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Post by stevil on Jun 9, 2022 18:24:19 GMT -5
Stevil - if you don't want to debate, thats fine. Just don't respond. I am sorry what I am saying is completely uncompelling to you. I am just telling what DeFronzo said about metformin, what Holme said about in the end the T2 will be on insulin anyway and why Al Mann put $1B of his own money into afrezza. I know this is not what you learned in school but its hard to argue with what we are now seeing with CGMs. I wish you the best of luck but when people are saying things which may not make sense listen. When I first met Al Mann he was saying all this stuff which made little sense to me either. One thing it did was challenge me to try and understand what he was saying and why. Maybe in the end Al was wrong. Maybe his understanding of diabetes was way off base. Maybe in the end Al's understanding was so screwed up he just wasted $1B. One suggestion for you is to go back and read Al's old interviews and available interviews. Then ask yourself, why is he saying that. You're probably right, and I'll do that going forward. I actually really admire your persistence, stubbornness, and unwavering self confidence. I'm sure that has led to incredible successes in your life. You just seem to have a lot of opinions and strong beliefs and speak with an authoritative voice. I just wanted to make sure that the readers of the board have the most accurate information from what the great majority of doctors believe. I suppose to each their own who they want to believe and trust. To be clear, I don't think you're wrong about all things. I just don't think you're zooming out far enough to see the whole picture. It's really hard to gauge where people's understanding is. It seems Aged understood what I was saying... it's sometimes hard to know if you're talking past someone or not because a lot of assumptions are built into the discussion. If we don't have the same starting point and general baseline understanding of what we're talking about, it's harder to discuss the finer details and nuances. I find that a lot of people on here think I am in any way diminishing Afrezza and how remarkable of a treatment it is. Far from the truth. It is the best insulin on the market, hands down. Researchers still cannot agree on what causes diabetes, which is, in part, why we're even having this debate. But when we can't agree on general principles we won't agree on the finer details either. |
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Post by cretin11 on Jun 9, 2022 18:48:11 GMT -5
Good discussion among all three of you, and you each know a lot about the topic. Nice to see healthy debate in a respectful tone without insults or assumptions about intent. It’s one of the legit purposes of this board.
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Post by agedhippie on Jun 9, 2022 19:08:15 GMT -5
I am not sure finding the inhaler in your pants pocket or on your kitchen counter is a big deal. After a few times this gets really old fast. I have this today with pens and I can vouch for this fact. Once or twice is fine, but Every. Single. Time. You. Eat. really sucks. Typically the nausea clears up quickly in the same way that metformin settles down. Mounjaro combines GIP and GLP-1 so I suspect that the nausea comes from the GLP-1 aspect and will track drugs like Trulicity and clear up after the second week (GIP is actually anti-emetic). I would look for the same sort of real world drop out rate as you see for Trulicity. This is why hammering the nausea point is self-defeating - doctors know it almost always passes quickly. The appetite control is because you are not hungry, not because you have a bellyache. Nothing weird there. When I was diagnosed and they told me I had to take shots I had a bit of a tantrum and the doctor said it was my choice - inject or die. Funnily once I started to inject it wasn't a problem any more despite still being needle phobic in other cases (blood draws - ugh) |
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Post by sweedee79 on Jun 10, 2022 1:37:49 GMT -5
Stevil - if you don't want to debate, thats fine. Just don't respond. I am sorry what I am saying is completely uncompelling to you. I am just telling what DeFronzo said about metformin, what Holme said about in the end the T2 will be on insulin anyway and why Al Mann put $1B of his own money into afrezza. I know this is not what you learned in school but its hard to argue with what we are now seeing with CGMs. I wish you the best of luck but when people are saying things which may not make sense listen. When I first met Al Mann he was saying all this stuff which made little sense to me either. One thing it did was challenge me to try and understand what he was saying and why. Maybe in the end Al was wrong. Maybe his understanding of diabetes was way off base. Maybe in the end Al's understanding was so screwed up he just wasted $1B. One suggestion for you is to go back and read Al's old interviews and available interviews. Then ask yourself, why is he saying that. You're probably right, and I'll do that going forward. I actually really admire your persistence, stubbornness, and unwavering self confidence. I'm sure that has led to incredible successes in your life. You just seem to have a lot of opinions and strong beliefs and speak with an authoritative voice. I just wanted to make sure that the readers of the board have the most accurate information from what the great majority of doctors believe. I suppose to each their own who they want to believe and trust. To be clear, I don't think you're wrong about all things. I just don't think you're zooming out far enough to see the whole picture. It's really hard to gauge where people's understanding is. It seems Aged understood what I was saying... it's sometimes hard to know if you're talking past someone or not because a lot of assumptions are built into the discussion. If we don't have the same starting point and general baseline understanding of what we're talking about, it's harder to discuss the finer details and nuances. I find that a lot of people on here think I am in any way diminishing Afrezza and how remarkable of a treatment it is. Far from the truth. It is the best insulin on the market, hands down. Researchers still cannot agree on what causes diabetes, which is, in part, why we're even having this debate. But when we can't agree on general principles we won't agree on the finer details either. Thank you Stevil... I haven't always been objective enough to appreciate your input... But I do now... Keep it coming... !!! |
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Post by stevil on Jun 10, 2022 12:16:26 GMT -5
My pleasure, Sweedee. I don't really get offended easily or tend to care too much about what others think of me... I try to do what is right regardless of whether it will be popular or not. That sometimes gets me in trouble with people, so I'm sorry if I come across too strong to anyone here. It's not my intention to belittle anyone or make anyone feel small. I'm motivated by truth and getting things right, not to harm anyone.
I know people used to question my motives when I first got here. Most of those people seemed to have moved on, or at least don't post as much as they used to. Hopefully I've won over the rest as I haven't been called out as a paid short in quite some time.
I often wonder if the investment of my time is worthwhile to the board, so it's nice to hear someone appreciates it from time to time. I try to lurk as much as possible just because I don't like the headache of conflict or the amount of time it takes to go back and forth. If some things need to be straightened out, I'll keep doing it as long as others appreciate it.
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Post by uvula on Jun 10, 2022 12:34:53 GMT -5
Stevil, sayhey, sweede,mango and the old hippie (and others): as a non-medical person I greatly appreciate the time you spend here. If nothing else it shows us all how complicated the real world is.
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Post by agedhippie on Jun 10, 2022 12:46:56 GMT -5
Stevil, sayhey, sweede,mango and the old hippie (and others): as a non-medical person I greatly appreciate the time you spend here. If nothing else it shows us all how complicated the real world is. Let's be clear, Stevil is the medical person here, I am just an amateur and interested in this topic for selfish diabetic reasons.  |
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Post by sportsrancho on Jun 10, 2022 14:57:03 GMT -5
My pleasure, Sweedee. I don't really get offended easily or tend to care too much about what others think of me... I try to do what is right regardless of whether it will be popular or not. That sometimes gets me in trouble with people, so I'm sorry if I come across too strong to anyone here. It's not my intention to belittle anyone or make anyone feel small. I'm motivated by truth and getting things right, not to harm anyone. I know people used to question my motives when I first got here. Most of those people seemed to have moved on, or at least don't post as much as they used to. Hopefully I've won over the rest as I haven't been called out as a paid short in quite some time. I often wonder if the investment of my time is worthwhile to the board, so it's nice to hear someone appreciates it from time to time. I try to lurk as much as possible just because I don't like the headache of conflict or the amount of time it takes to go back and forth. If some things need to be straightened out, I'll keep doing it as long as others appreciate it. Always liked you. Like some others you are true to yourself. Objectivity is hard for some people when they have a large investment, and it’s hard for me too …but I’m a give it to me straight even if it hurts type of person🤣 |
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Post by sayhey24 on Jun 11, 2022 8:34:44 GMT -5
Stevil, sayhey, sweede,mango and the old hippie (and others): as a non-medical person I greatly appreciate the time you spend here. If nothing else it shows us all how complicated the real world is. Let's be clear, Stevil is the medical person here, I am just an amateur and interested in this topic for selfish diabetic reasons.  me too, I am also an amateur. My interest is seeing proper care for T2s so they don't have a massive heart attack at 62 like my dad. As a side effect once afrezza takes its proper place in T2 treatment I fully expect the $100pps to be in the rearview mirror. I am not a doctor or a nurse. Then again neither was Al. BTW, neither was Richard Bernstein. Mango reminded me the other day of something Al said which is the "medically correct" way to treat post prandial glucose is with afrezza. I sure hope Mike picks up on that phrase. IMO, Al and Bernstein have done more to advance diabetic care and at every step of the way they where told time and time again "you can't do that". Its time Mike picks up the ball and starts advancing it in the T2 world and every time he is told "you can't do that" he give them that big smile. |
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Post by sayhey24 on Jun 11, 2022 12:00:21 GMT -5
Stevil - if you don't want to debate, thats fine. Just don't respond. I am sorry what I am saying is completely uncompelling to you. I am just telling what DeFronzo said about metformin, what Holme said about in the end the T2 will be on insulin anyway and why Al Mann put $1B of his own money into afrezza. I know this is not what you learned in school but its hard to argue with what we are now seeing with CGMs. I wish you the best of luck but when people are saying things which may not make sense listen. When I first met Al Mann he was saying all this stuff which made little sense to me either. One thing it did was challenge me to try and understand what he was saying and why. Maybe in the end Al was wrong. Maybe his understanding of diabetes was way off base. Maybe in the end Al's understanding was so screwed up he just wasted $1B. One suggestion for you is to go back and read Al's old interviews and available interviews. Then ask yourself, why is he saying that. You're probably right, and I'll do that going forward. I actually really admire your persistence, stubbornness, and unwavering self confidence. I'm sure that has led to incredible successes in your life. You just seem to have a lot of opinions and strong beliefs and speak with an authoritative voice. I just wanted to make sure that the readers of the board have the most accurate information from what the great majority of doctors believe. I suppose to each their own who they want to believe and trust. To be clear, I don't think you're wrong about all things. I just don't think you're zooming out far enough to see the whole picture. It's really hard to gauge where people's understanding is. It seems Aged understood what I was saying... it's sometimes hard to know if you're talking past someone or not because a lot of assumptions are built into the discussion. If we don't have the same starting point and general baseline understanding of what we're talking about, it's harder to discuss the finer details and nuances. I find that a lot of people on here think I am in any way diminishing Afrezza and how remarkable of a treatment it is. Far from the truth. It is the best insulin on the market, hands down. Researchers still cannot agree on what causes diabetes, which is, in part, why we're even having this debate. But when we can't agree on general principles we won't agree on the finer details either. Stevil - I love the word "stubbornness" maybe I am. I like to think of it more as "focused". When I first met Al he said things which I did not understand. In fact, I thought the guy was a little crazy and losing it. It did however, make me ask myself why was this guy saying what he was. It challenged me to learn why he was saying what he did. In simple terms Mango restated what Al said and that is that the "medically correct" way to treat a lack of post prandial insulin is with post prandial insulin, aka afrezza. Now if you want to talk about "stubbornness", I have to give that prize to Richard Bernstein. I believe he is about 88 years old and was expected at the time of his T1 diagnosis not to live much past 60. This guy would go to medical meetings and get kicked out because he was not a doctor. This guy was so stubborn that when they told him he was not smart enough because he was not a doctor, he went and became a doctor. Then he finds out the biggest roadblock he had in getting the community to accept glucose meters was the doctors were afraid they were going to lose their payday. Back then it was common practice to have the PWDs come in for monthly blood work and that was a nice revenue stream for the doctors. Sometimes when things don't seem to make sense as to why people do what they do "follow the money". Below is a summary of Bernstein's view on diabetes. The one thing about this guy is he "walked the walk" and he must have been right about something as he is still alive. BTW - I could never diet the way he does but as I told Jenny Ruhl one day "with afrezza no one needs to". IMO, Jenny has the best primer on T2 diabetes - not all right but its damn good. "Dr. Bernstein contends that high blood sugars are the cause of all diabetic complications, and therefore that tightly controlling blood sugar eliminates complications. This contention was at first at odds with established medical opinion, as the sugar-complications link was not yet clearly established from scientific studies. A 1993 study supported Bernstein's position that tight control of blood sugar leads to better health.[4][5] Bernstein's low-carbohydrate diet was initially opposed by the American Diabetes Association, which recommended a high-carbohydrate low-fat diet for diabetics.[6] The ADA has since changed its position to allow a low-carbohydrate diet as an acceptable option for diabetics.[7] The UK NHS has also introduced a low-carbohydrate plan for diabetics and prediabetics.[8] Bernstein's focus on maintaining low blood sugar targets conflicts with mainstream guidance to maintain a higher fasting blood sugar target for insulin-dependent patients (such as Type 1 diabetics).[9] This higher target is to reduce the risk of hypoglycemia which can be fatal. Bernstein's Type 1 patients need to be constantly on guard against hypoglycemia . Hypoglycemia risk is high in traditional ADA diet because requires high intake of insulin" en.wikipedia.org/wiki/Richard_K._Bernstein |
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Post by sportsrancho on Jun 11, 2022 12:23:38 GMT -5
We have come a long way since the high carbohydrate diet!
What in the world were they thinking🤦🏼♀️
Being a personal trainer I got a chance to witness how much sugar people eat just to start the day. I was flabbergasted by peoples habits.
If you start the day with the donut you’ve got the sugar blues until you consume some protein at lunch. You can pretty much tell from what you eat and the way it makes you feel if it’s good for you or not.
Sorry I got off topic.
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Post by agedhippie on Jun 11, 2022 12:34:05 GMT -5
Bernstein's focus on maintaining low blood sugar targets conflicts with mainstream guidance to maintain a higher fasting blood sugar target for insulin-dependent patients (such as Type 1 diabetics).[9] This higher target is to reduce the risk of hypoglycemia which can be fatal. Bernstein's Type 1 patients need to be constantly on guard against hypoglycemia . Hypoglycemia risk is high in traditional ADA diet because requires high intake of insulin" Whoever wrote that wikipedia entry doesn't understand Dr Bernstein's approach. He summarizes his view as the law of small numbers. The fewer carbs you eat the easier it is to maintain tight control because all movements are small. The analogy he makes is to driving - if you drive by making huge movements of the steering wheel then you are going to be all over the road, if you make small movements then corrections are also small movements and thus more accurate. His patients no more need to be on constant guard against hypoglycemia than any other patients. Indeed, he would argue that they are at less risk because they use less insulin and have an almost flat glucose level because they seldom eat enough carbs to seriously move that level. Like you I could use that diet though! |
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Post by sayhey24 on Jun 11, 2022 13:25:10 GMT -5
Sports - the topic is positive catalysts yet we all forget things and then rediscover them. The diet is one. I think Mango hit on something which I know I had forgotten. It was so simple but yet brilliant when Al said the "medically correct" way to treat a lack of post prandial insulin is with post prandial insulin, aka afrezza. How simple and how true. I think if Mike picks up on that and adds it into his "Seeing is Believing" pitch this could be a huge catalyst MNKD can control. Who at the ADA could argue with that? What a great tag line for an ad "the medically correct way to treat T2 diabetes, afrezza". On the diet we use to know what diabetics should be eating. We knew it before we knew what insulin was. Here is the dietary cookbook from 1917. How the ADA got from this to their high carb diet is a mystery and they fought Bernstein for years on his diet. Maybe another case of "follow the money". archive.org/stream/diabeticcookeryr00oppeiala#page/34/mode/2up |
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Post by sayhey24 on Jun 11, 2022 13:28:37 GMT -5
Bernstein's focus on maintaining low blood sugar targets conflicts with mainstream guidance to maintain a higher fasting blood sugar target for insulin-dependent patients (such as Type 1 diabetics).[9] This higher target is to reduce the risk of hypoglycemia which can be fatal. Bernstein's Type 1 patients need to be constantly on guard against hypoglycemia . Hypoglycemia risk is high in traditional ADA diet because requires high intake of insulin" Whoever wrote that wikipedia entry doesn't understand Dr Bernstein's approach. He summarizes his view as the law of small numbers. The fewer carbs you eat the easier it is to maintain tight control because all movements are small. The analogy he makes is to driving - if you drive by making huge movements of the steering wheel then you are going to be all over the road, if you make small movements then corrections are also small movements and thus more accurate. His patients no more need to be on constant guard against hypoglycemia than any other patients. Indeed, he would argue that they are at less risk because they use less insulin and have an almost flat glucose level because they seldom eat enough carbs to seriously move that level. Like you I could use that diet though! I think he wrote it but we could ask him. He is pretty good at writing. I forget how many books he has. Maybe he hasn't seen the last entry. I do like the banner at the top of the page with the "warning" about Bernstein's views being dangerous. Whoever added that probably added the entry you don't like. "Bernstein's Type 1 patients need to be constantly on guard against hypoglycemia" I think the attempt is to discredit him by sneaking that in. |
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Post by letitride on Jun 11, 2022 13:54:35 GMT -5
If I was to become a type 2 diabetic is it possible with a fist full of Afrezza and a CGM to continue to eat and drink like I always have thus life more human?
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