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Post by porkini on Jul 21, 2020 19:58:15 GMT -5
IMO Medtronic lost the CGM war and DXCM is too far ahead with the G7. The only reason people use the Guardians are because they have a MDT pump. They hurt more, rip out easier, and are less accurate. shawnflynn "the soft basher"....You and Aged are two peas in a pod. Spin any positive optimism into an ever so slightly negative narrative. OFFS!? |
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Post by agedhippie on Jul 21, 2020 20:00:28 GMT -5
IMO Medtronic lost the CGM war and DXCM is too far ahead with the G7. The only reason people use the Guardians are because they have a MDT pump. They hurt more, rip out easier, and are less accurate. shawnflynn "the soft basher"....You and Aged are two peas in a pod. Spin any positive optimism into an ever so slightly negative narrative. Maybe our perception has something to do with the fact that we are both Type 1 and use this stuff IRL. Shawn is right though. certainly I would not use a Guardian CGM. |
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Post by sayhey24 on Jul 22, 2020 6:27:28 GMT -5
Aged - you won't use afrezza either so whats the difference. If you are using a 670g I think you just might have a Guardian.
Galindo came to MNKD for a reason. It seems odd he still has one foot in the door at Medtronic while on his way to MNKD. Maybe its as simple as he needs a pay-check but if he got pushed guys in his position usually take a little time off. I hope he is here for more than a pay-check.
The slides KC posted and Galindo pitched in 2016 laid out a vision. Galindo was delivering double digit growth with that vision but it ended with Sugar IQ. Then what? The missing link with Sugar IQ is afrezza. Then again the missing link with the 780g is also afrezza.
Hope springs external, maybe I will buy some more NAK. Maybe they will hit gold. Afrezza the golden goose just keeps laying eggs and they have not been gold, at least not yet.
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Post by Clement on Jul 22, 2020 7:51:35 GMT -5
"Effect of Afrezza on Glucose Dynamics During HCL Treatment" pubmed.ncbi.nlm.nih.gov/32661108/Imagine fine-tuning the HCL software to handle Afrezza's lack of tail (compared to aspart). |
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Post by uvula on Jul 22, 2020 9:48:07 GMT -5
Someone on this thread mnkd.proboards.com/thread/12103Claimed that mnkd could make a liquid version of afrezza. If true, could it be used in a medtronic closed loop artificial pancreas? Maybe medtronic doesn't want another pump company to have access to it? |
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Post by Deleted on Jul 22, 2020 11:22:13 GMT -5
Someone on this thread mnkd.proboards.com/thread/12103Claimed that mnkd could make a liquid version of afrezza. If true, could it be used in a medtronic closed loop artificial pancreas? Maybe medtronic doesn't want another pump company to have access to it? That was a WEAK article from Liu. He did not do his homework when writing it. You can't claim ULTRA if there's a drug out there that is faster than the one you're claiming g which is Afrezza. |
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Post by agedhippie on Jul 22, 2020 11:40:57 GMT -5
Aged - you won't use afrezza either so whats the difference. If you are using a 670g I think you just might have a Guardian. Galindo came to MNKD for a reason. It seems odd he still has one foot in the door at Medtronic while on his way to MNKD. Maybe its as simple as he needs a pay-check but if he got pushed guys in his position usually take a little time off. I hope he is here for more than a pay-check. The slides KC posted and Galindo pitched in 2016 laid out a vision. Galindo was delivering double digit growth with that vision but it ended with Sugar IQ. Then what? The missing link with Sugar IQ is afrezza. Then again the missing link with the 780g is also afrezza. Hope springs external, maybe I will buy some more NAK. Maybe they will hit gold. Afrezza the golden goose just keeps laying eggs and they have not been gold, at least not yet. I don't use a 670G, I use MDI (insulin pens), because although it would probably get me better numbers I don't think it's there yet. Part of the gamble with pumps is that they are a decision you only get to make every few years and I think right now that we are entering a phase of rapid development for automated insulin delivery. If I am going to tie myself to a pump it has to do everything. Afrezza is not the answer for these products because it defeats the whole purpose of automated delivery. Automated means just that - no human involved. My view is that Galindo is at MNKD because MNKD have decided the future is UTHR deals and drug delivery. I also think that is why Dr Kendall is gone. Galindo is a devices man, not drugs, with his track record of GE and then Medtronics. I strongly suspect that his departure was tied to the arrival of his new boss Sean Salmon, who is cleaning house as the diabetes group as we speak. |
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Post by agedhippie on Jul 22, 2020 12:10:34 GMT -5
"Effect of Afrezza on Glucose Dynamics During HCL Treatment" pubmed.ncbi.nlm.nih.gov/32661108/Imagine fine-tuning the HCL software to handle Afrezza's lack of tail (compared to aspart). No manufacturer is going to do that work. The 670G is a step (already superseded by the 780G) down the path to fully automatic systems. That's the finish line in this particular race and that's what everyone is focused on. Re-engineering an existing systems to handle Afrezza is a waste of resources in that race (even in a future system since it's manual and not automated). This is why systems like Sugar.IQ are important to the manufacturers - nothing to do with showing you data, but all about being able to have the system predict and deal with events like meals, exercise, illness, etc. without human involvement. |
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Post by Clement on Jul 22, 2020 13:40:53 GMT -5
With BluHale, the only human involvement would be inhaling. BluHale could send dosage, initiate a time stamp, and confirm that the inhalation was properly performed. Patient history digitalized. Coming to you in 2021 according to MC.
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Post by sayhey24 on Jul 22, 2020 14:26:40 GMT -5
"Effect of Afrezza on Glucose Dynamics During HCL Treatment" pubmed.ncbi.nlm.nih.gov/32661108/Imagine fine-tuning the HCL software to handle Afrezza's lack of tail (compared to aspart). No manufacturer is going to do that work. The 670G is a step (already superseded by the 780G) down the path to fully automatic systems. That's the finish line in this particular race and that's what everyone is focused on. Re-engineering an existing systems to handle Afrezza is a waste of resources in that race (even in a future system since it's manual and not automated). This is why systems like Sugar.IQ are important to the manufacturers - nothing to do with showing you data, but all about being able to have the system predict and deal with events like meals, exercise, illness, etc. without human involvement. Aged - I think Clement is 100% correct. If you look at the slides KC posted, predictive algorithm downloads was something Galindo was pitching 4 years ago. Be it the 670 or 780 they all have the same problem Al was trying to solve when he invented afrezza - the insulins were too damn slow and too unpredictable. It does not take re-engineering the 780G to incorporate predictive algorithms incorporating afrezza. I am 100% sure I could write that code myself but I have written a lot of code in the past. I am sure a Medtronic SE working in conjunction with the IBM Watson feedback could knock it out pretty fast. In fact, I bet they already have. Its a hell of a lot easier than the algorithms to predict the actions of an unpredictable RAA. With afrezza the in and out are near constant. Add in the Bluhale communicating with Sugar IQ and I can see personalized algorithms being downloaded to the 780g. I do find it interesting that Galindo shows up and Kendall says he is leaving. Galindo is a diabetes guy and so is Kendall. Maybe Galindo is bringing in his guy who can actually get the SoC changes or get a new device/drug combo approved like the 780g/afrezza. Maybe the town was too small for the both of them. We will see. |
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Post by agedhippie on Jul 22, 2020 14:39:50 GMT -5
Someone on this thread mnkd.proboards.com/thread/12103Claimed that mnkd could make a liquid version of afrezza. If true, could it be used in a medtronic closed loop artificial pancreas? Maybe medtronic doesn't want another pump company to have access to it? A liquid version would have to be delivered the same way as RAA so you lose the absorption benefits. |
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Post by agedhippie on Jul 22, 2020 15:14:33 GMT -5
With BluHale, the only human involvement would be inhaling. BluHale could send dosage, initiate a time stamp, and confirm that the inhalation was properly performed. Patient history digitalized. Coming to you in 2021 according to MC. The problem is the decision and action to inhale still rests with the human, as does the dosing (I believe Bluhale doesn't control the dose dispensed although it would be really cool if it did). The aim is that the person does nothing and the system does it all. If you touch anything then they failed. Tandem, Medtronic, and the others out there have zero interest this because they have moved pass the HCL. As it stands you are chasing the puck and they are already heading where they expect it to go. I am not saying that you couldn't do, but if you wanted to you would have to code it yourself and contribute it to one of the open source system.I think there is even a demand for it especially when linked to things like InPen (which xDrip supports). The issue is going to be getting the curve right, and that for a very short duration insulin the person's carb absorption rate is going to be a lot more significant for the future predictor. |
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Post by sayhey24 on Jul 22, 2020 15:21:04 GMT -5
Aged - the RAAs are made up of monomers , dimmers and hexamers. The uptake of the monomers is very fast but the dimmers and hexamers not so much. The problem is stability. This is the problem monomer human insulin also has in liquid form. Its too damn unstable. FDKP solves that problem but makes it a powder.
Human interaction during mealtime is a natural occurrence. Taking a puff of afrezza after taking a bite is no big deal. The problem are times like when sleeping. Thats the benefit of the HCL. Its not during meals.
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Post by shawnonafrezza on Jul 22, 2020 15:43:07 GMT -5
No manufacturer is going to do that work. The 670G is a step (already superseded by the 780G) down the path to fully automatic systems. That's the finish line in this particular race and that's what everyone is focused on. Re-engineering an existing systems to handle Afrezza is a waste of resources in that race (even in a future system since it's manual and not automated). This is why systems like Sugar.IQ are important to the manufacturers - nothing to do with showing you data, but all about being able to have the system predict and deal with events like meals, exercise, illness, etc. without human involvement. It does not take re-engineering the 780G to incorporate predictive algorithms incorporating afrezza. Add in the Bluhale communicating with Sugar IQ and I can see personalized algorithms being downloaded to the 780g. Yes and no. The 780g is not able to update the software like the X2 so they'd have to release it as a whole new model. 780 just got CE approval so there is a 0% chance it incorporates Afrezza. Next model would be at least 2 years away. Then remember that you're tied via insurance to the same pump for 4 years so everyone who gets the 780 won't be eligible for the next revision. As for personalized algorithms, I'd love it but I don't think anybody does that yet. If anything they're making them more and more standard. Autotune exists in the DIY world so maybe something like that but AFAIK no commercial system has anything like it. Note, it's funny how so many people were anti pump until now. IMO having the rapid basal on board removes the benefit of Tresiba + Afrezza combo. |
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Post by agedhippie on Jul 22, 2020 15:51:28 GMT -5
Aged - I think Clement is 100% correct. If you look at the slides KC posted, predictive algorithm downloads was something Galindo was pitching 4 years ago. Be it the 670 or 780 they all have the same problem Al was trying to solve when he invented afrezza - the insulins were too damn slow and too unpredictable. It does not take re-engineering the 780G to incorporate predictive algorithms incorporating afrezza. I am 100% sure I could write that code myself but I have written a lot of code in the past. I am sure a Medtronic SE working in conjunction with the IBM Watson feedback could knock it out pretty fast. In fact, I bet they already have. Its a hell of a lot easier than the algorithms to predict the actions of an unpredictable RAA. With afrezza the in and out are near constant. Add in the Bluhale communicating with Sugar IQ and I can see personalized algorithms being downloaded to the 780g. I do find it interesting that Galindo shows up and Kendall says he is leaving. Galindo is a diabetes guy and so is Kendall. Maybe Galindo is bringing in his guy who can actually get the SoC changes or get a new device/drug combo approved like the 780g/afrezza. Maybe the town was too small for the both of them. We will see. There are a boat load of problems with this. The chief one is that Medtronic cannot significantly alter the algorithm without getting it revalidated by the FDA. They are not going to do that simply for the benefit of MNKD which is why the open source route is the best. Predicting RAA behavior is not hard, they have been doing that ever since the first basal suspend pump came out. When it comes down to it though Medtronic are in the business of automated insulin delivery so this idea is DOA. Lol. Kendall is an actual diabetes expert with over two decades in diabetes and was CMO. Galindo has six years working for a device manufacturer and is CCO. This is about pivoting to devices or Kendall would still be there, the roles don't overlap. The more interesting question was who was behind this, and what does this mean for Mike. As you say, we will see. |
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