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Post by peppy on Apr 29, 2022 7:31:37 GMT -5
Think subq insulin is difficult to use for users because they do not feel good. Going high or going low.
If people using subq insulin felt good/well, they would use it.
I have heard about (my neighbors dad) and seen, (the TV show Mike backed with the TV commercials) users that do not want to take the shot.
It is because they do not feel good.
Once more if they felt good, they would take it like we eat food because it feels good.
I do not think pre type two's want to take subq insulin.
Additionally, manage that for me so I do feel good.
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Post by sayhey24 on Apr 29, 2022 7:50:57 GMT -5
Why don't the insulin cartels could do a *trial to see if early insulin “cures” diabetes. Why don’t they do it. Are you kiidding??? Why? First - Injected insulins are dangerous. Second - there are a bunch of studies which have shown early insulin intervention stops and reverses progression BUT injected insulin is dangerous. UpJohn after German research during WWII took what they did and created an entire T2 market because insulin causes hypos and you need to inject. They created an entire industry because insulin is dangerous. Third - companies like Lilly want to make a lot of money in the T2 space by selling things like GLPs. www.clinicaltrialsarena.com/comment/eli-lilly-tirzepatide-outperform-diabetes-drugs/ If you want to make a lot of money the last thing you want to do is start them on afrezza and in 6 months half of them no longer need any medication. Good for afrezza but it kills a multi billion $$$ industry. In addition think about all the research dollars. Guys like Ralph DeFronzo has based is career promoting antiglycemics - first metformin, then GLP1s. This guy even developed the theory of insulin resistance to dissuade people from using insulin - their bodies were already making enough insulin so insulin was not the problem - sure Ralph. Mannkind investors might be okay if all Diabetics were on Afrezza for just 6 months. They would be right back on it later bc their diet had not changed. Diabetes is not a diet thing. Non-diabetic obese people grow more beta cells. We know that from autopsies. As we have seen first with the Joslin research years ago and now with Covid the beta cells are getting destroyed from viral infections. If the pancreas was healthy it would naturally make more beta cells to account for diet. If you talk with the levels people and even the Nutrisense people they are seeing people lose post prandial glucose control before weight gain. This is not what they were expecting and kind of messes up their business story. I will say the Levels people really have a handle on post prandial glucose. Diet can only reduce the body's need for more insulin. However if you can repair the beta cells who cares. The body can make as much insulin as it needs. In reality, most of these "repaired" people will probably still have some level of viral infection but that study has not been done yet. You may be right, some may be back on afrezza. |
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Post by sportsrancho on Apr 29, 2022 7:53:59 GMT -5
We/Vdex put people on pumps if that’s what they prefer. Sara in Owensboro has quite a few patients on them. Only thing is that’s not what they prefer when they get complete instructions on their options. Would you? Mind if I interrupt to inquire about VDEX? On their website, they have listed three locations in New Mexico and one in Owensboro, KY. There had been four clinics in New Mexico but now the Espagnola one is shown as "permanently closed." I'm not getting an impression of a thriving business -- is that a fair assessment? I answered these questions before on another thread. The website is being redone, we just opened a new clinic in Louisville Kentucky. Check “Vdex social media” on here. I don’t mind questions at all, just short on time at the moment. I’ll get back to this thread as soon as I can. |
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Post by uvula on Apr 29, 2022 8:08:55 GMT -5
I live this quote from sayhey
"If you want to make a lot of money the last thing you want to do is start them on afrezza and in 6 months half of them no longer need any medication. Good for afrezza but it kills a multi billion $$$ industry."
Is there an insurance company cartel that can do a study to prove this?
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Post by sayhey24 on Apr 29, 2022 8:22:40 GMT -5
I live this quote from sayhey "If you want to make a lot of money the last thing you want to do is start them on afrezza and in 6 months half of them no longer need any medication. Good for afrezza but it kills a multi billion $$$ industry." Is there an insurance company cartel that can do a study to prove this? Now thats a good question - I think the answer has to be a very well funded start-up who really wants to change the industry, like an Amazon. They don't need studies. They just need to do it. We already know the #1 cause of death in the U.S. is from heart attacks. We also know diabetes is the #1 cause of heart attacks. We already know micro/macro vascular damage is the root cause of a zillion problems included heart, stroke and sight issues. We also know that having a BG over 140 for 2+ hours causes vascular damage. The problem is the existing insurance companies are already in bed in this industry. You need someone willing to change the industry. |
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Reality
Apr 29, 2022 8:31:57 GMT -5
Post by sayhey24 on Apr 29, 2022 8:31:57 GMT -5
BTW - I thought years ago Onduo was going to try and do something in insurance onduo.com/They were started by Google. I have not talked with them to understand the issues they have run into. They also never embraced afrezza as I had hoped although Sanofi probably had a say in that. |
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Post by sportsrancho on Apr 29, 2022 13:19:14 GMT -5
Vdex…. Thriving maybe not, but we are expanding and hope to be thriving. Last year we became profitable. The Website is behind what’s going on and needs to be updated. It’s getting completely redone. We combined two clinics in New Mexico and they will be more coming in the area because it’s very lucrative. We get opportunities that lead us to certain states and then expand from there around those areas. Because we get well-known in the communities and surrounding hospitals.
We concentrate on excellence in each clinic before we move to start another. There’s a lot of training involved. And that is ongoing. There’s so much to learn about Afrezza our providers grow with us, and are continually amazed at the results. This gives them confidence to help recruit other outstanding practitioners. Check us out on LinkedIn, our following is growing rapidly.
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Post by sweedee79 on Apr 29, 2022 14:59:46 GMT -5
Vdex profitable... That sounds really good!!! Thanks for keeping us all updated Sports!!! If I ever have problems with diabetes in my lifetime I know who I'm reaching out to!!!
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Post by sayhey24 on Apr 29, 2022 15:04:02 GMT -5
Sports - is VDex getting any grant money for these clinics? At UPenn Medicne they are getting grant money for more ridiculous things which could be better used having a clinic utilizing afrezza. I think I will start looking into some of these grants and see what can be done.
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Reality
Apr 29, 2022 15:37:55 GMT -5
Post by sportsrancho on Apr 29, 2022 15:37:55 GMT -5
No, but that would be great.
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Reality
Apr 30, 2022 12:37:19 GMT -5
Post by agedhippie on Apr 30, 2022 12:37:19 GMT -5
... Its not an either pump or inhale, its both. The problem is the industry has spent a lot of time and money trying to come up with very complicated AP systems which are just not needed at this point. When the AP goes up against afrezza it always loses and always will because the insulin is too damn slow in the pumps. When Stevil says the pump study data wins is incorrect. It loses every time. That is flatly incorrect. There is large scale trial data to support an average TIR of 76% using a 780G ( www.ncbi.nlm.nih.gov/pmc/articles/PMC8817690/). Compare that to STAT-1 study ( www.ncbi.nlm.nih.gov/pmc/articles/PMC6161328/ for anyone who hasn't seen it) which had an average TIR of 62.5% in the Afrezza compliant group. Bear in mind that the 780G TIR is for all groups rather than just the compliant group. Even in a bad patch I can better 62.5% TIR. At this point the basal insulin gets blamed, but here is the thing; insulin is a mesh of basal and bolus so if those don't mesh that's a problem and cannot be disregarded. You don't see any other RAA insulin makers blaming the basal for their numbers, and in fairness you don't see Mannkind blaming the basal either. There are outliers like VDEX who have developed protocols to provide superior results for Afrezza. VDEX don't need trials they have their own clinical data. However, other doctors lack that data since they are not using Afrezza and rely on trials to provide it. What looks more compelling to a doctor; clinical data from a 4000+ population that supports an average TIR of 76%, or a 22 person study where the compliant group averaged a TIR of 62.5%. I suspect it is the former. To quote the STAT-1 paper. " A larger study in insulin-requiring patients with diabetes with a treat-to-target design would provide the opportunity to confirm these findings." Absent that nothing changes because there is no large scale trial data to support the assertion that Afrezza is superior and so the status quo prevails - Stevil is correct IMHO. |
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Reality
Apr 30, 2022 13:15:02 GMT -5
Post by peppy on Apr 30, 2022 13:15:02 GMT -5
... Its not an either pump or inhale, its both. The problem is the industry has spent a lot of time and money trying to come up with very complicated AP systems which are just not needed at this point. When the AP goes up against afrezza it always loses and always will because the insulin is too damn slow in the pumps. When Stevil says the pump study data wins is incorrect. It loses every time. That is flatly incorrect. There is large scale trial data to support an average TIR of 76% using a 780G ( www.ncbi.nlm.nih.gov/pmc/articles/PMC8817690/). Compare that to STAT-1 study ( www.ncbi.nlm.nih.gov/pmc/articles/PMC6161328/ for anyone who hasn't seen it) which had an average TIR of 62.5% in the Afrezza compliant group. Bear in mind that the 780G TIR is for all groups rather than just the compliant group. Even in a bad patch I can better 62.5% TIR. At this point the basal insulin gets blamed, but here is the thing; insulin is a mesh of basal and bolus so if those don't mesh that's a problem and cannot be disregarded. You don't see any other RAA insulin makers blaming the basal for their numbers, and in fairness you don't see Mannkind blaming the basal either. There are outliers like VDEX who have developed protocols to provide superior results for Afrezza. VDEX don't need trials they have their own clinical data. However, other doctors lack that data since they are not using Afrezza and rely on trials to provide it. What looks more compelling to a doctor; clinical data from a 4000+ population that supports an average TIR of 76%, or a 22 person study where the compliant group averaged a TIR of 62.5%. I suspect it is the former. To quote the STAT-1 paper. " A larger study in insulin-requiring patients with diabetes with a treat-to-target design would provide the opportunity to confirm these findings." Absent that nothing changes because there is no large scale trial data to support the assertion that Afrezza is superior and so the status quo prevails - Stevil is correct IMHO. Hello Aged. I have the charts with circles and arrows. Here is what I really think. In a made up world; the adult diabetic should have a choice which program they want to be on, which insulin they want to learn to manage, because insulin and blood glucose levels are a mangement game. We both know this. The corporate battles, are different..... the management of efficacy and the type of private/employer insurance management 55% of the population..... corporate as well. I like my made up world. I could bring the time in range results for afrezza into better blood glucose levels mg/dl with a second 4 unit dose at an hour or there after. and so could you. No one knows the game like you do. Pep   |
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Post by agedhippie on Apr 30, 2022 14:07:21 GMT -5
Hello Aged. I have the charts with circles and arrows. Here is what I really think. In a made up world; the adult diabetic should have a choice which program they want to be on, which insulin they want to learn to manage, because insulin and blood glucose levels are a mangement game. We both know this. The corporate battles, are different..... the management of efficacy and the type of private/employer insurance management 55% of the population..... corporate as well. I like my made up world. I could bring the time in range results for afrezza into better blood glucose levels mg/dl with a second 4 unit dose at an hour or there after. and so could you. No one knows the game like you do. Pep [STAT Post meal comparison graph] [Ultra Rapid profile graph] I am in favor of Afrezza despite what some people may think. As you said above, we both agree diabetics should have choices. I even know one person who still uses porcine insulin (I find this slightly alarming as AFAIK only vets have it these days, but I don't ask how they are getting it) because they swear that it works better for them than anything else. I think you could improve the STAT TIR with a second dose as well. TBH I was quite shocked with how mediocre those STAT results where, especially since I had bought calls in anticipation of a stellar result! The issue for me with a second dose per meal would be that now I am doubling the amount of work I have to do to manage my diabetes. That's a problem for me as I want to spend less time, not more. The real problem though for doctors is that there is no trial data showing that there is a long term impact. Logically better TIR should give better outcomes, but does it? Hence the trials to get that data and prove the theory. The same applies to Afrezza; do it's features translate into quantifiable benefits, and if so what is the impact. Again, hence the need for trials to get the data and quantify the impact. |
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Post by sayhey24 on Apr 30, 2022 18:20:31 GMT -5
Aged - the most recent trial they presented at ATTD this week did not require second dosing. They are simply doubling the label dosage and having no increase in hypos while at the 120 minute mark they are 51 points lower.
Great news - no additional work for you. Just do what we have been saying on this board for years, go big with the afrezza dose. Are you ready to give it a try? I promise your lungs will not explode but you BG control might get easier if not better, probably both. Maybe quality of life is a tangible benefit for you, not sure.
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Post by sayhey24 on Apr 30, 2022 18:32:10 GMT -5
... Its not an either pump or inhale, its both. The problem is the industry has spent a lot of time and money trying to come up with very complicated AP systems which are just not needed at this point. When the AP goes up against afrezza it always loses and always will because the insulin is too damn slow in the pumps. When Stevil says the pump study data wins is incorrect. It loses every time. That is flatly incorrect. There is large scale trial data to support an average TIR of 76% using a 780G ( www.ncbi.nlm.nih.gov/pmc/articles/PMC8817690/). Compare that to STAT-1 study ( www.ncbi.nlm.nih.gov/pmc/articles/PMC6161328/ for anyone who hasn't seen it) which had an average TIR of 62.5% in the Afrezza compliant group. Bear in mind that the 780G TIR is for all groups rather than just the compliant group. Even in a bad patch I can better 62.5% TIR. At this point the basal insulin gets blamed, but here is the thing; insulin is a mesh of basal and bolus so if those don't mesh that's a problem and cannot be disregarded. You don't see any other RAA insulin makers blaming the basal for their numbers, and in fairness you don't see Mannkind blaming the basal either. There are outliers like VDEX who have developed protocols to provide superior results for Afrezza. VDEX don't need trials they have their own clinical data. However, other doctors lack that data since they are not using Afrezza and rely on trials to provide it. What looks more compelling to a doctor; clinical data from a 4000+ population that supports an average TIR of 76%, or a 22 person study where the compliant group averaged a TIR of 62.5%. I suspect it is the former. To quote the STAT-1 paper. " A larger study in insulin-requiring patients with diabetes with a treat-to-target design would provide the opportunity to confirm these findings." Absent that nothing changes because there is no large scale trial data to support the assertion that Afrezza is superior and so the status quo prevails - Stevil is correct IMHO. Aged - I am not sure what you are smoking. When looking at afrezza for TIR you can only include the hours someone is awake. Afrezza has no affect when someone is sleeping. Thats the job of the basal. its also the beauty of afrezza - its in and out real fast. If you want to increase TIR during sleeping hours either take more basal or use a pump. Al use to say to use a simple patch pump. With afrezza there is no need for all the 780 complexity. However with the study just presented at ATTD with a single large dose of afrezza it seems they can bring the T1 safely down an additional 51 points which will bring the baseline down to carry them through the night. Combine the ATTD approach, apply the 51 points into the STAT results and afrezza kicks butt all over the 780 through the night. |
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