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Post by shawnonafrezza on Dec 14, 2019 13:48:06 GMT -5
Quite frankly until you've lived it you'll never understand. I mean, once again because I'll hammer it to death, the GIF picture is someone too busy to do it or they wouldn't have ended at 270, they would've corrected at 240, 200, 160, 140, or sooner. They didn't, they were busy. Period.
What you all present as a good thing I see (and probably aged) both sides of the coins. Good he had Afrezza to get down fast but bad because he got in that situation in the first place.
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Post by shawnonafrezza on Dec 14, 2019 13:52:26 GMT -5
I mean, you can post all you want but I'm part of the FB group and many d forums. As normal happy people are less likely to post but like Afrezza the numbers don't lie. If the eversense was that great and the patients loved it why are they struggling? Look at real world use, not the studies. The 99$ thing is for a one time bridge, so 3 months in the US. Whoopie. Sunlight? Oh, beach doesn't count, can't wear tanks (I live in SoCal) either. Ok. If it's so good I expect to google "SENS stock" and see how well it's being received right? If it's doing well and patients love it shouldn't that be positive? Down to 34% of what it started the year with. Like with Afrezza you can point to all you want but then you go talk to the PWD out there and this is the reality. The cost/convince just isn't there. I don't really care one way or another, I take it you probably have money in them too so I'm sorry about that. But I'll still speak my mind and my overall reflection on how the community reacts/reacted to the device. They get cheaper/more insurance and fix the sunlight thing as well as getting the 180 or 365 day version in the US and they'll have an actual selling point IMO. Also pump integrations. I've said it all over this board but partnerships and integrations matter. People stay on the tslim because of the g6 integration. Companion medical is pulling in people with their G6 integration. Tidepool is built around it and both Dexcom, Insulet, and Medtronic will benefit. You all are fighting uphill with two lone wolves. First, as to as going to the beach, is it really all that difficult to "double-up white adhesive patches"? And if you want "real world" data: www.senseonics.com/~/media/Files/S/Senseonics-IR/documents/publications/DTT_RealWorldData_FirstUS_Users_082819.pdf"Real-World Data from the First U.S. Commercial Users of an Implantable Continuous Glucose Sensor... ...In conclusion, the 90-day implanted Eversense CGM system appears to be a valuable and safe tool for management of diabetes with patients reinserting and using the device the majority of the time. Its use was associated with low rates of hypoglycemia and glycemic variability as measured by CV, and a favorable time in the target range in these initial patients. The Eversense CGM should be considered as an appropriate CGM system for those patients and providers wishing to improve diabetes outcomes." And Dexcom? Well, let's compare. Dexcom was founded 20 years ago; SENS only 8 years ago. Dexcom went public 14 years ago at around $10 a share. Three years later it was trading at $2.00 a share -- an 80% loss for those who sold. It didn't even get back to its offering price until three more years after that. SENS went public at $3 a share just 3 years ago. Trading at $1 now translates into a 67% loss -- at least a little better than where Dexcom stood at 3 years. Also, so far SENS has partnered with Geo-med, Beyond Type 1, Glooko, Beta Bionics, and R2Integrated. And not to be forgotten is the distribution agreement with Roche -- "a global leader in integrated diabetes management." How many partners did Dexcom have three years after its IPO? Then consider, three years after its IPO, Dexcom was reporting around 2 million in revenues a quarter. Three years after its IPO SENS is reporting about 5 million a quarter. In regards the bridge program, for $99 plus the cost of placing the device, you get 90 days of Eversense CGM service. How much would 90 days G6 service cost? Well a transmitter plus a month's supply of sensors costs $500; then you need $700 for two more months worth of sensors so the total cost of 90 days is $1,200. Dexcom does offer assistance to the tune of saving you a whopping $140 -- https://dexcom.pskw.com So the net would be $1,060. I'd say SENS deserves the kudos in terms of cost. It might also be worthwhile to review some of the threads on tudiabetes the past couple of weeks: "G6 adhesive not as good as before? Medicare No Longer Covers Test Strips for G6 Users The dread G6 session-restart block is here Just started Dexcom G6 - all readings incorrect Dexcom Share servers are down Dexcom’s latest comment regarding Medicare patients staying on the G5 [now mandatory to upgrade to the G6]" Don't exactly sound like a group of satisfied customers. Two halves, one I'll address short and sweet as far as my view. SENS isn't DXCM. Others success doesn't mean anything to yours. This amplifies when DXCM was the first to market with a good MARD.
For the threads about G6, do the same for sensonic or read what I posted earlier which is for both sides; people are more likely to post problems when they need help. I sure as heck don't just go to tudiabetes to talk about how great things are going, if they're going great I'm not in a diabetes mindset. As far as cost goes, well one is covered by most insurance plans and many even under pharmacy benefits instead of DME so no point looking at OOP costs.
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Post by shawnonafrezza on Dec 14, 2019 14:02:27 GMT -5
"Aged - it doesn't matter if its one PWD or 1000 PWDs, afrezza with a CGM and second dosing when needed will always win." Uhhhh, those are some fighting words that I promise you can't back up. We can get the whole JAEB study for DIY loop and compare it to a few Twitter posts if you want. Can do the T1GRIT study too. There's a good 8 hour chunk (1/3 of the day) of the day people are asleep and can't dose at all. I mean in this thread we have a picture of an afrezza user at 270mg/dl! Just that one excursion put them out of range for 12.5% of the day and every T1 knows how that drop from 270-110 in 60 minutes is going to leave them feeling for the next 12 hours. "Who wants to be a human pin cushion?" Ironic since the CGM is still a wire in you... Have you seen the gushers people get from the dexcom?! Mr. Flynn - I sense there is some confusion on your part. afrezza is a 2 hour insulin. Looking at the results of a single dose past 2.5 hours is meaningless but after 2 hours its done. Lets say your FG is 100 at 5pm, you eat and dose afrezza the question is whats your BG at 7pm? In an ideal world it would back to your baseline 100. The assumption with the T2 is the pancreas has enough function to keep it at that until the next meal. If the next meal is 8am the next morning then the BG should be no higher than 100 but in a non-diabetic will be at 87+-. Could it be lower than the 100 sure if the pancreas is producing enough insulin. If the T2 is not making enough insulin to offset liver sugar production thats a whole other ball of wax. A t that point they have really transitioned to a T1. In reality diabetes is on a continuum and the terms T1 and T2 are pretty meaningless. What has to be known is how much insulin is being produced during fasting and that will change on an individual basis. This is what Ralph DeFronza was talking about in his quote. The goal with afrezza is to get the T2 back to baseline within 2 hours. If they are not then second dose. If the baseline is 100 then they should be back to baseline. Worst case they are down under 140 because thats when vascluar degeneration starts happening. The studies you reference are about T1's who are not producing enough insulin during the fasting period, let alone for meals. The goal of the loop is to keep the T1 at a steady baseline. What complicates things is when they eat. So, the loop tries to release more RAA for the meals. Well, the problem is the RAA is too damn slow. As a result the best results which have been gotten is using afrezza for meals and the loop after the 2 hours when afrezza is gone. The thing is whats the real value of a com plex loop when l you really need is afrezza and a patch pump? I think the Yale study is proving this again. Shawn please, Mr. Flynn was my father. 
Bold #1 and #2, that is just wrong. No antibodies, not t1. Period. There are clear medical definitions. Period. If the T2 doesn't produce enough insulin to offset liver my answer is to lower glycogen stores ala fasting, HIIT, weights, and LC eating. Not more insulin. They're already hyperinflation. It's a known thing for human physiology that you can only store so much glycogen and if you have too much it spills. So empty the tank. Bodybuilders have done this forever, it's literally how that sport works.
Bold #3, yes that is what T1 diabetes will net you. Once again, should be obvious for people backing an insulin.
Bold #4, that is the goal of all diabetes treatments
Bold #5. Yes. Or are dehydrated, didn't exercise, did exercise, drank beer, got stressed, menstrual cycle, lack of sleep, the list doesn't ever end.
Bold #6. No, it is not. I can post these all day, this is NORMAL for loop systems in the DIY world. Medtroic and Tandem are still behind the ball here. What nobody seems to consider is the time to action of the human. You all, for whatever reason, think the PWD can inhale always and just move on so I will, once again, reference the GIF in this thread. That is the reality for human time to action. God forbid you're asleep and don't hear the alarm...
Bold #7. I'd say it'd help for some foods, 100%. Best results though? That sample size is like 5 people at best.
Bold #8, see #5. The patch pump doesn't do shit on it's own, it's the loop that deals with #5.
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Post by peppy on Dec 14, 2019 21:35:38 GMT -5
Mr. Flynn - I sense there is some confusion on your part. afrezza is a 2 hour insulin. Looking at the results of a single dose past 2.5 hours is meaningless but after 2 hours its done. Lets say your FG is 100 at 5pm, you eat and dose afrezza the question is whats your BG at 7pm? In an ideal world it would back to your baseline 100. The assumption with the T2 is the pancreas has enough function to keep it at that until the next meal. If the next meal is 8am the next morning then the BG should be no higher than 100 but in a non-diabetic will be at 87+-. Could it be lower than the 100 sure if the pancreas is producing enough insulin. If the T2 is not making enough insulin to offset liver sugar production thats a whole other ball of wax. A t that point they have really transitioned to a T1. In reality diabetes is on a continuum and the terms T1 and T2 are pretty meaningless. What has to be known is how much insulin is being produced during fasting and that will change on an individual basis. This is what Ralph DeFronza was talking about in his quote. The goal with afrezza is to get the T2 back to baseline within 2 hours. If they are not then second dose. If the baseline is 100 then they should be back to baseline. Worst case they are down under 140 because thats when vascluar degeneration starts happening. The studies you reference are about T1's who are not producing enough insulin during the fasting period, let alone for meals. The goal of the loop is to keep the T1 at a steady baseline. What complicates things is when they eat. So, the loop tries to release more RAA for the meals. Well, the problem is the RAA is too damn slow. As a result the best results which have been gotten is using afrezza for meals and the loop after the 2 hours when afrezza is gone. The thing is whats the real value of a com plex loop when l you really need is afrezza and a patch pump? I think the Yale study is proving this again. Shawn please, Mr. Flynn was my father.
Bold #1 and #2, that is just wrong. No antibodies, not t1. Period. There are clear medical definitions. Period. If the T2 doesn't produce enough insulin to offset liver my answer is to lower glycogen stores ala fasting, HIIT, weights, and LC eating. Not more insulin. They're already hyperinflation. It's a known thing for human physiology that you can only store so much glycogen and if you have too much it spills. So empty the tank. Bodybuilders have done this forever, it's literally how that sport works.
Bold #3, yes that is what T1 diabetes will net you. Once again, should be obvious for people backing an insulin.
Bold #4, that is the goal of all diabetes treatments
Bold #5. Yes. Or are dehydrated, didn't exercise, did exercise, drank beer, got stressed, menstrual cycle, lack of sleep, the list doesn't ever end.
Bold #6. No, it is not. I can post these all day, this is NORMAL for loop systems in the DIY world. Medtroic and Tandem are still behind the ball here. What nobody seems to consider is the time to action of the human. You all, for whatever reason, think the PWD can inhale always and just move on so I will, once again, reference the GIF in this thread. That is the reality for human time to action. God forbid you're asleep and don't hear the alarm...
Bold #7. I'd say it'd help for some foods, 100%. Best results though? That sample size is like 5 people at best.
Bold #8, see #5. The patch pump doesn't do shit on it's own, it's the loop that deals with #5.
Quote: If the T2 doesn't produce enough insulin to offset liver my answer is to lower glycogen stores ala fasting, HIIT, weights, and LC eating. I just want to throw it out into the atmosphere, if a T2 could fast, they wouldn't be a T2.  |
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Post by shawnonafrezza on Dec 14, 2019 21:42:17 GMT -5
peppy , VirtaHealth has whole cohorts doing the above. Dr McDougall says and I quote: "The goal is to keep their fasting blood sugars between 150 mg/dL and 300 mg/dL. I discourage blood sugar measurements at any other time of the day unless they suspect hypoglycemia (too low a sugar). The finding of elevated sugars later in the day after eating just upsets the patient and does not add any useful information in deciding on the next dosage of insulin to be given." So you can follow McDougall if you want but then supporting Afrezza also makes no sense. Personally I'd stay away from his advice if you want to keep your eyes and feet!!
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Post by peppy on Dec 14, 2019 21:55:35 GMT -5
peppy , VirtaHealth has whole cohorts doing the above. Dr McDougall says and I quote: "The goal is to keep their fasting blood sugars between 150 mg/dL and 300 mg/dL. I discourage blood sugar measurements at any other time of the day unless they suspect hypoglycemia (too low a sugar). The finding of elevated sugars later in the day after eating just upsets the patient and does not add any useful information in deciding on the next dosage of insulin to be given." So you can follow McDougall if you want but then supporting Afrezza also makes no sense. Personally I'd stay away from his advice if you want to keep your eyes and feet!! Shawn, you have found the quote!. heh cohorts doing the above? you have heard of GLP-2. You are a type one and a type one expert. I do not think you are an expert in type two. Yeah, mcdoughal will allow them to run high on his diet, because he knows them so well. not sure where that quote came from. off topic. About a year and a half ago I got a new neighbor. Guessing her weight was 500 to 550 pounds. She was a dentist. 4 weeks ago on a Monday, I got up early and my neighbor was on my mind. I waited until 7 am and called my other neighbor susie about this neighbor, asking susie if she had seen her. On Wednesday susie came over and told me she had died on Sunday night. she was 49. McDoughall or a stomach stapling (old term) were her only hope, when she had hope. |
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Post by shawnonafrezza on Dec 14, 2019 22:05:42 GMT -5
The quote came from his own site. You don't need to be an expert to know that a BGL of 200mg/dl isn't ok ever. That would yield an 8.6% A1C. McDougall can ask his buddy Barnard if that's ok but he too has also failed to reverse T2DM via his HCLF diet even after 74 weeks of it. www.ncbi.nlm.nih.gov/pmc/articles/PMC2677007/A 7.65% A1C down from 8.05% after 74 weeks WITH metformin and GLP-2 inhibitors. Christ, they're killing people.
High carb low fat nor WFPB diets have NEVER been shown to reverse T2DM in any randomized clinical trial and I'll leave it at that.
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Post by peppy on Dec 14, 2019 22:14:18 GMT -5
The quote came from his own site. You don't need to be an expert to know that a BGL of 200mg/dl isn't ok ever. That would yield an 8.6% A1C. McDougall can ask his buddy Barnard if that's ok but he too has also failed to reverse T2DM via his HCLF diet even after 74 weeks of it. www.ncbi.nlm.nih.gov/pmc/articles/PMC2677007/A 7.65% A1C down from 8.05% after 74 weeks WITH metformin and GLP-2 inhibitors. Christ, they're killing people.
High carb low fat nor WFPB diets have NEVER been shown to reverse T2DM in any randomized clinical trial and I'll leave it at that.
"A 7.65% A1C down from 8.05% after 74 weeks WITH metformin and GLP-2 inhibitors. Christ, they're killing people." we agree. |
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Post by rfogel on Dec 14, 2019 23:06:06 GMT -5
First, as to as going to the beach, is it really all that difficult to "double-up white adhesive patches"? And if you want "real world" data: www.senseonics.com/~/media/Files/S/Senseonics-IR/documents/publications/DTT_RealWorldData_FirstUS_Users_082819.pdf"Real-World Data from the First U.S. Commercial Users of an Implantable Continuous Glucose Sensor... ...In conclusion, the 90-day implanted Eversense CGM system appears to be a valuable and safe tool for management of diabetes with patients reinserting and using the device the majority of the time. Its use was associated with low rates of hypoglycemia and glycemic variability as measured by CV, and a favorable time in the target range in these initial patients. The Eversense CGM should be considered as an appropriate CGM system for those patients and providers wishing to improve diabetes outcomes." And Dexcom? Well, let's compare. Dexcom was founded 20 years ago; SENS only 8 years ago. Dexcom went public 14 years ago at around $10 a share. Three years later it was trading at $2.00 a share -- an 80% loss for those who sold. It didn't even get back to its offering price until three more years after that. SENS went public at $3 a share just 3 years ago. Trading at $1 now translates into a 67% loss -- at least a little better than where Dexcom stood at 3 years. Also, so far SENS has partnered with Geo-med, Beyond Type 1, Glooko, Beta Bionics, and R2Integrated. And not to be forgotten is the distribution agreement with Roche -- "a global leader in integrated diabetes management." How many partners did Dexcom have three years after its IPO? Then consider, three years after its IPO, Dexcom was reporting around 2 million in revenues a quarter. Three years after its IPO SENS is reporting about 5 million a quarter. In regards the bridge program, for $99 plus the cost of placing the device, you get 90 days of Eversense CGM service. How much would 90 days G6 service cost? Well a transmitter plus a month's supply of sensors costs $500; then you need $700 for two more months worth of sensors so the total cost of 90 days is $1,200. Dexcom does offer assistance to the tune of saving you a whopping $140 -- https://dexcom.pskw.com So the net would be $1,060. I'd say SENS deserves the kudos in terms of cost. It might also be worthwhile to review some of the threads on tudiabetes the past couple of weeks: "G6 adhesive not as good as before? Medicare No Longer Covers Test Strips for G6 Users The dread G6 session-restart block is here Just started Dexcom G6 - all readings incorrect Dexcom Share servers are down Dexcom’s latest comment regarding Medicare patients staying on the G5 [now mandatory to upgrade to the G6]" Don't exactly sound like a group of satisfied customers. Two halves, one I'll address short and sweet as far as my view. SENS isn't DXCM. Others success doesn't mean anything to yours. This amplifies when DXCM was the first to market with a good MARD.
For the threads about G6, do the same for sensonic or read what I posted earlier which is for both sides; people are more likely to post problems when they need help. I sure as heck don't just go to tudiabetes to talk about how great things are going, if they're going great I'm not in a diabetes mindset. As far as cost goes, well one is covered by most insurance plans and many even under pharmacy benefits instead of DME so no point looking at OOP costs.
Yes, SENS is not Dexcom, but the point I was trying to make was that SENS at this point in time 3 years after its IPO is in much better shape than Dexcom was 3 years after its IPO. As far as insurance the latest addition of HCSC -- announced a couple of months ago -- added 16 million to the coverage rolls, a number whose total is rapidly approaching 100 million. I imagine that by this time next year coverage will be every bit as good as Dexcom's. And speaking of "others success": diabetesstrong.com/eversense-implantable-cgm-review/"What I enjoy most about the Eversense CGM is that I don’t have to think about changing the sensor weekly or having to carry around tapes, an inserter, disinfectant, and all the plastic packaging. And of course – no more ripping out the sensor (which is one of the biggest advantages for me, since I have a special talent for ripping it out whenever I’m passing a door frame.) I also didn’t have any problems with my skin compatibility while wearing the tape on which the transmitter gets placed. All in all, I really enjoyed using the Eversense System. Monitoring my CGM curves on my smartphone really helps me in my daily life with T1D because it makes keeping an eye on my blood sugar so much easier." |
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Post by peppy on Dec 14, 2019 23:43:35 GMT -5
Two halves, one I'll address short and sweet as far as my view. SENS isn't DXCM. Others success doesn't mean anything to yours. This amplifies when DXCM was the first to market with a good MARD.
For the threads about G6, do the same for sensonic or read what I posted earlier which is for both sides; people are more likely to post problems when they need help. I sure as heck don't just go to tudiabetes to talk about how great things are going, if they're going great I'm not in a diabetes mindset. As far as cost goes, well one is covered by most insurance plans and many even under pharmacy benefits instead of DME so no point looking at OOP costs.
Yes, SENS is not Dexcom, but the point I was trying to make was that SENS at this point in time 3 years after its IPO is in much better shape than Dexcom was 3 years after its IPO. As far as insurance the latest addition of HCSC -- announced a couple of months ago -- added 16 million to the coverage rolls, a number whose total is rapidly approaching 100 million. I imagine that by this time next year coverage will be every bit as good as Dexcom's. And speaking of "others success": diabetesstrong.com/eversense-implantable-cgm-review/"What I enjoy most about the Eversense CGM is that I don’t have to think about changing the sensor weekly or having to carry around tapes, an inserter, disinfectant, and all the plastic packaging. And of course – no more ripping out the sensor (which is one of the biggest advantages for me, since I have a special talent for ripping it out whenever I’m passing a door frame.) I also didn’t have any problems with my skin compatibility while wearing the tape on which the transmitter gets placed. All in all, I really enjoyed using the Eversense System. Monitoring my CGM curves on my smartphone really helps me in my daily life with T1D because it makes keeping an eye on my blood sugar so much easier." I look at how it is powered. I am glad to hear it has been a good tool for you. |
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Post by agedhippie on Dec 15, 2019 6:00:45 GMT -5
- people only took a single dose because they had other things to do. You make it sound like they have to carry a cinder block in to the bathroom, BETTER THINGS TO DO , taking a sip on a whistle... how busy are these people you speak of ...🤔 Life gets in the way. If you are doing something else you do not want the interruption of having to deal with your diabetes. That context switch is jarring and gets really annoying with time. It is hard to explain, but it's definitely real and that's where burnout starts (screw it, just mute all the alarms and don't bother with the insulin). I have seen burnout kill two people. This is why I would use an artificial pancreas. It removes that lack of control from your life - no distraction lurking at the back of your mind as to whether the alarm is about to go and you are going to have to deal with it. Today I avoid this problem by using a CGM but disabling all it's alarms. |
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Post by sayhey24 on Dec 15, 2019 8:45:41 GMT -5
- people only took a single dose because they had other things to do. You make it sound like they have to carry a cinder block in to the bathroom, BETTER THINGS TO DO , taking a sip on a whistle... how busy are these people you speak of ...🤔 Life gets in the way. If you are doing something else you do not want the interruption of having to deal with your diabetes. That context switch is jarring and gets really annoying with time. It is hard to explain, but it's definitely real and that's where burnout starts (screw it, just mute all the alarms and don't bother with the insulin). I have seen burnout kill two people. This is why I would use an artificial pancreas. It removes that lack of control from your life - no distraction lurking at the back of your mind as to whether the alarm is about to go and you are going to have to deal with it. Today I avoid this problem by using a CGM but disabling all it's alarms. Aged - life gets in the way for sure but its become part of life to check your cell phone and most people do this more than once an hour. PWD CGM users as a result also check their BG as a result of checking the phone. Thats just the way it is and much different than 5 years ago or even 3 with the CGMs. Times have changed just as many here predicted they would as others (they know who they are) argued CGM users were outliers and CGM use would not become mainstream. They even still argue today taking slow acting RAA shots for meals is better than taking ultra acting afrezza which mimics first phase release. As was predicted here on this board years ago about the coming adoption of CGM, let me predict with pediatric approval afrezza will change how the kids are treated. I will also bet life won't get in the way of their mom's checking their kids CGM for second dosing of afrezza. Aged - insulin is a "tool" . When you have a screw its best to use a screwdriver. When you have a nail its best to use a hammer. Lets not forget why "second dosing" in most during Affiinity 1 and 2 was not done. Its was discussed during the ADCOM. In fact the FDA analyst accused the one doctor who did second dosing and whose PWD A1c numbers blew the RAA numbers away of "Cheating". In fact the FDA told the doctor if he second dosed his RAA PWDs like he did with afrezza they would have gotten numbers as good as his afrezza PWDs. The doctors response to her was chilling as he said "If I did as you suggest, I would have killed my patients". The reality is for T2s afrezza should be Step 1 and will slowly get there. Dr Kendall seems to be making progress on the SoC front. For the T1 kids I just don't know why any parent would not want afrezza for meals. For the AI Loop/pump developers the complicated problem they have been trying to solve is nearly solved with afrezza so I am sure they will find other jobs. I think Sanofi's departure from the R&D space speaks volumes. Paul Hudson knows he can't do better than Tresiba and afrezza and he knows when Ollie bet the farm on Toujeo he rolled "Snake eyes". By stepping back on Onduo he has now unshackled them so they no longer need to use Sanofi only products. |
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Post by peppy on Dec 15, 2019 9:36:46 GMT -5
Life gets in the way. If you are doing something else you do not want the interruption of having to deal with your diabetes. That context switch is jarring and gets really annoying with time. It is hard to explain, but it's definitely real and that's where burnout starts (screw it, just mute all the alarms and don't bother with the insulin). I have seen burnout kill two people. This is why I would use an artificial pancreas. It removes that lack of control from your life - no distraction lurking at the back of your mind as to whether the alarm is about to go and you are going to have to deal with it. Today I avoid this problem by using a CGM but disabling all it's alarms. Aged - life gets in the way for sure but its become part of life to check your cell phone and most people do this more than once an hour. PWD CGM users as a result also check their BG as a result of checking the phone. Thats just the way it is and much different than 5 years ago or even 3 with the CGMs. Times have changed just as many here predicted they would as others (they know who they are) argued CGM users were outliers and CGM use would not become mainstream. They even still argue today taking slow acting RAA shots for meals is better than taking ultra acting afrezza which mimics first phase release. As was predicted here on this board years ago about the coming adoption of CGM, let me predict with pediatric approval afrezza will change how the kids are treated. I will also bet life won't get in the way of their mom's checking their kids CGM for second dosing of afrezza. Aged - insulin is a "tool" . When you have a screw its best to use a screwdriver. When you have a nail its best to use a hammer. Lets not forget why "second dosing" in most during Affiinity 1 and 2 was not done. Its was discussed during the ADCOM. In fact the FDA analyst accused the one doctor who did second dosing and whose PWD A1c numbers blew the RAA numbers away of "Cheating". In fact the FDA told the doctor if he second dosed his RAA PWDs like he did with afrezza they would have gotten numbers as good as his afrezza PWDs. The doctors response to her was chilling as he said "If I did as you suggest, I would have killed my patients". The reality is for T2s afrezza should be Step 1 and will slowly get there. Dr Kendall seems to be making progress on the SoC front. For the T1 kids I just don't know why any parent would not want afrezza for meals. For the AI Loop/pump developers the complicated problem they have been trying to solve is nearly solved with afrezza so I am sure they will find other jobs. I think Sanofi's departure from the R&D space speaks volumes. Paul Hudson knows he can't do better than Tresiba and afrezza and he knows when Ollie bet the farm on Toujeo he rolled "Snake eyes". By stepping back on Onduo he has now unshackled them so they no longer need to use Sanofi only products. Loop is a flavor of automated insulin delivery that is open-source and do-it-yourself (DIY). The Loop app runs on an iPhone and receives CGM values every five minutes from compatible Dexcom or Medtronic CGMs. The app communicates with a small bridging device called a RileyLink (white box in picture above), which allows the phone to communicate with old Medtronic pumps. The Loop app takes the CGM values, runs them through an algorithm, and automatically adjusts basal insulin delivery on the pump.
Loop aims to minimize low and high blood sugars and target a customizable glucose value or range. As my blood sugar trends above target, Loop delivers more basal insulin (see picture at right). As it trends down, it reduces or suspends insulin. Currently, my Loop system is set to target 100 mg/dl and is configured to deliver up to 4.5 units per hour of basal insulin, which is between 4-5 times my normal basal rate. Like the MiniMed 670G, Loop is a “hybrid closed loop,” meaning it only adjusts basal insulin and cannot give automatic boluses. I tell the app when I’m about to eat, it recommends a bolus, and then I use a fingerprint to confirm the amount and send it to the pump. Loop also allows me to bolus from an Apple Watch without touching my pump or phone. Loop is a do-it-yourself experimental app developed by people with diabetes and their loved ones who didn’t want to wait for device manufacturers and the FDA. The current “DIY” version described below is not FDA approved, uses old Medtronic pumps that are out-of-warranty, and requires some perseverance and troubleshooting to install and maintain. There are an estimated 1,000-1,500 DIY Loop users globally. You can read about setting up Loop here. diatribe.org/how-i-loop-two-years-using-iphone-app-automate-my-insulin-delivery==================================================================================== Heh. Amazing type one's taking their care upon themselves and developing a system that works better for basal delivery. shawnonafrezza agedhippie are you using this? and how is this done? "Loop also allows me to bolus from an Apple Watch without touching my pump or phone." reading the article, plenty of tinkering with loop. diatribe.org/how-i-loop-two-years-using-iphone-app-automate-my-insulin-delivery |
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Post by sayhey24 on Dec 15, 2019 9:48:43 GMT -5
peppy , VirtaHealth has whole cohorts doing the above. Dr McDougall says and I quote: "The goal is to keep their fasting blood sugars between 150 mg/dL and 300 mg/dL. I discourage blood sugar measurements at any other time of the day unless they suspect hypoglycemia (too low a sugar). The finding of elevated sugars later in the day after eating just upsets the patient and does not add any useful information in deciding on the next dosage of insulin to be given." So you can follow McDougall if you want but then supporting Afrezza also makes no sense. Personally I'd stay away from his advice if you want to keep your eyes and feet!! Mr. Shawn Flynn - that was an interesting article. I may just reach out to Dr. McDougall to get his thought on Joslin's work in the root cause of T1 and T2 diabetes - viral infections. hms.harvard.edu/news/insulin-goes-viralIf Joslin is correct, and I suspect they are much can be explained. In an early post you said T1 have anti-bodies and T2s don't. Well Joslin's research says T1s are under an active attack and T2s are not but rather the attack happened and the damage has been done. For the T2s the anti-bodies are gone or nearly gone. However for the LADAs we see a more recent attack or an active attack which has not devestated the beta cells. The first question Dr. McDougall has to answer is if "fat" is the root cause then why are not all fat people diabetic? In fact the body naturally adapts in non-PWDs. Obese non diabetics naturally grow huge clumps of beta cells and they naturally release more insulin. That is mother nature's approach to a healthy but over-weight persons need for additional insulin. However, if Joslin is correct what the PWD is releasing is an insulin like virus which attaches to the insulin receptors which causes the resistance. I think CGM use and the numbers we get from them are at odds with Dr. McDougall's thoughts. In fact I will say his approach to keep the goal of their fasting blood sugars between 150 mg/dL and 300 mg/dL. in todays world is malpractice. We know sugars above 140 for 2+ hours cause vascular degeneration. We also know the chance of hypos in a T2 with the use of afrezza is extremely low. In 118 ZERO when taking afrezza and not eating. I 100% agree with you - "if you want to keep your eyes and feet!!" then "stay away from his advice". |
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Post by sayhey24 on Dec 15, 2019 9:56:28 GMT -5
Peppy - Why are so many so motivated to develop a do-it-yourself kit? The short answer is "for the kids". They were mostly parents of T1 kids looking to get real time monitoring and action to adjust their kids sugars.
Lets just get them the afrezza and the kids and parents lives will become much easier and safer. Lets hope this time next year we will have tackled that hurdle and pediatric afrezza will be approved.
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