help in this direction?
Educating the doctors and hoping the RIGHT patients will just show up at these doctors and the doctors are willing to run through hoops to prescribe Afrezza is not going to work for MNKD. It simply does not have the resources to blanket enough doctors to generate any momentum.
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Post by sportsrancho on Apr 9, 2016 21:41:17 GMT -5
I hope someone e-mails Matt this thread!
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