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Post by sayhey24 on Aug 19, 2018 17:56:22 GMT -5
Aged - I believe I heard Al Mann talk numerous times about afrezza not only stopping the progression but in some cases reverse the disease. Is this reduced insulin resistance, increased beta function or both? I guess we will just need to wait and see. The great news is afrezza works like no other treatment, oral or insulin. As Dr. Kendall said a "Superior" insulin. While you don't seem to have the study information Al did and I believe Dr. Kendall does. Maybe this is one of his veins of gold you were asking about. Here is a more simple explanation on TZDs for simple minded people like me - www.endocrineweb.com/conditions/type-2-diabetes/thiazolidinediones-tzds-or-glitazones-type-2-diabetes |
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Post by agedhippie on Aug 19, 2018 20:05:31 GMT -5
Aged - I believe I heard Al Mann talk numerous times about afrezza not only stopping the progression but in some cases reverse the disease. Is this reduced insulin resistance, increased beta function or both? I guess we will just need to wait and see. The great news is afrezza works like no other treatment, oral or insulin. As Dr. Kendall said a "Superior" insulin. While you don't seem to have the study information Al did and I believe Dr. Kendall does. Maybe this is one of his veins of gold you were asking about. Here is a more simple explanation on TZDs for simple minded people like me - www.endocrineweb.com/conditions/type-2-diabetes/thiazolidinediones-tzds-or-glitazones-type-2-diabetesI think the evidence suggests that what you see is the beta cells recovering from the effects of hyperglycemia. This is the honeymoon effect in Type 1 or the early insulin use effect in Type 2 that mholden was posting links to. I don't think I have ever seen a paper saying insulin reduces insulin resistance. Was there a study proving that insulin resistance was reduced? I don't think I ever saw in in Clinical Trials and I thought I had read them all. |
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Post by rockstarrick on Aug 19, 2018 20:33:36 GMT -5
Aged - I believe I heard Al Mann talk numerous times about afrezza not only stopping the progression but in some cases reverse the disease. Is this reduced insulin resistance, increased beta function or both? I guess we will just need to wait and see. The great news is afrezza works like no other treatment, oral or insulin. As Dr. Kendall said a "Superior" insulin. While you don't seem to have the study information Al did and I believe Dr. Kendall does. Maybe this is one of his veins of gold you were asking about. Here is a more simple explanation on TZDs for simple minded people like me - www.endocrineweb.com/conditions/type-2-diabetes/thiazolidinediones-tzds-or-glitazones-type-2-diabetesI think the evidence suggests that what you see is the beta cells recovering from the effects of hyperglycemia. This is the honeymoon effect in Type 1 or the early insulin use effect in Type 2 that mholden was posting links to. I don't think I have ever seen a paper saying insulin reduces insulin resistance. Was there a study proving that insulin resistance was reduced? I don't think I ever saw in in Clinical Trials and I thought I had read them all. I’ve heard it, I couldn’t tell you where, but I remember hearing about this very topic, and if there is chatter like this going around, we’re just a trial away from finding out if it’s true. Wouldn’t that be something !! an insulin that actually stops the progression of T2, or even better, reverses it. If I even thought for a moment that I possessed something like that, I’d have a trial going so fast it’d make your head spin. ✌🏻😎 |
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Post by brentie on Aug 19, 2018 22:15:52 GMT -5
Aged - I believe I heard Al Mann talk numerous times about afrezza not only stopping the progression but in some cases reverse the disease. Is this reduced insulin resistance, increased beta function or both? I guess we will just need to wait and see. The great news is afrezza works like no other treatment, oral or insulin. As Dr. Kendall said a "Superior" insulin. While you don't seem to have the study information Al did and I believe Dr. Kendall does. Maybe this is one of his veins of gold you were asking about. Here is a more simple explanation on TZDs for simple minded people like me - www.endocrineweb.com/conditions/type-2-diabetes/thiazolidinediones-tzds-or-glitazones-type-2-diabetesAl: "Key opinion leaders are becoming increasingly positive and enthusiastic about the potential of AFREZZA. Some are suggesting that by reducing pancreatic stress, AFREZZA may slow and perhaps stop and even reverse progression of type 2 disease. Moreover, delivery of AFREZZA by the inhalation with a tiny, whistle-size inhaler is so simple, so convenient and will be so very cost effective. I truly believe many patients will prefer this therapy modality." seekingalpha.com/article/1173611-mannkind-management-discusses-q4-2012-results-earnings-call-transcript |
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Post by sayhey24 on Aug 20, 2018 5:40:30 GMT -5
Aged - I believe I heard Al Mann talk numerous times about afrezza not only stopping the progression but in some cases reverse the disease. Is this reduced insulin resistance, increased beta function or both? I guess we will just need to wait and see. The great news is afrezza works like no other treatment, oral or insulin. As Dr. Kendall said a "Superior" insulin. While you don't seem to have the study information Al did and I believe Dr. Kendall does. Maybe this is one of his veins of gold you were asking about. Here is a more simple explanation on TZDs for simple minded people like me - www.endocrineweb.com/conditions/type-2-diabetes/thiazolidinediones-tzds-or-glitazones-type-2-diabetesI think the evidence suggests that what you see is the beta cells recovering from the effects of hyperglycemia. This is the honeymoon effect in Type 1 or the early insulin use effect in Type 2 that mholden was posting links to. I don't think I have ever seen a paper saying insulin reduces insulin resistance. Was there a study proving that insulin resistance was reduced? I don't think I ever saw in in Clinical Trials and I thought I had read them all. Was there a study? Al always had studies. I believe Dr. Kendall now has them.
With afrezza and T2s I think what Al saw was the "reverse of the honeymoon period". With a T1 the attack comes on so fast and pancreatic function is lost so fast the cells in the other part of the body are not yet effected. If you buy into the Joslin theory the virus then spreads over time to the rest of the body and the honeymoon period is over.
With a T2 the virus has slowly spread through the body and by keeping near non-diabetic numbers the virus is reduced. Prior to afrezza has anyone been able to keep near non-diabetic numbers and taken the load off the pancreas to allow recovery?
While Joslin says they have identified four viruses at this point its all theory but its the first theory which makes sense to me.
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Post by MnkdWASmyRtrmntPlan on Aug 20, 2018 8:33:52 GMT -5
The question of how insulin resistance works is still confusing to me. I had a surgeon explain to me that diet was the principal cause of insulin resistance. That there was too much sugar on board in a persons body and that the pancreas was overloaded and could not deal with more sugars and more insulin would do no good. So how would Afrezza overcome that? Its still confusing to everyone because no one is sure what the root cause is. We know TZDs reduce insulin resistance. They basically do this by getting the body to produce new fat cells, and those cells are actually more sensitive to insulin.
Why? It could very well be Joslin is correct and the virus has not yet infected these cells. The same could hold try with exercise and the break down/ build up of new muscle.
What we do know is keep near non-diabetic numbers and insulin resistance decreases. What we also know from the 118 study that afrezza blocks the alpha cells which then shuts off glucose release from the liver thereby reducing glucose in the blood.
In short, afrezza provides a double whammy; reduced resistance; and reduce glucose.
Thanks Seyhey. I always appreciate you sharing your knowledge. I thought the pancreas manufactured and released alpha cells into the blood when it saw Afrezza (or, an abundance of insulin) in the blood (but not when it saw synthetic insulin). Then, the liver saw those alpha cells, and that is why it stopped gluconeogenesis. I thought that was the way the pancreas and liver communicated. However, that belief of mine was probably just an assumption that I made. So, if instead, Afrezza BLOCKS alpha cells, which effectively stops gluconeogenesis, then how does that work? How are Alpha cells used for that communication? It seems that Alpha cells are used to stimulate gluconeogenesis instead. Is that it? |
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Post by agedhippie on Aug 20, 2018 8:42:18 GMT -5
I think the evidence suggests that what you see is the beta cells recovering from the effects of hyperglycemia. This is the honeymoon effect in Type 1 or the early insulin use effect in Type 2 that mholden was posting links to. I don't think I have ever seen a paper saying insulin reduces insulin resistance. Was there a study proving that insulin resistance was reduced? I don't think I ever saw in in Clinical Trials and I thought I had read them all. Was there a study? Al always had studies. I believe Dr. Kendall now has them.
With afrezza and T2s I think what Al saw was the "reverse of the honeymoon period". With a T1 the attack comes on so fast and pancreatic function is lost so fast the cells in the other part of the body are not yet effected. If you buy into the Joslin theory the virus then spreads over time to the rest of the body and the honeymoon period is over.
With a T2 the virus has slowly spread through the body and by keeping near non-diabetic numbers the virus is reduced. Prior to afrezza has anyone been able to keep near non-diabetic numbers and taken the load off the pancreas to allow recovery?
While Joslin says they have identified four viruses at this point its all theory but its the first theory which makes sense to me.
Have a look at the Accelerator Hypothesis is you haven't already seen it. The idea is that Type 1 and 2 are basically the same disease with speed of onset the main difference. It's getting a reasonable amount of traction in the endo community. |
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Post by MnkdWASmyRtrmntPlan on Aug 20, 2018 10:24:13 GMT -5
Episode 67 of AFP podcast addressed intensive insulin therapy for type 1's and the benefits of tight glucose control. No mention of Afrezza... I emailed afppodcast@aafp.org thanking them but that I was disappointed that inhalable insulin was not even mentioned, and that some believe there is more of a future in that for T1 mealtime treatments than in closed-loop systems. I will post any responses. Here is their response: Our podcasts are based on the articles from each issue in American Family Physician. The article did not discuss inhaled insulin so we also did not discuss it. Sounds like the email should have gone to the author of that article instead of the podcast team. |
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Post by peppy on Aug 20, 2018 10:27:39 GMT -5
I emailed afppodcast@aafp.org thanking them but that I was disappointed that inhalable insulin was not even mentioned, and that some believe there is more of a future in that for T1 mealtime treatments than in closed-loop systems. I will post any responses. Here is their response: Our podcasts are based on the articles from each issue in American Family Physician. The article did not discuss inhaled insulin so we also did not discuss it. Sounds like the email should have gone to the author of that article instead of the podcast team. Wonder who/how the author got paid for the work. |
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Post by MnkdWASmyRtrmntPlan on Aug 20, 2018 10:30:20 GMT -5
Here is their response: Our podcasts are based on the articles from each issue in American Family Physician. The article did not discuss inhaled insulin so we also did not discuss it. Sounds like the email should have gone to the author of that article instead of the podcast team. Wonder who paid the author for the work. IDK, Peppy, but I replied and asked if he could forward it to that author. Perhaps that will encourage her/him to write about it in their next article. |
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Post by babaoriley on Aug 20, 2018 19:21:48 GMT -5
Was there a study? Al always had studies. I believe Dr. Kendall now has them.
With afrezza and T2s I think what Al saw was the "reverse of the honeymoon period". With a T1 the attack comes on so fast and pancreatic function is lost so fast the cells in the other part of the body are not yet effected. If you buy into the Joslin theory the virus then spreads over time to the rest of the body and the honeymoon period is over.
With a T2 the virus has slowly spread through the body and by keeping near non-diabetic numbers the virus is reduced. Prior to afrezza has anyone been able to keep near non-diabetic numbers and taken the load off the pancreas to allow recovery?
While Joslin says they have identified four viruses at this point its all theory but its the first theory which makes sense to me.
Have a look at the Accelerator Hypothesis is you haven't already seen it. The idea is that Type 1 and 2 are basically the same disease with speed of onset the main difference. It's getting a reasonable amount of traction in the endo community.And Afrezza isn't. WTF. |
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Post by sayhey24 on Aug 20, 2018 20:04:51 GMT -5
Was there a study? Al always had studies. I believe Dr. Kendall now has them.
With afrezza and T2s I think what Al saw was the "reverse of the honeymoon period". With a T1 the attack comes on so fast and pancreatic function is lost so fast the cells in the other part of the body are not yet effected. If you buy into the Joslin theory the virus then spreads over time to the rest of the body and the honeymoon period is over.
With a T2 the virus has slowly spread through the body and by keeping near non-diabetic numbers the virus is reduced. Prior to afrezza has anyone been able to keep near non-diabetic numbers and taken the load off the pancreas to allow recovery?
While Joslin says they have identified four viruses at this point its all theory but its the first theory which makes sense to me.
Have a look at the Accelerator Hypothesis is you haven't already seen it. The idea is that Type 1 and 2 are basically the same disease with speed of onset the main difference. It's getting a reasonable amount of traction in the endo community. Aged - I am one who believes that the underlying cause is one or more viruses which cause varying degrees of damage to the pancreas at varying speed. When I started following Joslin's work I found it interesting because they also believe a class of viruses are also responsible for insulin resistance. That I found very interesting as it would explain a great deal if they are correct. Prior I thought maybe it was the body trying to adapt to higher BG.
I am not a believer in the fat hypothesis. There are plenty of obese people who are not diabetic. I know a number of T1s who were never fat as children.
The healthy body has a way of adapting and in the case of being fat the healthy body will grow more beta cells and make more insulin. This has been know for a very long time through autopsy. I am a little surprised the fat hypothesis is gaining traction. I am not surprised they are saying the root cause for T1 and T2 is the same.
Diabetes is simply defined as the body not making enough insulin for the body's needs. If your body needs more it should make more and the healthy body will. As more and more T2s get tested they jump for joy when antibodies are found and they can now say they are LADA.
Why are they happy? Well T2 has a social stigma of being fat and lazy but if its auto-immune or maybe a virus thats a whole new ball game. I bet if we tested all T2s soon enough nearly all would have traceable antibodies. A virus would also explain T2 hot spot clusters if the virus can be transmitted between people. Shamokin PA is one such cluster. Its a some what closed community in the PA anthracite region. The current diabetes rate is 16% but Geisinger says 22k are prediabetic, yep the body not making enough insulin for its needs. The estimate total diabetic plus prediabetic is about 50% of the population. www.geisinger.org/freshfoodfarmacy/our-purpose/where-did-we-start |
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Post by brotherm1 on Aug 21, 2018 0:20:38 GMT -5
whose to say the cause is not fats and/or viruses? fats keep oxygen and nutrients away from organs. Fats can be hard on the immune system and a strong one is needed to fight off viruses.
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Post by peppy on Aug 21, 2018 0:23:41 GMT -5
whose to say it’s not fats and/or viruses? fats keep oxygen and nutrients away from organs. Fats can be hard on the immune system and a strong one is needed to fight off viruses. notice stomach stapling cures type two? stomach stapling on the standards of care. things that make me say, hmmmmm |
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Post by thekindaguyiyam on Aug 21, 2018 0:50:25 GMT -5
I had my endo appointment today. My A1C came down for 7.2 to 6.9. I spoke again of not willing to take metformin. The doctor game me some Afrezza samples.. he wanted to give me 8's and 12's. I told him since my in range # average is 135 I don't want the higher dose so he gave me a box of samps 4's and 8's. testing the limits I just ate 1/2 of a middle size pizza that I made thin crust and took a 4 unit dosage. No cough I didn't inhale hard. The doctor gave me the outdated samps exp. april 2018. He said he's glad to regain the refrigeration space! My doctor is exactly the type that the new sales reps face to convert. Most likely last contacted by a sanofi rep and holding Older outdated Afrezza samps. I know the samps will work long after their expiration. It will be interesting to see my morning glucose level. The endo stated clearly that once the pancreas beta cells died they will not be replaced. Apparently my education regarding early intervention with Afrezza given my A1C will be a very personal study. I personally buy into the concept that the disease can be reversed is the beta cells are given a respite in the pancreas. Likewise; mu Endo's story gives me a real perspective of the obstructions to all MNKD Sales Reps. New guys who haven't known rejection in contrast to the older pro's who do don't know the ymeaning of defeat.. this is not an easy drug to market given the mind set of those endo's who have a mind set based on old information like my endo represents. I left the office both discouraged by his attitude and excited about trying a drug that may possibly be the game changer.
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