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Post by brotherm1 on Jul 23, 2019 15:49:09 GMT -5
That would certainly make a terrific TV ad if the FDA would permit it
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Post by akemp3000 on Jul 23, 2019 17:03:38 GMT -5
Just saw a post saying the insulin market is "mature" and was stunned in disbelief. The insulin market is antiquated, stale and currently offers ineffective results with existing standards-of-care. With cgm's, the insulin market is entering a new generation and is the opposite of mature.
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Post by shawnonafrezza on Jul 23, 2019 21:26:01 GMT -5
Perhaps you haven’t been around long enough to remember the video of a guy taking his Afrezza while riding his motorcycle? An Afrezza inhaler is way different than your pen. I haven't and I just watched it. I wouldn't condone that at all. I remember the first call I ever got as an EMT-B was a dude with a half helmet who did nothing wrong and still crashed (wonder how many of you have seen brain splattered across a backboard). Inhaling while riding (God forbid you get in a coughing fit) is just stupid. Not surprising since people think phones are ok while driving. But I guess he already has no gear so his rules his life. I agree that CGMs are changing the market and if you don't think that includes outdated insulins you're mistaken. Reality doesn't so much care about opinions as it does results. imgur.com/a/lvoX7EPimgur.com/a/fkrcglaimgur.com/a/gNOiWwEThose are my graphs (happily showing the good and bad, there was a super shit crash in there on the 17th and today I rode high stuck at 150 from stress). Those are using Humalog on a pump not carb restricted and no manual bolusing and letting my phone deal with it. I can tighten it a bit if I use my 2Us (Oh, yeah, remember I do use it so I'm quite aware it's different than a pen) but my pharmacy doesn't carry Afrezza so it's harder for me to get atm since I have to have it delivered or drive 2 hours. As I've said many times, Afrezza has a place but too many of you trumpet it without really being invested into what is happening in the diabetes space. You'll see the above and discount it. I know that because whenever hippy brings it up you do. If you don't think urli and the likes of tidepool/780g/tamdem control-iq/beta bionics/insulet horizon aren't a threat because of subq limitation you aren't paying attention. 14k people in a fb diy group to make your own APS should tell you what people are voting for. What's better? Quickly correcting the high or the high never happening in the first place? Mike C (from that chart he had) knows Mannkinds gold is more technosphere and not just insulin.
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Post by peppy on Jul 23, 2019 22:32:02 GMT -5
Perhaps you haven’t been around long enough to remember the video of a guy taking his Afrezza while riding his motorcycle? An Afrezza inhaler is way different than your pen. I haven't and I just watched it. I wouldn't condone that at all. I remember the first call I ever got as an EMT-B was a dude with a half helmet who did nothing wrong and still crashed (wonder how many of you have seen brain splattered across a backboard). Inhaling while riding (God forbid you get in a coughing fit) is just stupid. Not surprising since people think phones are ok while driving. But I guess he already has no gear so his rules his life. I agree that CGMs are changing the market and if you don't think that includes outdated insulins you're mistaken. Reality doesn't so much care about opinions as it does results. imgur.com/a/lvoX7EPimgur.com/a/fkrcglaimgur.com/a/gNOiWwEThose are my graphs (happily showing the good and bad, there was a super shit crash in there on the 17th and today I rode high stuck at 150 from stress). Those are using Humalog on a pump not carb restricted and no manual bolusing and letting my phone deal with it. I can tighten it a bit if I use my 2Us (Oh, yeah, remember I do use it so I'm quite aware it's different than a pen) but my pharmacy doesn't carry Afrezza so it's harder for me to get atm since I have to have it delivered or drive 2 hours. As I've said many times, Afrezza has a place but too many of you trumpet it without really being invested into what is happening in the diabetes space. You'll see the above and discount it. I know that because whenever hippy brings it up you do. If you don't think urli and the likes of tidepool/780g/tamdem control-iq/beta bionics/insulet horizon aren't a threat because of subq limitation you aren't paying attention. 14k people in a fb diy group to make your own APS should tell you what people are voting for. What's better? Quickly correcting the high or the high never happening in the first place? Mike C (from that chart he had) knows Mannkinds gold is more technosphere and not just insulin. Thank you for the links. 3.5% of readings below 70. how much time is that? Then the average and median of the lows, not the numbers. I know statistic wise it looks very good. I would want look at the graphs as well. the graphs are a quick read and allows the eyeballs to zero in. Graphs give more detailed information. they give a lot of information. In premature infants the electro cardio gram graph allows determination of the alarm. is the alarm real, is the baby really bradycardic. soon you can glance at the ECG and know, it is not the number showing that verifies, rather, the wave.
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Post by shawnonafrezza on Jul 23, 2019 22:37:02 GMT -5
I haven't and I just watched it. I wouldn't condone that at all. I remember the first call I ever got as an EMT-B was a dude with a half helmet who did nothing wrong and still crashed (wonder how many of you have seen brain splattered across a backboard). Inhaling while riding (God forbid you get in a coughing fit) is just stupid. Not surprising since people think phones are ok while driving. But I guess he already has no gear so his rules his life. I agree that CGMs are changing the market and if you don't think that includes outdated insulins you're mistaken. Reality doesn't so much care about opinions as it does results. imgur.com/a/lvoX7EPimgur.com/a/fkrcglaimgur.com/a/gNOiWwEThose are my graphs (happily showing the good and bad, there was a super shit crash in there on the 17th and today I rode high stuck at 150 from stress). Those are using Humalog on a pump not carb restricted and no manual bolusing and letting my phone deal with it. I can tighten it a bit if I use my 2Us (Oh, yeah, remember I do use it so I'm quite aware it's different than a pen) but my pharmacy doesn't carry Afrezza so it's harder for me to get atm since I have to have it delivered or drive 2 hours. As I've said many times, Afrezza has a place but too many of you trumpet it without really being invested into what is happening in the diabetes space. You'll see the above and discount it. I know that because whenever hippy brings it up you do. If you don't think urli and the likes of tidepool/780g/tamdem control-iq/beta bionics/insulet horizon aren't a threat because of subq limitation you aren't paying attention. 14k people in a fb diy group to make your own APS should tell you what people are voting for. What's better? Quickly correcting the high or the high never happening in the first place? Mike C (from that chart he had) knows Mannkinds gold is more technosphere and not just insulin. Thank you for the links. 3.5% of readings below 70. how much time is that? Then the average and median of the lows, not the numbers. I know statistic wise it looks very good. I would want look at the graphs as well. the graphs are a quick read and allows the eyeballs to zero in. Graphs give more detailed information. they give a lot of information. In premature infants the electro cardio gram graph allows determination of the alarm. is the alarm real, is the baby really bradycardic. soon you can glance at the ECG and know, it is not the number showing that verifies, rather, the wave. 67 readings below 70 is 335 minutes (1 reading every 5 minutes) below 70 over the course of 7 days or roughly 10k minutes. If I adjust the low to be below 65 (my dexcom goes off at 65) then it is .6% of readings or 60 minutes out of the 10k minutes. Getting the median per range and stuff isn't supported with what made those charts sadly but if you look anything that is a red dot in the third graph is a high or low (140/70) and the second graph does percentile charts. If I want to change it to the ada TIR standard of 70-180 then I have 96.3% TIR with only .3% high. Can slice it many ways but I wouldn't at all disagree that I need to tighten up that low number. Most are happening post gym around 1830ish so either I need to eat before or cut back basal/set a higher target while I workout or my basal around 1600ish is off. Also on the 19th overnight I havce no idea what happened. That is the better thing on just Tresiba/Afrezza, the why on basals is simple and you can course correct fast with less fog.
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Post by olebob1 on Jul 23, 2019 22:51:13 GMT -5
Thank you for the links. 3.5% of readings below 70. how much time is that? Then the average and median of the lows, not the numbers. I know statistic wise it looks very good. I would want look at the graphs as well. the graphs are a quick read and allows the eyeballs to zero in. Graphs give more detailed information. they give a lot of information. In premature infants the electro cardio gram graph allows determination of the alarm. is the alarm real, is the baby really bradycardic. soon you can glance at the ECG and know, it is not the number showing that verifies, rather, the wave. 67 readings below 70 is 335 minutes (1 reading every 5 minutes) below 70 over the course of 7 days or roughly 10k minutes. If I adjust the low to be below 65 (my dexcom goes off at 65) then it is .6% of readings or 60 minutes out of the 10k minutes. Getting the median per range and stuff isn't supported with what made those charts sadly but if you look anything that is a red dot in the third graph is a high or low (140/70) and the second graph does percentile charts. If I want to change it to the ada TIR standard of 70-180 then I have 96.3% TIR with only .3% high. Can slice it many ways but I wouldn't at all disagree that I need to tighten up that low number. Most are happening post gym around 1830ish so either I need to eat before or cut back basal/set a higher target while I workout or my basal around 1600ish is off. That is the better thing on just Tresiba/Afrezza, the why on basals is simple and you can course correct fast with less fog. So Shawn, if you had a store close by that provided Afrezza would you consider Tresiba/Afrezza as SOC for you?
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Post by shawnonafrezza on Jul 23, 2019 23:08:38 GMT -5
67 readings below 70 is 335 minutes (1 reading every 5 minutes) below 70 over the course of 7 days or roughly 10k minutes. If I adjust the low to be below 65 (my dexcom goes off at 65) then it is .6% of readings or 60 minutes out of the 10k minutes. Getting the median per range and stuff isn't supported with what made those charts sadly but if you look anything that is a red dot in the third graph is a high or low (140/70) and the second graph does percentile charts. If I want to change it to the ada TIR standard of 70-180 then I have 96.3% TIR with only .3% high. Can slice it many ways but I wouldn't at all disagree that I need to tighten up that low number. Most are happening post gym around 1830ish so either I need to eat before or cut back basal/set a higher target while I workout or my basal around 1600ish is off. That is the better thing on just Tresiba/Afrezza, the why on basals is simple and you can course correct fast with less fog. So Shawn, if you had a store close by that provided Afrezza would you consider Tresiba/Afrezza as SOC for you? No. And I'll elaborate somewhat on the why. More if people really want to listen to me rant. A lot of times people really don't understand what is hard with T1DM. Kinked cannulas on a pump suck. Coughing out the powder after inhaling sucks. Misdosing sucks. Lows suck. Stubborn highs suck. Man, T1DM just sucks but after 14 years it's not the little things that bother me. I cough out Afrezza? I take a new dose. Overdose, eat a few glucose tabs. The fact I have to do any of that is what gets to me. Imagine you have an alarm going off every 10 minutes that you need to check and decide what you're going to do next. Maybe that's too often, you'll burn out. 30 minutes? 60? 90? 120? Now we've slacked too much, you need to check more and fix your blood sugars! Constant, that is the word for T1DM. It. Does. Not. Stop. What is your blood sugar right now? Are you still digesting? Do you need to dose? Maybe. But I should wait 10 minutes and check again. Ok, 10 minutes again and now my blood sugar is 5mg/dl higher. Should I correct that? Inhale? Well I'm only at 123mg/dl, will the 4U drop me too much? Probably not... right? Dosed, check back in 45 minutes. Hell yeah, 4U was right, now we're at 82mg/dl. Continue on. Evaluate again in 45-60. Now we're at 95mg/dl. Nothing needs doing, go to that meeting. Dexcom alert goes off, somehow I hit 140mg/dl. Why? Doesn't matter, excuse me, need to dose. [....] Go to bed, been two hours since I last ate. BGL at 101mg/dl. Good to sleep. Two hours later, woken up by low alarm. Oh right, we trained legs and it was a hell of a workout so glycogen stores are down and my normal basal was too much. 12g glucose tablets, go to bed. Wake up an hour later, now high. Why? Liver dumped glucose along with the 12g, was too much. Inhale. Back to bed. Do that daily. Afrezza helps, Afrezza is amazing for what it is but for me it doesn't address the underlying issue of me having to monitor. IPhones have that "how often do you open an app thing" and when I'm using a close loop I spend an average of about 12 minutes a day dealing with diabetes. When I did Afrezza + Tresiba I'd be looking at my CGM every 30-45 minutes. That's 28 intended glances a day. That doesn't count the little voice in the back of my head asking "are you ok"? Where Afrezza shines for me is the unpredictable. The "I'm at Disneyland and that cupcake is going to ruin my day because they somehow crammed 1k calories into 3 bites and not even a healthy body is prepared for this". It helps with the "WTF just happened and why am I at 200mg/dl?!". It solves the unsolvable that is diabetes with he problems that really don't have answers and just exist because I have multiple missing hormones. I think that is the best solution really. A closed loop + Afrezza for the big boluses. The problem is getting the Afrezza on a consistent basis and $$$. Not so much for me, I only pay $60 I think it is per month to get it but I know others aren't as fortunate.
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Post by sayhey24 on Jul 24, 2019 8:20:01 GMT -5
Shawnflynn - do you think the www.insulinsavings.com program is not working or the $5 a day rate is not real? Or is it no one knows of the program or some other reason? While $150 is a bit more than $60 its not huge.
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Post by mnholdem on Jul 24, 2019 8:23:14 GMT -5
Perhaps you haven’t been around long enough to remember the video of a guy taking his Afrezza while riding his motorcycle? An Afrezza inhaler is way different than your pen. [Clipped] Mike C (from that chart he had) knows Mannkinds gold is more technosphere and not just insulin. Technosphere is gold, but CEO Castagna likely views TS as the only way to save his job since he doesn’t know how to penetrate the market with Afrezza.
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Post by rtmd on Jul 24, 2019 9:17:53 GMT -5
Shawnflynn - do you think the www.insulinsavings.com program is not working or the $5 a day rate is not real? Or is it no one knows of the program or some other reason? While $150 is a bit more than $60 its not huge. I posted elsewhere that Lilly, per goodrx, has apparently lowered the price of its pens to as low as $78 for three pens. Presuming 3 pens last 2-3 months, that works out to about less than a dollar a day. Can afrezza go that low and still make a profit?
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Post by shawnonafrezza on Jul 24, 2019 9:29:42 GMT -5
Shawnflynn - do you think the www.insulinsavings.com program is not working or the $5 a day rate is not real? Or is it no one knows of the program or some other reason? While $150 is a bit more than $60 its not huge. I don't think I can really answer that. It's more what will competition do and what can people afford. $150/mo is about $1500 a year which is fine by me financially but that then isn't including other diabetes supplies. The difference a year is $720 and for quite a large population that is money they just don't have.
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Post by peppy on Jul 24, 2019 9:44:44 GMT -5
So Shawn, if you had a store close by that provided Afrezza would you consider Tresiba/Afrezza as SOC for you? No. And I'll elaborate somewhat on the why. More if people really want to listen to me rant. A lot of times people really don't understand what is hard with T1DM. Kinked cannulas on a pump suck. Coughing out the powder after inhaling sucks. Misdosing sucks. Lows suck. Stubborn highs suck. Man, T1DM just sucks but after 14 years it's not the little things that bother me. I cough out Afrezza? I take a new dose. Overdose, eat a few glucose tabs. The fact I have to do any of that is what gets to me. Imagine you have an alarm going off every 10 minutes that you need to check and decide what you're going to do next. Maybe that's too often, you'll burn out. 30 minutes? 60? 90? 120? Now we've slacked too much, you need to check more and fix your blood sugars! Constant, that is the word for T1DM. It. Does. Not. Stop. What is your blood sugar right now? Are you still digesting? Do you need to dose? Maybe. But I should wait 10 minutes and check again. Ok, 10 minutes again and now my blood sugar is 5mg/dl higher. Should I correct that? Inhale? Well I'm only at 123mg/dl, will the 4U drop me too much? Probably not... right? Dosed, check back in 45 minutes. Hell yeah, 4U was right, now we're at 82mg/dl. Continue on. Evaluate again in 45-60. Now we're at 95mg/dl. Nothing needs doing, go to that meeting. Dexcom alert goes off, somehow I hit 140mg/dl. Why? Doesn't matter, excuse me, need to dose. [....] Go to bed, been two hours since I last ate. BGL at 101mg/dl. Good to sleep. Two hours later, woken up by low alarm. Oh right, we trained legs and it was a hell of a workout so glycogen stores are down and my normal basal was too much. 12g glucose tablets, go to bed. Wake up an hour later, now high. Why? Liver dumped glucose along with the 12g, was too much. Inhale. Back to bed. Do that daily. Afrezza helps, Afrezza is amazing for what it is but for me it doesn't address the underlying issue of me having to monitor. IPhones have that "how often do you open an app thing" and when I'm using a close loop I spend an average of about 12 minutes a day dealing with diabetes. When I did Afrezza + Tresiba I'd be looking at my CGM every 30-45 minutes. That's 28 intended glances a day. That doesn't count the little voice in the back of my head asking "are you ok"? Where Afrezza shines for me is the unpredictable. The "I'm at Disneyland and that cupcake is going to ruin my day because they somehow crammed 1k calories into 3 bites and not even a healthy body is prepared for this". It helps with the "WTF just happened and why am I at 200mg/dl?!". It solves the unsolvable that is diabetes with he problems that really don't have answers and just exist because I have multiple missing hormones. I think that is the best solution really. A closed loop + Afrezza for the big boluses. The problem is getting the Afrezza on a consistent basis and $$$. Not so much for me, I only pay $60 I think it is per month to get it but I know others aren't as fortunate. Thank you.
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Post by olebob1 on Jul 24, 2019 10:34:58 GMT -5
So Shawn, if you had a store close by that provided Afrezza would you consider Tresiba/Afrezza as SOC for you? No. And I'll elaborate somewhat on the why. More if people really want to listen to me rant. A lot of times people really don't understand what is hard with T1DM. Kinked cannulas on a pump suck. Coughing out the powder after inhaling sucks. Misdosing sucks. Lows suck. Stubborn highs suck. Man, T1DM just sucks but after 14 years it's not the little things that bother me. I cough out Afrezza? I take a new dose. Overdose, eat a few glucose tabs. The fact I have to do any of that is what gets to me. Imagine you have an alarm going off every 10 minutes that you need to check and decide what you're going to do next. Maybe that's too often, you'll burn out. 30 minutes? 60? 90? 120? Now we've slacked too much, you need to check more and fix your blood sugars! Constant, that is the word for T1DM. It. Does. Not. Stop. What is your blood sugar right now? Are you still digesting? Do you need to dose? Maybe. But I should wait 10 minutes and check again. Ok, 10 minutes again and now my blood sugar is 5mg/dl higher. Should I correct that? Inhale? Well I'm only at 123mg/dl, will the 4U drop me too much? Probably not... right? Dosed, check back in 45 minutes. Hell yeah, 4U was right, now we're at 82mg/dl. Continue on. Evaluate again in 45-60. Now we're at 95mg/dl. Nothing needs doing, go to that meeting. Dexcom alert goes off, somehow I hit 140mg/dl. Why? Doesn't matter, excuse me, need to dose. [....] Go to bed, been two hours since I last ate. BGL at 101mg/dl. Good to sleep. Two hours later, woken up by low alarm. Oh right, we trained legs and it was a hell of a workout so glycogen stores are down and my normal basal was too much. 12g glucose tablets, go to bed. Wake up an hour later, now high. Why? Liver dumped glucose along with the 12g, was too much. Inhale. Back to bed. Do that daily. Afrezza helps, Afrezza is amazing for what it is but for me it doesn't address the underlying issue of me having to monitor. IPhones have that "how often do you open an app thing" and when I'm using a close loop I spend an average of about 12 minutes a day dealing with diabetes. When I did Afrezza + Tresiba I'd be looking at my CGM every 30-45 minutes. That's 28 intended glances a day. That doesn't count the little voice in the back of my head asking "are you ok"? Where Afrezza shines for me is the unpredictable. The "I'm at Disneyland and that cupcake is going to ruin my day because they somehow crammed 1k calories into 3 bites and not even a healthy body is prepared for this". It helps with the "WTF just happened and why am I at 200mg/dl?!". It solves the unsolvable that is diabetes with he problems that really don't have answers and just exist because I have multiple missing hormones. I think that is the best solution really. A closed loop + Afrezza for the big boluses. The problem is getting the Afrezza on a consistent basis and $$$. Not so much for me, I only pay $60 I think it is per month to get it but I know others aren't as fortunate. Thanks for the explanation. Sorry for your challenges. Best of luck in your dealing with T1D.
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