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Post by mytakeonit on May 25, 2018 1:37:13 GMT -5
Cracker joke? Dont' go there tingtong ... I'm asian from Hawaii so I don't really care. Ha! The thing is that we should wait till June to see where we are at. I just love that this stock has held under $2 and I've been loading up with the dips. Have you also noticed that the shorts haven't really been able to leave because the shares available are so in short supply? Love it!!!
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Post by sayhey24 on May 25, 2018 5:58:22 GMT -5
Going back a bit in this thread, I thought that the inhaled aspect of Afrezza made it faster than RAA (subcutaneous makes that slow), and that has nothing to do with monomer vs dimer vs hexamer. IV insulin is still fastest in, I have not heard if IV insulin has a long tail or not. But all that is again taking the science too far down the rabbit hole. The simply said advantages of Afrezza are: - Much faster in, much faster out than anything else
- "Faster in" is fast enough to mimic first phase insulin response of the pancreas. The benefits of that could be extra reading for some docs, but it sounds sciencey enough to capture the layman's attention and would make a great soundbyte. Also, no other product does this.
- "Faster in" means you can take it a few min after you start eating, so much less risk of dosing and then not eating due to unexpected circumstance
- "Faster out" causes significantly less incidence of hypos (35% I think has been backed up by studies?), and less risk of stacking is needed
- "Faster out" means you can dose a bit higher with safety (no clue how this could be quantified), getting better A1c results
Oh, and it's inhaled vs injected. That is both an advantage and a disadvantage. Most people hate injections, but most people are careful about sucking unknown stuff into their lungs. Especially if it makes them cough. Concrete proof of inhalation safety would do wonders to turn this into a real advantage. It could be talked about as an advantage to getting corrections easily. 8u at the start of the meal and 4u later (because, dessert) is easier with inhaled Don't let them fool ya. No rabbit hole here. MannKind inhalation science mimics intra-arterial administration. Before Afrezza came along all insulin monomers were just insulin monomers. No other kind of insulin monomer is like an Afrezza insulin monomer, but all other insulin monomers are like all other insulin monomers. In short, the zinc is washed from the insulin molecules, which simultaneously attract to the FDKP particles (prepped with a strong attractor). So the suspended insulin molecules simultaneously become trapped/coupled in FDKP particles once the zinc is removed. The change. What's left in charge?🧐 Their separation factor is set to pH, the change in pH in the deep lung. Afrezza is zinc-free human insulin. There is no dissociation phase that must take place, which means immediate uptake into systemic circulation. The patent explains this better than I do. The insulin molecules trapped in FDKP particles is sorta like having a fleet of Apaches transporting insulin safely to the deep lung. 😎 Here is the MannKind patent: 7,648,960 Method for delivery of monomeric or dimeric insulin complexed to diketopiperazine microparticles Snippet Mango - Aged made an unsubstantiated claim the other day that taking hexamer insulin IV was faster than afrezza. While I suspect it would be a photo finish, I suspect afrezza would actually win the race. Any data on this?
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Post by uvula on May 25, 2018 7:45:58 GMT -5
"****** made an unsubstantiated claim the other day that taking hexamer insulin IV was faster than afrezza. While I suspect it would be a photo finish, I suspect afrezza would actually win the race. Any data on this?"
Irrelevant. IV insulin is not used for long term diabetes management.
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Post by straightly on May 25, 2018 9:05:20 GMT -5
"****** made an unsubstantiated claim the other day that taking hexamer insulin IV was faster than afrezza. While I suspect it would be a photo finish, I suspect afrezza would actually win the race. Any data on this?" Irrelevant. IV insulin is not used for long term diabetes management. Relevant: they were talking about emergency care use: if Afrezza is used there, that will be a wonderful sales leader.
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Post by agedhippie on May 25, 2018 10:21:50 GMT -5
"****** made an unsubstantiated claim the other day that taking hexamer insulin IV was faster than afrezza. While I suspect it would be a photo finish, I suspect afrezza would actually win the race. Any data on this?" Irrelevant. IV insulin is not used for long term diabetes management. Relevant: they were talking about emergency care use: if Afrezza is used there, that will be a wonderful sales leader. If you are in ER for hyperglycemia (since we are talking about insulin) rapidly dropping levels will dump your potassium levels and may very well kill you. IV insulin is used because it can be drip feed at a very precise rate to lower the level without killing the patient. Before they do that though they give fluids and electrolytes because that is the crisis, not the glucose levels. Speed of action is not particularly relevant in treating hyperglycemia in an ER setting.
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Post by peppy on May 25, 2018 10:32:23 GMT -5
Relevant: they were talking about emergency care use: if Afrezza is used there, that will be a wonderful sales leader. If you are in ER for hyperglycemia (since we are talking about insulin) rapidly dropping levels will dump your potassium levels and may very well kill you. IV insulin is used because it can be drip feed at a very precise rate to lower the level without killing the patient. Before they do that though they give fluids and electrolytes because that is the crisis, not the glucose levels. Speed of action is not particularly relevant in treating hyperglycemia in an ER setting. on the other side of the spectrum, in an ECMO lab, when the training is done, the sheep is sacrificed. They are given a large IV dose of potassium. Potassium, the interesting electrolyte.
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Post by ilovekauai on May 25, 2018 10:39:19 GMT -5
That's some really scary stuff there. I hope that never happens to me. Afrezza will prevent that scenario for me.
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Post by cretin11 on May 25, 2018 12:04:21 GMT -5
Cracker joke? Dont' go there tingtong ... I'm asian from Hawaii so I don't really care. Ha! The thing is that we should wait till June to see where we are at. I just love that this stock has held under $2 and I've been loading up with the dips. Have you also noticed that the shorts haven't really been able to leave because the shares available are so in short supply? Love it!!! Is it true that shorts "haven't really been able to leave because the shares available are so in short supply"? The share lending/borrowing rates have plummeted, so I thought that meant shares are NOT in short supply. But i don't have the best understanding of share lending/borrowing/shorting dynamics. I would think shorts should have no problem leaving if they want to, it seems shares are plentiful based on those rates being so low.
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Post by dreamboatcruise on May 25, 2018 13:19:35 GMT -5
Mango - Aged made an unsubstantiated claim the other day that taking hexamer insulin IV was faster than afrezza. While I suspect it would be a photo finish, I suspect afrezza would actually win the race. Any data on this? The pancreas dumps insulin into the portal vein in hexamer form. So if you're looking for data and can't find any on it's exogenous IV use, you might compare to a clamp study with a non diabetic cohort and natural insulin response. Hexamers dissociate very quickly once they dilute in the blood stream. Disassociation of hexamers vs dissolving of FDKP... I would suspect it is a photo finish. It may be that the techniques they use for clamp studies wouldn't be precise enough to pick up any tiny difference that may exist. However, I would place a large bet there is no clinical relevance to any difference.
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Post by dreamboatcruise on May 25, 2018 13:25:49 GMT -5
Cracker joke? Dont' go there tingtong ... I'm asian from Hawaii so I don't really care. Ha! The thing is that we should wait till June to see where we are at. I just love that this stock has held under $2 and I've been loading up with the dips. Have you also noticed that the shorts haven't really been able to leave because the shares available are so in short supply? Love it!!! Is it true that shorts "haven't really been able to leave because the shares available are so in short supply"? The share lending/borrowing rates have plummeted, so I thought that meant shares are NOT in short supply. But i don't have the best understanding of share lending/borrowing/shorting dynamics. I would think shorts should have no problem leaving if they want to, it seems shares are plentiful based on those rates being so low. I think he meant shares being sold by longs rather than shares available to borrow. Short interest is going down without driving price up much, so to me it seems there are shares available from longs for them to exit... at least the modest level of exiting that has occurred recently.
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Post by sophie on May 25, 2018 13:43:42 GMT -5
Relevant: they were talking about emergency care use: if Afrezza is used there, that will be a wonderful sales leader. If you are in ER for hyperglycemia (since we are talking about insulin) rapidly dropping levels will dump your potassium levels and may very well kill you. IV insulin is used because it can be drip feed at a very precise rate to lower the level without killing the patient. Before they do that though they give fluids and electrolytes because that is the crisis, not the glucose levels. Speed of action is not particularly relevant in treating hyperglycemia in an ER setting. Added to this, patients often have an altered mental status or are sometimes even completely unconscious, rendering anything other than IV to be ineffective. I don't think any doctor will reach for an inhaler under DKA or Hyperglycemic Hyperosmolar Syndrome as lawyers would have a field day. I cannot see anything other than IV being used in emergencies, especially since they have to start a line for fluids and potassium, like agedhippie stated.
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Post by peppy on May 25, 2018 14:12:40 GMT -5
If you are in ER for hyperglycemia (since we are talking about insulin) rapidly dropping levels will dump your potassium levels and may very well kill you. IV insulin is used because it can be drip feed at a very precise rate to lower the level without killing the patient. Before they do that though they give fluids and electrolytes because that is the crisis, not the glucose levels. Speed of action is not particularly relevant in treating hyperglycemia in an ER setting. Added to this, patients often have an altered mental status or are sometimes even completely unconscious, rendering anything other than IV to be ineffective. I don't think any doctor will reach for an inhaler under DKA or Hyperglycemic Hyperosmolar Syndrome as lawyers would have a field day. I cannot see anything other than IV being used in emergencies, especially since they have to start a line for fluids and potassium, like agedhippie stated. I found the incidence data. Diabetic ketoacidosis (DKA) and the hyperglycemic hyperosmolar state (HHS) appear as 2 extremes in the spectrum of diabetic decompensation.1 They remain the most serious acute metabolic complications of diabetes mellitus and are still associated with excess mortality. Because the approach to the diagnosis and treatment of these hyperglycemic crises are similar, we have opted to address them together. The incidence of DKA is between 4.6 and 8.0 per 1000 person-years among patients with diabetes, whereas that of HHS is less than 1 per 1000 person-years.2 Based on the estimated diabetic population in Canada,3 we can anticipate that 5000–10 000 patients will be admitted to hospital because of DKA every year and 500–1000 patients because of HHS. The estimated mortality rate for DKA is between 4% and 10%, whereas the rate for HHS varies from 10% to 50%, the range most likely owing to underlying illnesses.2 www.ncbi.nlm.nih.gov/pmc/articles/PMC151994/
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Post by mytakeonit on May 25, 2018 14:12:53 GMT -5
It was really difficult for me to hit that "thumbs up" for DBC ... but, by george ... I think he got it. Ha!
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Post by sportsrancho on May 25, 2018 14:35:28 GMT -5
It was really difficult for me to hit that "thumbs up" for DBC ... but, by george ... I think he got it. Ha! Too funny I was thinking...must’ve been really hard for him to hit that thumbs up☺️😂🤣 And then you said exactly that!
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Post by sportsrancho on Jun 4, 2018 15:43:43 GMT -5
5/16 Mike C. @mannkindcorp thank you to all the shareholders who showed up today. We were excited to host you and answer all your questions. Look forward to making 2018 successful!
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