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Post by mango on Dec 11, 2019 11:12:09 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. What sayhey (and Al Mann) is saying about basal being medically incorrect for a T2D is right. It is basic science. Every single person with diabetes, regardless of the type, has a lose of the first-phase. This is the primary defect in T2D and is a prandial problem, not a basal problem. This is basic science that basal insulin for T2D is medically incorrect. The only reason it has been given first is because before Afrezza, prandial insulins were extremely dangerous because of how easily one could get a severe hypo etc. |
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Post by rfogel on Dec 11, 2019 11:21:38 GMT -5
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. What sayhey (and Al Mann) is saying about basal being medically incorrect for a T2D is right. It is basic science. Every single person with diabetes, regardless of the type, has a lose of the first-phase. This is the primary defect in T2D and is a prandial problem, not a basal problem. This is basic science that basal insulin for T2D is medically incorrect. As I understand it, T2s don't "lose" the first phase so much as they become constantly hyperinsulinemic so whatever "phase" is no longer relevant. It appears the idea behind starting basal insulin is to reduce the need for the pancreas to constantly secrete insulin itself to meet physiological need. |
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Post by mango on Dec 11, 2019 11:23:25 GMT -5
What sayhey (and Al Mann) is saying about basal being medically incorrect for a T2D is right. It is basic science. Every single person with diabetes, regardless of the type, has a lose of the first-phase. This is the primary defect in T2D and is a prandial problem, not a basal problem. This is basic science that basal insulin for T2D is medically incorrect. As I understand it, T2s don't "lose" the first phase so much as they become constantly hyperinsulinemic so whatever "phase" is no longer relevant. It appears the idea behind starting basal insulin is to reduce the need for the pancreas to constantly secrete insulin itself to meet physiological need. Every person with type 2 has a diminished first-phase. It’s the primary defect. |
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Post by rfogel on Dec 11, 2019 11:26:49 GMT -5
As I understand it, T2s don't "lose" the first phase so much as they become constantly hyperinsulinemic so whatever "phase" is no longer relevant. It appears the idea behind starting basal insulin is to reduce the need for the pancreas to constantly secrete insulin itself to meet physiological need. Every person with type 2 has a diminished first-phase. It’s the primary defect. If they are already hyperinsulinemic, how could loss of first phase have any impact? What are they losing? |
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Post by mango on Dec 11, 2019 11:30:20 GMT -5
Every person with type 2 has a diminished first-phase. It’s the primary defect. If they are already hyperinsulinemic, how could loss of first phase have any impact? What are they losing? I recommend you conduct some research. Much of it has already been done for you even and is within this website. They are losing a lot. Diminished first-phase causes the hyperinsulinemia. It’s the failure of the early phase insulin release to suppress the glycemic excursion that generates the late postprandial hyperinsulinemia. |
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Post by ktim on Dec 11, 2019 11:33:10 GMT -5
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. What sayhey (and Al Mann) is saying about basal being medically incorrect for a T2D is right. It is basic science. Every single person with diabetes, regardless of the type, has a lose of the first-phase. This is the primary defect in T2D and is a prandial problem, not a basal problem. This is basic science that basal insulin for T2D is medically incorrect. It's basic scientific speculation which has yet to be proven. If Al believed that he should have collected the data. Yes, there are studies that show that insulin resistance and degradation of first phase portion of prandial response are the early physiological changes. And as I said, that is an intuitive rationale for why prandial might provide better results. But it is not science at all to assume something that is intuitive is true until it is proven with controlled experiments which do, or can reasonably be expected to, provide repeatable results. In science you have what is called a hypothesis. Basic science says it has to be tested rigorously before it is accepted. Even doctors that are very supportive of and give talks about Afrezza have never repeated Al's (who was not a medical professional) line about "medically incorrect", and they likely wouldn't until there is clinical evidence to back it up. |
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Post by mango on Dec 11, 2019 11:40:01 GMT -5
What sayhey (and Al Mann) is saying about basal being medically incorrect for a T2D is right. It is basic science. Every single person with diabetes, regardless of the type, has a lose of the first-phase. This is the primary defect in T2D and is a prandial problem, not a basal problem. This is basic science that basal insulin for T2D is medically incorrect. It's basic scientific speculation which has yet to be proven. If Al believed that he should have collected the data. Yes, there are studies that show that insulin resistance and degradation of first phase portion of prandial response are the early physiological changes. And as I said, that is an intuitive rationale for why prandial might provide better results. But it is not science at all to assume something that is intuitive is true until it is proven with controlled experiments which do, or can reasonably be expected to, provide repeatable results. In science you have what is called a hypothesis. Basic science says it has to be tested rigorously before it is accepted. Even doctors that are very supportive of and give talks about Afrezza have never repeated Al's (who was not a medical professional) line about "medically incorrect", and they likely wouldn't until there is clinical evidence to back it up. [ Not speculation. Sorry you think that way. There is abundant lit on the subject I suggest you read it because it’s false to claim it’s speculation. 😁 |
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Post by rfogel on Dec 11, 2019 11:46:09 GMT -5
It's basic scientific speculation which has yet to be proven. If Al believed that he should have collected the data. Yes, there are studies that show that insulin resistance and degradation of first phase portion of prandial response are the early physiological changes. And as I said, that is an intuitive rationale for why prandial might provide better results. But it is not science at all to assume something that is intuitive is true until it is proven with controlled experiments which do, or can reasonably be expected to, provide repeatable results. In science you have what is called a hypothesis. Basic science says it has to be tested rigorously before it is accepted. Even doctors that are very supportive of and give talks about Afrezza have never repeated Al's (who was not a medical professional) line about "medically incorrect", and they likely wouldn't until there is clinical evidence to back it up. [ Not speculation. Sorry you think that way. There is abundant lit on the subject I suggest you read it because it’s false to claim it’s speculation. 😁 Well, I still don't get it. I can find how loss of first phase is a predictor of diabetes onset but no clear explanation as to why it matters once the person becomes hyperinsulinemic. If the T2 already has an overabundant amount of insulin circulating, how does losing the first phase harm him? |
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Post by mango on Dec 11, 2019 11:53:28 GMT -5
[ Not speculation. Sorry you think that way. There is abundant lit on the subject I suggest you read it because it’s false to claim it’s speculation. 😁 Well, I still don't get it. I can find how loss of first phase is a predictor of diabetes onset but no clear explanation as to why it matters once the person becomes hyperinsulinemic. If the T2 already has an overabundant amount of insulin circulating, how does losing the first phase harm him? I told you above a few posts: Diminished first-phase causes the hyperinsulinemia. It’s the failure of the early phase insulin release to suppress the glycemic excursion that generates the late postprandial hyperinsulinemia. Read more: mnkd.proboards.com/thread/11607/couple-april-poster?page=4#ixzz67ommINqx |
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Post by ktim on Dec 11, 2019 11:55:51 GMT -5
It's basic scientific speculation which has yet to be proven. If Al believed that he should have collected the data. Yes, there are studies that show that insulin resistance and degradation of first phase portion of prandial response are the early physiological changes. And as I said, that is an intuitive rationale for why prandial might provide better results. But it is not science at all to assume something that is intuitive is true until it is proven with controlled experiments which do, or can reasonably be expected to, provide repeatable results. In science you have what is called a hypothesis. Basic science says it has to be tested rigorously before it is accepted. Even doctors that are very supportive of and give talks about Afrezza have never repeated Al's (who was not a medical professional) line about "medically incorrect", and they likely wouldn't until there is clinical evidence to back it up. [ Not speculation. Sorry you think that way. There is abundant lit on the subject I suggest you read it because it’s false to claim it’s speculation. 😁 Show me literature with data proving prandial gives superior results to basal as a first insulin treatment. By the way there is lots of literature with discussions of things that aren't yet considered proven. Very often a scientist will discuss some idea or hypothesis and then say "more studies are needed". The only way of having it be proven is to design an experiment to test it directly. Or write to Dr. Edelman, a big Afrezza supporter, and see if you can get him to endorse your belief that it is proven that basal insulin as first step is medically incorrect. Obviously you could probably get a doc at VDex to say that, though I think that is a requirement in their employment contract. |
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Post by mango on Dec 11, 2019 11:56:46 GMT -5
[ Not speculation. Sorry you think that way. There is abundant lit on the subject I suggest you read it because it’s false to claim it’s speculation. 😁 Show me literature with data proving prandial gives superior results to basal as a first insulin treatment. By the way there is lots of literature with discussions of things that aren't yet considered proven. Very often a scientist will discuss some idea or hypothesis and then say "more studies are needed". The only way of having it be proven is to design an experiment to test it directly. Or write to Dr. Edelman, a big Afrezza supporter, and see if you can get him to endorse your belief that it is proven that basal insulin as first step is medically incorrect. Obviously you could probably get a doc at VDex to say that, though I think that is a requirement in their employment contract. I’m talking about basic science, not clinical trials. Your lack of understand the disease is the underlying reason for your thinking. I cannot help you there. |
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Post by dh4mizzou on Dec 11, 2019 11:59:26 GMT -5
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Post by ktim on Dec 11, 2019 12:05:06 GMT -5
Show me literature with data proving prandial gives superior results to basal as a first insulin treatment. By the way there is lots of literature with discussions of things that aren't yet considered proven. Very often a scientist will discuss some idea or hypothesis and then say "more studies are needed". The only way of having it be proven is to design an experiment to test it directly. Or write to Dr. Edelman, a big Afrezza supporter, and see if you can get him to endorse your belief that it is proven that basal insulin as first step is medically incorrect. Obviously you could probably get a doc at VDex to say that, though I think that is a requirement in their employment contract. I’m talking about basic science, not clinical trials. It's usually obvious you aren't in science. Designed experiments are the basis of science. Anyway, short of directing you to your nearest local university to have someone that does scientific research explain it to you, I think we've come to an impasse. Blindly believing in your deductive intuition is folly within science. Though, as stated multiple times my intuition aligns with yours in this case, just being a scientist I know the difference between deductive intuition and proven science. |
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Post by brentie on Dec 11, 2019 12:08:23 GMT -5
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Post by mango on Dec 11, 2019 12:28:26 GMT -5
I’m talking about basic science, not clinical trials. It's usually obvious you aren't in science. Designed experiments are the basis of science. Anyway, short of directing you to your nearest local university to have someone that does scientific research explain it to you, I think we've come to an impasse. Blindly believing in your deductive intuition is folly within science. Though, as stated multiple times my intuition aligns with yours in this case, just being a scientist I know the difference between deductive intuition and proven science. No, I am not a scientist but that doesn’t mean I can’t understand a concept. I don’t blindly believe in my “deductive intuition” as you claim. I believe the research I have read over the years makes logical, common sense and can easily agree with the late particle physicist and diabetes pioneer and innovator, Alfred E. Mann, that basal insulin for T2D is medically incorrect. 😉 What we do know is that people who get put on basal insulin for T2D always gets worse. Makes logical sense considering it has nothing to do with the first-phase and so the disease just continually progresses. |
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