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Post by mango on Dec 10, 2019 13:16:21 GMT -5
Had to look this one up.
Definition of pontificate (Entry 1 of 2)
intransitive verb
1 : to speak or express opinions in a pompous or dogmatic way
He does not pontificate about whether one ought to choose, if forced to it, to betray one's country rather than one's friends …
— Robin W. Winks
What these interviews generally come down to is an invitation to writers to pontificate upon things for which it is either unseemly for them to speak (the quality of their own work) or upon which they are unfit to judge (the state of the cosmos).
— Joseph Epstein
2a : to officiate as a pontiff
b : to celebrate pontifical mass
pontificate noun
pon·tif·i·cate | \ pän-ˈti-fi-kət , -ˌkāt \
Definition of pontificate (Entry 2 of 2)
: the state, office, or term of office of a pontiff
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Post by agedhippie on Dec 10, 2019 13:44:10 GMT -5
Really, how so? Agedhippie is here more than anybody, pontificating his expertise on diabetes. Dick move? Hardly !! Maybe you just are unaware. If so, try to catch up. Of course it's a dick move and as a Type 1 you should know that. You don't criticize how people manage their diabetes because everyone is different and has different aims, and your A1c is not a reflection of you. Do I want your A1c? No because I am perfectly happy with mine and I am not about to make changes for what I view as negligible gain. Do I think you are a bad person for wanting a low A1c? No, that's entirely your decision. Like you I also rarely get bad hypos. |
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Post by sellhighdrinklow on Dec 10, 2019 14:31:29 GMT -5
Really, how so? Agedhippie is here more than anybody, pontificating his expertise on diabetes. Dick move? Hardly !! Maybe you just are unaware. If so, try to catch up. Of course it's a dick move and as a Type 1 you should know that. You don't criticize how people manage their diabetes because everyone is different and has different aims, and your A1c is not a reflection of you. Do I want your A1c? No because I am perfectly happy with mine and I am not about to make changes for what I view as negligible gain. Do I think you are a bad person for wanting a low A1c? No, that's entirely your decision. Like you I also rarely get bad hypos. You both are missing the obvious point. Being tethered to a machine secreting insulin vs using Afrezza and NOT being tethered with much better outcomes in A1C. Healthier, easier, safer = Afrezza. Mic is dropped. |
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Post by peppy on Dec 10, 2019 14:43:55 GMT -5
Had to look this one up. Definition of pontificate (Entry 1 of 2) intransitive verb 1 : to speak or express opinions in a pompous or dogmatic way He does not pontificate about whether one ought to choose, if forced to it, to betray one's country rather than one's friends … — Robin W. Winks What these interviews generally come down to is an invitation to writers to pontificate upon things for which it is either unseemly for them to speak (the quality of their own work) or upon which they are unfit to judge (the state of the cosmos). — Joseph Epstein 2a : to officiate as a pontiff b : to celebrate pontifical mass pontificate noun pon·tif·i·cate | \ pän-ˈti-fi-kət , -ˌkāt \ Definition of pontificate (Entry 2 of 2) : the state, office, or term of office of a pontiff  |
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Post by mango on Dec 10, 2019 14:50:21 GMT -5
Had to look this one up. Definition of pontificate (Entry 1 of 2) intransitive verb 1 : to speak or express opinions in a pompous or dogmatic way He does not pontificate about whether one ought to choose, if forced to it, to betray one's country rather than one's friends … — Robin W. Winks What these interviews generally come down to is an invitation to writers to pontificate upon things for which it is either unseemly for them to speak (the quality of their own work) or upon which they are unfit to judge (the state of the cosmos). — Joseph Epstein 2a : to officiate as a pontiff b : to celebrate pontifical mass pontificate noun pon·tif·i·cate | \ pän-ˈti-fi-kət , -ˌkāt \ Definition of pontificate (Entry 2 of 2) : the state, office, or term of office of a pontiff Epitome of evil. 👁 (we better stay on topic liane is watching us) |
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Post by shawnonafrezza on Dec 10, 2019 18:43:12 GMT -5
Of course it's a dick move and as a Type 1 you should know that. You don't criticize how people manage their diabetes because everyone is different and has different aims, and your A1c is not a reflection of you. Do I want your A1c? No because I am perfectly happy with mine and I am not about to make changes for what I view as negligible gain. Do I think you are a bad person for wanting a low A1c? No, that's entirely your decision. Like you I also rarely get bad hypos. You both are missing the obvious point. Being tethered to a machine secreting insulin vs using Afrezza and NOT being tethered with much better outcomes in A1C. Healthier, easier, safer = Afrezza. Mic is dropped. Sadly you are missing the point, it is every diabetics choice as to how they treat themselves. You are missing that you assigned Ages worth to his A1C and you are a better person for yours (PS, by your standard I'm better than you and my best A1C was off Lantus and R so...  ) That and the whole I>^v, that you are more than a number, that you should be free for what you want to do. I'm a huge LMB83 believer, I love it and I'll tell people how awesome LCHF but I will not be dogmatic on it, that is the persons choice to what they eat. If you want to mic drop via healthier, easier, safer I'd tell you it was dropped 40 years ago but I recognize people have choice and their own pros and cons. I'd tell you to catch up but I have a feeling the community support aspect of T1DM isn't your thing. Afrezza, pump, MDI, we're in this together. Period. PS: 99% sure aged is MDI not pump so to think he talks about them because he is biased from person use is funny. Also pretty sure he mentions in most posts where he thinks Afrezza is the best fit because he's not anti Afrezza. |
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Post by sayhey24 on Dec 10, 2019 19:09:54 GMT -5
Really, how so? Agedhippie is here more than anybody, pontificating his expertise on diabetes. Dick move? Hardly !! Maybe you just are unaware. If so, try to catch up. Of course it's a dick move and as a Type 1 you should know that. You don't criticize how people manage their diabetes because everyone is different and has different aims, and your A1c is not a reflection of you. Do I want your A1c? No because I am perfectly happy with mine and I am not about to make changes for what I view as negligible gain. Do I think you are a bad person for wanting a low A1c? No, that's entirely your decision. Like you I also rarely get bad hypos. Aged - sometimes I just have to scratch my head when I read your posts. After how many years of being on this board are you still telling me you don't understand what happens when some one eats and the associated prandial needs? I find that hard to believe. The father of the artificial pancreas was Al Mann and the one big thing he learned was no matter how he tuned the algorithms the RAA insulin was too damn slow. This was when he went looking for a solution to this and came up with afrezza. Once he had afrezza he realized afrezza obsoleted the need for the AP and he also realized his new insulin was so damn fast the chance of hypos was so low it was the perfect front-line treatment for T2s. A few years back you argued that CGMs were not the norm and were too expensive. Well, CGMs are now nearly the norm for T1s and will be the same for many T2s. Soon we will have a new classification with the ADA, ultra acting. This class will be defined by its speed of action allowing for fewer hypos. This time next year afrezza will be approved for the kids and provide a huge advance forward in dealing with pediatric diabetes. The reality is once the kids start on afrezza they will stay on afrezza. Once mainstream in the T1 community, early use in T2s will soon follow. Things are changing in diabetes. Sanofi is out of R&D. They bet the farm on Toujeo and blew it. They could have bet the farm on afrezza and could have moved the market much faster but afrezza is slowly getting there will no money and the entire market fighting it. |
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Post by golfeveryday on Dec 10, 2019 19:23:35 GMT -5
Of course it's a dick move and as a Type 1 you should know that. You don't criticize how people manage their diabetes because everyone is different and has different aims, and your A1c is not a reflection of you. Do I want your A1c? No because I am perfectly happy with mine and I am not about to make changes for what I view as negligible gain. Do I think you are a bad person for wanting a low A1c? No, that's entirely your decision. Like you I also rarely get bad hypos. Aged - sometimes I just have to scratch my head when I read your posts. After how many years of being on this board are you still telling me you don't understand what happens when some one eats and the associated prandial needs? I find that hard to believe. The father of the artificial pancreas was Al Mann and the one big thing he learned was no matter how he tuned the algorithms the RAA insulin was too damn slow. This was when he went looking for a solution to this and came up with afrezza. Once he had afrezza he realized afrezza obsoleted the need for the AP and he also realized his new insulin was so damn fast the chance of hypos was so low it was the perfect front-line treatment for T2s. A few years back you argued that CGMs were not the norm and were too expensive. Well, CGMs are now nearly the norm for T1s and will be the same for many T2s. Soon we will have a new classification with the ADA, ultra acting. This class will be defined by its speed of action allowing for fewer hypos. This time next year afrezza will be approved for the kids and provide a huge advance forward in dealing with pediatric diabetes. The reality is once the kids start on afrezza they will stay on afrezza. Once mainstream in the T1 community, early use in T2s will soon follow. Things are changing in diabetes. Sanofi is out of R&D. They bet the farm on Toujeo and blew it. They could have bet the farm on afrezza and could have moved the market much faster but afrezza is slowly getting there will no money and the entire market fighting it. my kid would never go back to novolog now that he has used Afrezza. The flexibility with Afrezza is unmatched. |
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Post by shawnonafrezza on Dec 10, 2019 19:38:36 GMT -5
Of course it's a dick move and as a Type 1 you should know that. You don't criticize how people manage their diabetes because everyone is different and has different aims, and your A1c is not a reflection of you. Do I want your A1c? No because I am perfectly happy with mine and I am not about to make changes for what I view as negligible gain. Do I think you are a bad person for wanting a low A1c? No, that's entirely your decision. Like you I also rarely get bad hypos. Aged - sometimes I just have to scratch my head when I read your posts. After how many years of being on this board are you still telling me you don't understand what happens when some one eats and the associated prandial needs? I find that hard to believe. The father of the artificial pancreas was Al Mann and the one big thing he learned was no matter how he tuned the algorithms the RAA insulin was too damn slow. This was when he went looking for a solution to this and came up with afrezza. Once he had afrezza he realized afrezza obsoleted the need for the AP and he also realized his new insulin was so damn fast the chance of hypos was so low it was the perfect front-line treatment for T2s. A few years back you argued that CGMs were not the norm and were too expensive. Well, CGMs are now nearly the norm for T1s and will be the same for many T2s. Soon we will have a new classification with the ADA, ultra acting. This class will be defined by its speed of action allowing for fewer hypos. This time next year afrezza will be approved for the kids and provide a huge advance forward in dealing with pediatric diabetes. The reality is once the kids start on afrezza they will stay on afrezza. Once mainstream in the T1 community, early use in T2s will soon follow. Things are changing in diabetes. Sanofi is out of R&D. They bet the farm on Toujeo and blew it. They could have bet the farm on afrezza and could have moved the market much faster but afrezza is slowly getting there will no money and the entire market fighting it. Sometimes I scratch my head and wonder where you all get your info. CGMs are not the norm and still are too expensive and out of reach for most PWD. That hasn't changed, market penetration is low. That is just the reality. Even in the US where they are most used the penetration rate is 30% for T1 and sub 10% for T2. It is lower in Europe, lower in India/Brazil/Japan, really any anywhere else. Not here or there but sometimes I think you all rag on Aged for thinking malicious intent when it's just blunt reality. Not good, not bad, just is. You then hate him because I'm not sure why but if things were as you (overarching "you") say then the stock price and sales volume wouldn't be what it is. Either way, I apologize because I derailed this thread, should stay back on the poster. |
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Post by sayhey24 on Dec 10, 2019 20:42:50 GMT -5
I don't know but 30% market penetration in a few years seems to me "now nearly the norm for T1s". What do you think it will be in another few years? Eleven years ago DXCM was trading at $2pps. Two years ago it was at $44 and today closed over $215. If you believe what Verily and Dexcom are saying the future is broad T2 adoption and they are making the band-aid CGM a reality. verily.com/projects/sensors/miniaturized-gcm/Now, as far as "hating" Aged thats just plain wrong and not the case. However, many things he/she says are just plain wrong like why giving T2s basal is a better approach than treating with afrezza. Other times "they" really seem to know their stuff. I am not sure but it sure seems strange. |
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Post by shawnonafrezza on Dec 10, 2019 22:20:10 GMT -5
30% US penetration. If you look at global it's not that large. So no, they are not the norm. They should be, they aren't yet. The G7 with it's lower cost may do it but I think a 30% worldwide adoption is still many years away so saying it's not the norm holds. Not going to speak for Aged, but as far as basal > afrezza I think he/she usually falls back to what the SoC is and that is the SoC. Period. Not their doing, just what it is. Doctors rarely break the SoC.
As far as Afrezza adoption anyone who things "right" trumps "SoC" is a delusional fool and should go see how the medical world works. Afrezza is awesome, it has it's place, it should probably have it's own classification but alas it doesn't and the SoC gives little to no reason to use it for anybody. So until Mike or someone can make headway on that Aged will always be right via technicality. Maybe not "right" but he's right.
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Post by rfogel on Dec 10, 2019 23:03:47 GMT -5
Of course it's a dick move and as a Type 1 you should know that. You don't criticize how people manage their diabetes because everyone is different and has different aims, and your A1c is not a reflection of you. Do I want your A1c? No because I am perfectly happy with mine and I am not about to make changes for what I view as negligible gain. Do I think you are a bad person for wanting a low A1c? No, that's entirely your decision. Like you I also rarely get bad hypos. Aged - sometimes I just have to scratch my head when I read your posts. After how many years of being on this board are you still telling me you don't understand what happens when some one eats and the associated prandial needs? I find that hard to believe. The father of the artificial pancreas was Al Mann and the one big thing he learned was no matter how he tuned the algorithms the RAA insulin was too damn slow. This was when he went looking for a solution to this and came up with afrezza. Once he had afrezza he realized afrezza obsoleted the need for the AP and he also realized his new insulin was so damn fast the chance of hypos was so low it was the perfect front-line treatment for T2s. A few years back you argued that CGMs were not the norm and were too expensive. Well, CGMs are now nearly the norm for T1s and will be the same for many T2s. Soon we will have a new classification with the ADA, ultra acting. This class will be defined by its speed of action allowing for fewer hypos. This time next year afrezza will be approved for the kids and provide a huge advance forward in dealing with pediatric diabetes. The reality is once the kids start on afrezza they will stay on afrezza. Once mainstream in the T1 community, early use in T2s will soon follow. Things are changing in diabetes. Sanofi is out of R&D. They bet the farm on Toujeo and blew it. They could have bet the farm on afrezza and could have moved the market much faster but afrezza is slowly getting there will no money and the entire market fighting it. You say CGMs are nearly the norm but according to this: diatribe.org/cgm-and-time-range-what-do-diabetes-experts-think-about-goals...from two years ago, only 15% of T1s used CGMs. Has that number changed greatly since? |
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Post by lennymnkd on Dec 11, 2019 4:25:39 GMT -5
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Post by prcgorman2 on Dec 11, 2019 7:00:37 GMT -5
30% US penetration. If you look at global it's not that large. So no, they are not the norm. They should be, they aren't yet. The G7 with it's lower cost may do it but I think a 30% worldwide adoption is still many years away so saying it's not the norm holds. Not going to speak for Aged, but as far as basal > afrezza I think he/she usually falls back to what the SoC is and that is the SoC. Period. Not their doing, just what it is. Doctors rarely break the SoC.
As far as Afrezza adoption anyone who things "right" trumps "SoC" is a delusional fool and should go see how the medical world works. Afrezza is awesome, it has it's place, it should probably have it's own classification but alas it doesn't and the SoC gives little to no reason to use it for anybody. So until Mike or someone can make headway on that Aged will always be right via technicality. Maybe not "right" but he's right.
This just has to be the most interesting and informative thread I’ve seen on Proboards in months. Thank you and Sayhey and Aged and Mango and Peppy and RockStarRick and everyone else who has contributed to it. I can’t be too judgemental about the move that was discussed a bit because I think it is a natural thing to be competitive and a little rough and tumble is not necessarily all bad. Iron sharpens iron is the saying. With regard to the market penetration of CGMs, I do think Sayhey’s argument there is solid partly based on percentage of increase in use by PWDs and partly because we often argue here that proof of success is in the stock price. (DXCM $2 to $200 in 11 years! Patience can pay handsomely). But more than even those data points I will suggest Sayhey is right because of two other factors which are Moore’s Law and the economies of scale. CGMs are complex electronic devices based on solid-state electronics. Devices based on solid-state electronics have proven over and over that given time and demand the value shoots up while the cost dives through the floor. The two-way wrist TV was the stuff of science fiction in the Dick Tracy comic strip and now it’s called an Apple Watch. It too is expensive, but how much will it cost 5 or 10 years from now? Computers, game machines, smart phones, digital TVs are all good examples of the effect Moore’s Law and manufacturing scale have on the price/value of consumer electronics and I think we can agree there is unfortunately a very large market for CGMs. |
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Post by ktim on Dec 11, 2019 11:04:14 GMT -5
I don't know but 30% market penetration in a few years seems to me "now nearly the norm for T1s". What do you think it will be in another few years? Eleven years ago DXCM was trading at $2pps. Two years ago it was at $44 and today closed over $215. If you believe what Verily and Dexcom are saying the future is broad T2 adoption and they are making the band-aid CGM a reality. verily.com/projects/sensors/miniaturized-gcm/Now, as far as "hating" Aged thats just plain wrong and not the case. However, many things he/she says are just plain wrong like why giving T2s basal is a better approach than treating with afrezza. Other times "they" really seem to know their stuff. I am not sure but it sure seems strange. You give a lot of credence to everything Al has said. If Al had conducted studies showing that Afrezza alone provides superior results over basal alone in the progression of T2, we'd be in a very different place than we are currently. I personally suspect he had a valid point in that, but based on the overall results with MNKD it's obvious the man was not flawless. The medical community in general certainly doesn't believe that about prandial first. You are citing one man, whereas aged is citing current consensus within the medical community. It's very different perspective and I don't think the two of you will ever agree on things since you have very different methods of forming your opinions. Everyone here understands by now what the two of you are saying and from where it comes... and there is no proof, without a real clinical trial, as to who is right and who is wrong. Perhaps direct your ire at Al and current MNKD management for not having produced the data to back up your beliefs. I personally believe there is some intuitive rationale to support your opinion, but in science and particularly medicine, lots of seemingly intuitive things don't turn out to align with reality and some absolutely counter intuitive ones do. |
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) That and the whole I>^v, that you are more than a number, that you should be free for what you want to do. I'm a huge LMB83 believer, I love it and I'll tell people how awesome LCHF but I will not be dogmatic on it, that is the persons choice to what they eat.
