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Post by agedhippie on Jul 5, 2018 17:14:24 GMT -5
Thanks peppy I guess that shows the shortcomings of using the FAERS database  |
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Post by sayhey24 on Jul 5, 2018 17:44:14 GMT -5
If it's so easy to stack RAA to correct high, then PWD on injected RAA or insulin pump should mostly have good A1C number. If that were the case, then really there wouldn't be a market for Afrezza.Given how poor the weekly script numbers still are after several long years, I'm not really sure how to interpret that remark. Current weekly script numbers and the market are very different. The market for afrezza is $25B. However, the customers for afrezza are the prescribing doctors. Until Dr. Kendall delivers on what he said he is going to do and make afrezza the standard of care no doctor in his right mind would ever prescribe afrezza unless they are highly knowledgeable of it and there are very few.
Rapid-acting inhaled insulin used before meals in patients with type 1 diabetes was shown to be noninferior when compared with aspart insulin for A1C lowering, with less hypoglycemia observed with inhaled insulin therapy (21). However, the mean reduction in A1C was greater with aspart (–0.21% vs. –0.40%, satisfying the noninferiority margin of 0.4%), and more patients in the insulin aspart group achieved A1C goals of ≤7.0% (53 mmol/mol) and ≤6.5% (48 mmol/mol). Because inhaled insulin cartridges are only available in 4-, 8-, and 12-unit doses, limited dosing increments to fine-tune prandial insulin doses in type 1 diabetes are a potential limitation.
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Post by gareaudan on Jul 5, 2018 18:02:39 GMT -5
Given how poor the weekly script numbers still are after several long years, I'm not really sure how to interpret that remark. Current weekly script numbers and the market are very different. The market for afrezza is $25B. However, the customers for afrezza are the prescribing doctors. Until Dr. Kendall delivers on what he said he is going to do and make afrezza the standard of care no doctors in his right mind would ever prescribe afrezza unless they are highly knowledgeable of it and there are very few.
Rapid-acting inhaled insulin used before meals in patients with type 1 diabetes was shown to be noninferior when compared with aspart insulin for A1C lowering, with less hypoglycemia observed with inhaled insulin therapy (21). However, the mean reduction in A1C was greater with aspart (–0.21% vs. –0.40%, satisfying the noninferiority margin of 0.4%), and more patients in the insulin aspart group achieved A1C goals of ≤7.0% (53 mmol/mol) and ≤6.5% (48 mmol/mol). Because inhaled insulin cartridges are only available in 4-, 8-, and 12-unit doses, limited dosing increments to fine-tune prandial insulin doses in type 1 diabetes are a potential limitation.
so, how long do you think it will take before they turn around and make afrezza the SOC like Dr K said it should be? Some said maybe jan. 2019. Which is only in 6 months. Does the stat studies convincing enough to change the SOC in such a short period? If not, what is our next move with the money and the time that we have? |
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Post by sayhey24 on Jul 5, 2018 18:18:18 GMT -5
How long? Dr. Kendall says he has everything he needs and says its the easiest job he has ever had. Given that January 2019 for the T1s plus an update into the T2 section to mention afrezza. This should make afrezza a legitimate $1B product.
The big one is getting afrezza in the T2 section to be Step 2 and replace all the verbiage about adding an anti-glycemic to medformin. This will take another study which will need to be presented at ADA2019. You are looking at January 2020 for that. This is worth about $6B.
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Post by gareaudan on Jul 5, 2018 18:24:53 GMT -5
How long? Dr. Kendall says he has everything he needs and says its the easiest job he has ever had. Given that January 2019 for the T1s plus an update into the T2 section to mention afrezza. This should make afrezza a legitimate $1B product. The big one is getting afrezza in the T2 section to be Step 2 and replace all the verbiage about adding an anti-glycemic to medformin. This will take another study which will need to be presented at ADA2019. You are looking at January 2020 for that. This is worth about $6B. thanks sayhey. I would be happy just to have a confirmation that afrezza will be à 1b product eventually.i can wait another 6 months but getting tired of waiting for the next 6 month. |
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Post by golfeveryday on Jul 5, 2018 18:25:43 GMT -5
How long? Dr. Kendall says he has everything he needs and says its the easiest job he has ever had. Given that January 2019 for the T1s plus an update into the T2 section to mention afrezza. This should make afrezza a legitimate $1B product. The big one is getting afrezza in the T2 section to be Step 2 and replace all the verbiage about adding an anti-glycemic to medformin. This will take another study which will need to be presented at ADA2019. You are looking at January 2020 for that. This is worth about $6B. price moves way before then in anticipation and partners jump on well in advance. Just a guess. |
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Post by gareaudan on Jul 5, 2018 19:02:49 GMT -5
How long? Dr. Kendall says he has everything he needs and says its the easiest job he has ever had. Given that January 2019 for the T1s plus an update into the T2 section to mention afrezza. This should make afrezza a legitimate $1B product. The big one is getting afrezza in the T2 section to be Step 2 and replace all the verbiage about adding an anti-glycemic to medformin. This will take another study which will need to be presented at ADA2019. You are looking at January 2020 for that. This is worth about $6B. price moves way before then in anticipation and partners jump on well in advance. Just a guess. so you think well before jan 2019? |
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Post by traderdennis on Jul 5, 2018 19:28:52 GMT -5
price moves way before then in anticipation and partners jump on well in advance. Just a guess. so you think well before jan 2019? I will take the over. |
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Post by gareaudan on Jul 5, 2018 19:56:08 GMT -5
so you think well before jan 2019? I will take the over. sorry but i dont understand what that mean. Do you mean that you think it will take more than 6 month? If so, i unfortunatly think you will be right. |
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Post by brotherm1 on Jul 5, 2018 21:00:18 GMT -5
aged: love you. More specifically, ketosis happens when fat/lipids are being burned as an energy source. Sorry, I should have said that. Lacking glucose the body burns fat for energy and to preserve glucose for the brain (the brain cannot use ketones and must have glucose). In dietary ketosis the continuing presence of low levels of insulin moderate the ketosis and keep you safe. In diabetic ketosis there is no insulin so there is no moderation and you get runaway ketosis that will kill you. The quick check is to test your blood glucose. If you have more than trace ketones and are under 250 that is almost certainly dietary ketones. If you are over 250 and have more than trace ketones start to worry. If you are over 350 and have ketones go to hospital immediately. DKA worries me far more than hypos. All the diabetics I know who have died were killed by DKA. [ That’s not at all (edit: entirely true) true there Aged about the brain not being able to use ketones. The brain uses ketones very well in place of glucose. |
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Post by sweedee79 on Jul 5, 2018 21:08:40 GMT -5
brotherm1 You are correct about ketones.. check out the science behind the ketogenic diet.. People live on 20 to 50gm carbs daily.. 100 gms fat.. and moderate protien.. and they do quite well using fat for energy..
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Post by peppy on Jul 5, 2018 21:41:12 GMT -5
Sorry, I should have said that. Lacking glucose the body burns fat for energy and to preserve glucose for the brain (the brain cannot use ketones and must have glucose). In dietary ketosis the continuing presence of low levels of insulin moderate the ketosis and keep you safe. In diabetic ketosis there is no insulin so there is no moderation and you get runaway ketosis that will kill you. The quick check is to test your blood glucose. If you have more than trace ketones and are under 250 that is almost certainly dietary ketones. If you are over 250 and have more than trace ketones start to worry. If you are over 350 and have ketones go to hospital immediately. DKA worries me far more than hypos. All the diabetics I know who have died were killed by DKA. [ That’s not at all true there Aged about the brain not being able to use ketones. The brain uses ketones very well in place of glucose. The brain cells only use glucose for energy. Brain. Glucose is virtually the sole fuel for the human brain, except during prolonged starvation. The brain lacks fuel stores and hence requires a continuous supply of glucose. It consumes about 120 g daily, which corresponds to an energy input of about 420 kcal (1760 kJ), accounting for some 60% of the utilization of glucose by the whole body in the resting state. Much of the energy, estimates suggest from 60% to 70%, is used to power transport mechanisms that maintain the Na+-K+ membrane potential required for the transmission of the nerve impulses. The brain must also synthesize neurotransmitters and their receptors to propagate nerve impulses. Overall, glucose metabolism remains unchanged during mental activity, although local increases are detected when a subject performs certain tasks. Fatty acids do not serve as fuel for the brain, because they are bound to albumin in plasma and so do not traverse the blood-brain barrier. In starvation, ketone bodies generated by the liver partly replace glucose as fuel for the brain.Muscle. The major fuels for muscle are glucose, fatty acids, and ketone bodies. Muscle differs from the brain in having a large store of glycogen (1200 kcal, or 5000 kJ). Adipose tissue. The triacylglycerols stored in adipose tissue are an enormous reservoir of metabolic fuel Liver. The metabolic activities of the liver are essential for providing fuel to the brain, muscle, and other peripheral organs. Let us first consider how the liver metabolizes carbohydrates. The liver removes two-thirds of the glucose from the blood and all of the remaining monosaccharides. Some glucose is left in the blood for use by other tissues. The absorbed glucose is converted into glucose 6-phosphate by hexokinase and the liver-specific glucokinase. Glucose 6-phosphate, as already stated, has a variety of fates, although the liver uses little of it to meet its own energy needs. Much of the glucose 6-phosphate is converted into glycogen. The liver also plays a central role in the regulation of lipid metabolism. When fuels are abundant, fatty acids derived from the diet or synthesized by the liver are esterified and secreted into the blood in the form of very low density lipoprotein (see Figure 30.15). However, in the fasting state, the liver converts fatty acids into ketone bodies. How is the fate of liver fatty acids determined? The selection is made according to whether the fatty acids enter the mitochondrial matrix. Recall that long-chain fatty acids traverse the inner mitochondrial membrane only if they are esterified to carnitine. www.ncbi.nlm.nih.gov/books/NBK22436/ |
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Post by mango on Jul 5, 2018 21:41:57 GMT -5
 β-hydroxybutyrate (βHB) and acetoacetate (AcAc) |
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Post by gareaudan on Jul 5, 2018 21:46:50 GMT -5
brotherm1 You are correct about ketones.. check out the science behind the ketogenic diet.. People live on 20 to 50gm carbs daily.. 100 gms fat.. and moderate protien.. and they do quite well using fat for energy.. i am not a dietitian but im pretty sure that when you eat meat or potato you eat glucose polymere like starch or glycogen so you actually dont only eat ketone (which is only a different kind of sugar by the way) or use only fat for energy. The "science" behind those diet are usually not very solid. |
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Post by uvula on Jul 5, 2018 23:17:08 GMT -5
What will the ADA do?
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