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Post by longliner on Dec 17, 2019 21:45:52 GMT -5
If you wanna do vegan The Happy Pear has amazing cheap/easy food. When I tried WFPB I used their recipes as a base for a lot.
And that's all I'll say on my personal feeling on that kind of diet. Was not blood sugar friendly for me.
I'm not sure if I have stated this here, but when a bloodless glucose monitor becomes available I will be in line to buy one. I really want to know the affect of everything I eat on my blood sugar. It will hopefully be mainstream and investable. Do you think there might be some large food service companies that don't want me to see this?  |
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Post by sayhey24 on Dec 18, 2019 6:29:39 GMT -5
Bottom line is 70, between 55-70 is yellow, under 55 is red. Todays highest number was 171, happened overnight even after a correction 8U. Most people would love my numbers but I'm a grit believer so today is an utter disaster. If we go off the ADA 70-180 I probably spend 95% TIR* but on my phone I put my range as 65-120 because I believe in normal, non diabetic, numbers. Is today good enough for most? Yes. For me? Not even close.
* I just ran that report, 90% TIR for the last month if we want to use the lack luster ADA standard.
OK - how about the Tresiba? When is that taken? When was the 8u correction taken? |
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Post by agedhippie on Dec 18, 2019 7:05:30 GMT -5
Bottom line is 70, between 55-70 is yellow, under 55 is red. Todays highest number was 171, happened overnight even after a correction 8U. Most people would love my numbers but I'm a grit believer so today is an utter disaster. If we go off the ADA 70-180 I probably spend 95% TIR* but on my phone I put my range as 65-120 because I believe in normal, non diabetic, numbers. Is today good enough for most? Yes. For me? Not even close.
* I just ran that report, 90% TIR for the last month if we want to use the lack luster ADA standard.
OK - how about the Tresiba? When is that taken? When was the 8u correction taken? You probably need to be a bit more explicit for Shawn to answer that. What are you asking about the Tresiba? |
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Post by shawnonafrezza on Dec 18, 2019 9:21:44 GMT -5
Bottom line is 70, between 55-70 is yellow, under 55 is red. Todays highest number was 171, happened overnight even after a correction 8U. Most people would love my numbers but I'm a grit believer so today is an utter disaster. If we go off the ADA 70-180 I probably spend 95% TIR* but on my phone I put my range as 65-120 because I believe in normal, non diabetic, numbers. Is today good enough for most? Yes. For me? Not even close.
* I just ran that report, 90% TIR for the last month if we want to use the lack luster ADA standard.
OK - how about the Tresiba? When is that taken? When was the 8u correction taken? 20u at 745am 10u at 830pm Trust me, I've triaged this. If you have the same day to days in a row and get different results that's diabetes. This is why it's not as simple as treaiba and afrezza which is my point. The FIRST correction was at like 2am. |
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Post by sayhey24 on Dec 19, 2019 7:39:06 GMT -5
OK, on 12/16 at 10:30am and 12:30am you eat and dose 4u of afrezza and BG stays flat. At around 3pm you eat but don't dose and your BG drops 40pts. It then rises at about 8pm to 140 and then starts dropping at or before the 8:30pm Tresiba dose until it hits 70. It then rises and flattens through the night at about 150 after the 8u of afrezza at 2am. The next morning at 7:45am you dose Tresiba and you again drop really fast - you drop from 140 to 70 in a short period. Then you have your 10:30am meal and dose afrezza as the Tresiba is dropping you and you go red As Al said, with T1s things get a bit more tricky as you never know what the basal is going to do. In the ideal world it should be keeping you flat. It looks like afrezza is working great and keeping you flat at meals when you use it but the subq not so much. With T2s you don't have the x-factor of the subq. This is a huge difference. If they did with T1s the ZERO carb challenge as they did in the 118 with T2s it probably would not have turned out too good. Is an AP going to change issues like absorption - probably not but it may work better for you than Tresiba but maybe not. Have you tried something like the Omnipod? They were giving out free demos but I am not sure what their current deals are but there is a phone# here www.myomnipod.com/welcome Then again I would say most T1s would trade their chart for yours even with you off days. |
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Post by agedhippie on Dec 19, 2019 8:21:52 GMT -5
.. With T2s you don't have the x-factor of the subq. This is a huge difference. If they did with T1s the ZERO carb challenge as they did in the 118 with T2s it probably would not have turned out too good... The 118 trial (aka. NCT00570687) gets mentioned a lot but I think that is due to a misunderstanding. Nowhere do they administer insulin to a fasted diabetic in either the lispro or Afrezza groups and then see what happened. What they did was a glycemic clamp. For this you have to be fasted because you are hooked to a glucose drip and that has to be your sole source of glucose. The aim is to give the person insulin and then continually adjust the glucose to keep the blood glucose level flat. A graph is plotted based on the glucose flow rates to see the activity of the insulin. For obvious reasons you will never get a hypo regardless of the quantity or type of insulin used (as was the case, neither Afrezza nor Humalog users had a hypo in this test) I have done one of these glycemic clamps (my endo needed a guinea pig for some research) and I cannot recommend the experience, it's really boring and you are staving, literally! |
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Post by ktim on Dec 19, 2019 12:29:47 GMT -5
Joslin isn't saying they think viruses cause T2, so that's your theory not theirs. Fine to have your own, just attribute it properly. Though one technical correction... the viruses do not attach to insulin receptors, it is a peptides created by the viral RNA that bind. There are likely countless viruses that have peptides that can bind to various receptors, just as plants create peptides that can interact with receptors... e.g. pot, soy, etc. In general these do not cause permanent impairment of the receptors as your theory would seem to imply you believe. In general peptides that bind to receptors are broken down and cleared from the system leaving receptors to respond to future chemical peptide signals... that's the way the system works. As for "root" cause of complicated physiological conditions, I think that is a bit of a non-scientific game of semantics. It's sort of like if someone is driving 35 mph and the brakes fail, they hit something, fly out the window and die because they aren't wearing a seat belt, is the root cause of death the brakes failing or not wearing a seat belt... or the positioning by the person that planted the tree. Root cause might be a legal concept in arguments in court about the accident, but from larger societal perspective as well as simple logical perspective there were two significant contributing factors. At this point we know conclusively that genetics, diet and exercise are significant contributing factors in T2. Only 10-15% percent of people who smoke get lung cancer though medical profession is willing to use the word "caused" in relation to lung cancers... as in 90% of all lung cancers are caused by smoking. Obviously some people have genetics that do not predispose them to be susceptible. So some, likely including the tobacco companies, might claim the root cause isn't the smoking. But looking at it from epidemiological perspective it can be shown that there is clearly a large excess number of lung cancer cases that would not have occurred if not for the smoking. Diet and exercise are very effective in reducing risk of developing T2 and in slowing its progression. Worldwide diabetes rates have been soaring and there is high correlation with adoption of "Western" diets, urbanization and more sedentary lifestyles. ktim - I wish I could take credit for the virus theory but its not mine. Its actually a little more than a theory. Here is one abstract www.ncbi.nlm.nih.gov/pubmed/29467286As the abstract states its viral insulin/IGF-1-like peptides (VILPs) that binds, aka the virus or as they call it the "viral insulin". The question is after a virus has bound to a receptor does it make it harder for non-viral insulin to bind later? Something is causing new cells made through TZDs and exercise to work better than the older cells. Maybe the older ones have been corrupted by the virus - thats my theory and I will take credit for that. I could be wrong but then again I could be right. The root cause of diabetes is not up for debate. Its is simply the body is not producing enough insulin for its needs. As can be seen with the CGM nearly all T2s first lose first phase insulin release. What is up for debate is what has killed off the beta cells. As Aged said its not weight just pointing to the Asians as an example settles that. We also know genetics plays into it but why? We also know reducing the load on the pancreas allows for slowing progression and even stopping or reversing the progression. Diet and exercise are effective in reducing the risk of progression but we also know 70% progress over time. Diet and exercise probably play no role in preventing the initial destruction of the beta cells but a fit active person sure seems to have a better chance to slow or stop and maybe reverse the beta cell lose, after the fact. Then again in some they can diet and exercise until the cows come home and nothing. I have a friend who owns rehab centers and is one of the fittest people I know. His FB is now near 200 but he has not yet thrown in the towel to get the afrezza script. Pretty soon he is going to need a good meal but he has read all the web sites about dieting curing T2 diabetes. I keep telling him, its not about the diet, its about the beta cells. He is learning the hard way. Maybe another 6 month until afrezza. As I have said before why try and rely on just diet and exercise when we have the "silver bullet" in afrezza. Nearly all T2s should be started day 1 on afrezza. The same day when they are told to lose some weight and take a walk they should get the afrezza script. My advice on smoking, don't smoke. Even if you don't get cancer your fingers turn yellow and skin wrinkles up and smelling like smoke is not great. My advice is take the money you would spend on the smokes and buy MNKD stock. At least with MNKD you now have a fighting chance of not having your money go up in smoke. That abstract says nothing about a theory that T2 is caused by viruses. In fact it says "injection of VILPs into mice significantly lowers blood glucose" so on the face of it, if there is a period when someone has one of these viruses they should have lower blood glucose levels... the opposite of diabetes. As for "silver bullet" Afrezza... I wouldn't recommend it to anyone in place of diet and exercise because diabetes isn't the only health issue caused by poor diet and lack of exercise, but given that affluent people around the world have a tendency to not adhere to healthy lifestyles, Afrezza does have market opportunity. There certainly is a theory T1 (and other autoimmune disorders) might be caused by viruses. For T2 it comes down to overworking the pancreas. For many this comes from sugary diets followed by weight gain and insulin resistance. For others it may be genetic predisposition to earlier decline in pancreatic function that is a natural part of aging even with a reasonably healthy lifestyle... though it seems even that can be addressed by more vigilance in diet and exercise. Show me large numbers of people that eat low carb, maintain low BMI and exercise an hour a day and develop T2 and I'll be interested in your virus theory. Why genetics? Because diabetes is a metabolic disease and that is controlled by countless genes. Peoples' metabolisms are an incredibly complex balance and feedback control system with lots of mechanism coming into play. Some people genetically tilted in one direction and some in others. Poor diet, high BMI and lack of exercise simply is a large pushing factor towards diabetes. |
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Post by sayhey24 on Dec 19, 2019 14:45:41 GMT -5
ktim - everyone has a theory for root cause. Some people use to be certain the earth was flat. No one knows root cause. In my younger days people thought ulcers were caused by acidic food. What I can tell you is diabetes is simply defined as the body not making enough insulin for its needs. I can also tell you people who over work their pancreas usually develop more beta cells. Thats just a fact we know from autopsy. If you want to believe diabetes is caused by overworking the pancreas you can but the simple fact is most fat people are not diabetic but rather have grown more beta cells. Dr. Sinha was taught what you believe but that was not what he was seeing in his clinic. Maybe its "skinny-fats" maybe not as that would not explain the extra beta cells. www.latimes.com/health/la-me-asian-americans-diabetes-20160419-story.htmlThe bottom line is its all theory but interesting. The good news is we now have an easy fix to this in afrezza. The problem is far too few are using it and not using it early enough when diagnosed. Hopefully Dr. Kendall will get some substantial updates to the SoC in the next 2 years for T2s. I wonder how may "skinny-fats" will be in the Indian study? |
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Post by shawnonafrezza on Dec 19, 2019 14:48:58 GMT -5
Is a drug you'd take forever really a fix?
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Post by sayhey24 on Dec 19, 2019 14:54:37 GMT -5
.. With T2s you don't have the x-factor of the subq. This is a huge difference. If they did with T1s the ZERO carb challenge as they did in the 118 with T2s it probably would not have turned out too good... The 118 trial (aka. NCT00570687) gets mentioned a lot but I think that is due to a misunderstanding. Nowhere do they administer insulin to a fasted diabetic in either the lispro or Afrezza groups and then see what happened. What they did was a glycemic clamp. For this you have to be fasted because you are hooked to a glucose drip and that has to be your sole source of glucose. The aim is to give the person insulin and then continually adjust the glucose to keep the blood glucose level flat. A graph is plotted based on the glucose flow rates to see the activity of the insulin. For obvious reasons you will never get a hypo regardless of the quantity or type of insulin used (as was the case, neither Afrezza nor Humalog users had a hypo in this test) I have done one of these glycemic clamps (my endo needed a guinea pig for some research) and I cannot recommend the experience, it's really boring and you are staving, literally! Aged - There is no reason to speculate. Here is from the 3Q2009 quarterly call - "The basis of my (Al Mann) view was derived from the dose escalation study with meal challenges in which better glucose control was achieved with ever greater doses of AFRESA, yet without any hypos. Yet based on decades of battling these challenges of conventional insulin therapy, some physicians have questioned my suggestion. Therefore, I proposed a meal escalation study in which patients would take a fixed dose of AFRESA and then a series of meal challenges. Our clinical team designed a protocol to set a standard meal with 50 g of carbohydrates. That was the 100% challenge. This was followed by challenges at 200%, 50% and zero percent. When I heard of zero I was shocked. Surely there would be severe hypo. The remarkable thing was that with the regular prescribed dose of AFRESA regardless of carbohydrate intake between zero and 100 grams the range of excursion is only plus or minus 30-35 mg [reduction] from baseline for all of the Type II patients in the study." I can tell you at the Adcom the FDA challenged the one doctor who second dosed his afrezza patients and not his RAAs and got amazing results with afrezza. The FDA said he cheated. He was convinced he would have killed his RAA patients if he did and told the FDA they were wrong. |
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Post by sayhey24 on Dec 19, 2019 15:02:18 GMT -5
Is a drug you'd take forever really a fix? Thats the question we need to answer with the T2s. Do you? I can tell you some T2s have taken afrezza, lost a few pounds and started taking daily walks and are now maintaining FBG in the low 90's. They have gotten back some phase one release and are nolonger taking afrezza. The thing is until a large scale multi-year study is done no one wants to believe. At the same time whats a T2 got to lose? We know the ADA step program is designed for failure. |
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Post by ktim on Dec 19, 2019 15:09:41 GMT -5
ktim - everyone has a theory for root cause. Some people use to be certain the earth was flat. No one knows root cause. In my younger days people thought ulcers were caused by acidic food. What I can tell you is diabetes is simply defined as the body not making enough insulin for its needs. I can also tell you people who over work their pancreas usually develop more beta cells. Thats just a fact we know from autopsy. If you want to believe diabetes is caused by overworking the pancreas you can but the simple fact is most fat people are not diabetic but rather have grown more beta cells. Dr. Sinha was taught what you believe but that was not what he was seeing in his clinic. Maybe its "skinny-fats" maybe not as that would not explain the extra beta cells. www.latimes.com/health/la-me-asian-americans-diabetes-20160419-story.htmlThe bottom line is its all theory but interesting. The good news is we now have an easy fix to this in afrezza. The problem is far too few are using it and not using it early enough when diagnosed. Hopefully Dr. Kendall will get some substantial updates to the SoC in the next 2 years for T2s. I wonder how may "skinny-fats" will be in the Indian study? No, I think most scientific people would say it has many contributing factors not one root cause, though when addressing the lay population scientists and medical professionals do tend to focus on diet and exercise as the main causes since those are the things that people can change to decrease risk... and they have lots of other health benefits. There are many dozens of conditions caused or made worse by being overweight and sedentary. "At all ages, the risk of type 2 diabetes rises with increasing body weight. The prevalence of type 2 diabetes is three to seven times higher in those who are affected by obesity than in normal weight adults, and is 20 times more likely in those with a body mass index (BMI) greater than 35 kg/m" HSPH’s Willett, who chairs the Department of Nutrition, said that getting Americans’ diet right can mean the difference between being healthy or ill. Studies have shown that not smoking, eating properly, and keeping a healthy weight — a body mass index of under 25 — reduces the risk of diabetes by 90 percent. “Apart from lung cancer, there is no other disease that can be almost eliminated with simple lifestyle changes,” Willett said. Research has shown that increased consumption of soda and fruit juice has closely paralleled the diabetes and obesity epidemics. It has found that even a little bit of moderate-intensity physical activity, such as walking 30 minutes a day, lowers the risk of type 2 diabetes by 30 percent. Not theory... facts. |
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Post by shawnonafrezza on Dec 19, 2019 15:39:18 GMT -5
Is a drug you'd take forever really a fix? Thats the question we need to answer with the T2s. Do you? I can tell you some T2s have taken afrezza, lost a few pounds and started taking daily walks and are now maintaining FBG in the low 90's. They have gotten back some phase one release and are nolonger taking afrezza. The thing is until a large scale multi-year study is done no one wants to believe. At the same time whats a T2 got to lose? We know the ADA step program is designed for failure. Do I what? Consider it a fix? No. Is it better than nothing? Yes. But IMO diet/lifestyle should always come first if appropriate and if you look at the T2 population it is often appropriate. |
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Post by ktim on Dec 19, 2019 15:49:28 GMT -5
Is a drug you'd take forever really a fix? Thats the question we need to answer with the T2s. Do you? I can tell you some T2s have taken afrezza, lost a few pounds and started taking daily walks and are now maintaining FBG in the low 90's. They have gotten back some phase one release and are nolonger taking afrezza.The thing is until a large scale multi-year study is done no one wants to believe. At the same time whats a T2 got to lose? We know the ADA step program is designed for failure. I agree with you on this one, and really wish MNKD had started at least a small scale study on this years ago. If they had a protocol that could be used with early prediabetics and showed it could lead to remission in some or most without causing ANY serious hypos... we would not have suffered nearly as much dilution as we have. I think that could have been much more impact than peds will be. I believe that is possible. I think A Mann believed it. Does current management? Have they vetted the idea with FDA? Is there a reason for not doing such a pilot trial? With regard to bolded, a trial is needed to show that diet, exercise plus Afrezza produces this more often than diet and exercise alone. Other STII trials would seem to indicate that should be the case. |
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Post by mango on Dec 19, 2019 16:00:32 GMT -5
Thats the question we need to answer with the T2s. Do you? I can tell you some T2s have taken afrezza, lost a few pounds and started taking daily walks and are now maintaining FBG in the low 90's. They have gotten back some phase one release and are nolonger taking afrezza.The thing is until a large scale multi-year study is done no one wants to believe. At the same time whats a T2 got to lose? We know the ADA step program is designed for failure. I agree with you on this one, and really wish MNKD had started at least a small scale study on this years ago. If they had a protocol that could be used with early prediabetics and showed it could lead to remission in some or most without causing ANY serious hypos... we would not have suffered nearly as much dilution as we have. I think that could have been much more impact than peds will be. I believe that is possible. I think A Mann believed it. Does current management? Have they vetted the idea with FDA? Is there a reason for not doing such a pilot trial? With regard to bolded, a trial is needed to show that diet, exercise plus Afrezza produces this more often than diet and exercise alone. Other STII trials would seem to indicate that should be the case. Or, we could also use real-life evidence. If there is enough real-life data to support it, FDA would accept it. Not everything has to be done via RCTs. There are many drawbacks and limitations with RCTs that do not exist in real-life. The two should compliment one another and may offset the need for xyz depending on the case and circumstances. Lucky, FDA fully supports and accepts real-life data and evidence in making such decisions! |
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