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Post by harrys on Oct 13, 2015 17:39:00 GMT -5
It is highly unlikely the practitioners at the Cleveland Clinic will be some of the first to adopt Afrezza. Many of the practitioners there are dinosaurs and their advice to patients is super conservative and plagued with medical dogma. It is a VERY conservative health organization. Who killed the Coronary Artery Calcium Scan in lieu of the medieval stint....? While very conservative, you should probably check out their new crop of Fellows of Cardiovascular Medicine. I don't think CC would be bringing in many advocates of TAVR if CC was still stuck in the dinosaur age. I do agree that these CC practitioners will probably not be leading the charge for Afrezza, but that's why I find this posting so powerful! What's going on at CC where someone could get away with this under the CC banner? Hmmmm.... I think they're definitely working on their image, particularly online. Considering they are one of the most prestigious medical institutes in the world it would be nice to see them innovate, and maybe providing this information to patients online is there attempt at doing so. Admittedly my experience with them as "dinosaurs" was years ago but I've never gone back since, I am very down on western doctors in general. |
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Post by jpg on Oct 13, 2015 17:57:51 GMT -5
Who killed the Coronary Artery Calcium Scan in lieu of the medieval stint....? What are you talking about? A little info can get you in trouble but will just about make it seem as if you know 'medical stuff'... Unrelated concepts at best (and you misspelled stent). |
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Post by jpg on Oct 13, 2015 18:00:37 GMT -5
And again not to go on a tangent (as seems to be the aim of some of our more tenacious 'glass 1/4 full' types):
Insulin Inhaler Is A New Option If You Have Diabetes
health.clevelandclinic.org/2015/10/insulin-inhaler-new-option-diabetes/
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Post by harrys on Oct 13, 2015 18:04:59 GMT -5
Who killed the Coronary Artery Calcium Scan in lieu of the medieval stint....? What are you talking about? A little info can get you in trouble but will just about make it seem as if you know 'medical stuff'... Unrelated concepts at best (and you misspelled stent). I hope you're not a cardiologist... ever heard of "prevention" vs. "unnecessary invasive intervention". These are two concepts you should understand if you are investing in biotech. |
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Post by jpg on Oct 13, 2015 18:14:15 GMT -5
What are you talking about? A little info can get you in trouble but will just about make it seem as if you know 'medical stuff'... Unrelated concepts at best (and you misspelled stent). I hope you're not a cardiologist... ever heard of "prevention" vs. "unnecessary invasive intervention". These are two concepts you should understand if you are investing in biotech. CT scan looking for coronary calcium are prevention? No. You are simply trying to dilute good posts with gibberish and I'm helping you! |
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Post by brentie on Oct 13, 2015 18:14:38 GMT -5
A CME Dinner Program Series Practical Strategies to Address Postprandial Hyperglycemia in Type 1 and Type 2 Diabetes: An Important Aspect of Overall Diabetes Care The Med-IQ/Taking Control Of Your Diabetes Practical Strategies to Address Postprandial Hyperglycemia evening series will be offered in ten different cities during the 2015 year. The importance of postprandial glucose control has long been overlooked. In type 1 diabetes,there is an unmet need for ultra fast-acting insulins to more effectively and efficiently control postmeal glucose values while simultaneously limiting delayed hypoglycemia. In addition to controlling postprandial glucose values, there is a need to treat incidental hyperglycemia between meals, which points to the demand for a rapid-on, rapid-off insulin. In type 2 diabetes, the endogenous ability of the pancreas to secrete insulin diminishes over time. Initiation of prandial insulin in type 2’s, typically after basal insulin has been added, is often a stepwise approach and, unfortunately, education and training for health care providers (HCPs) regarding how best to initiate and titrate prandial insulin has been broadly deficient or absent. With the advent and availability of new insulin preparations, including inhaled insulin, there is the urgent need for HCP education on all aspects of glycemic control with insulin-- including initiation, titration and ongoing adjustment.
In type 2 diabetes, there is also a marked behavioral resistance to advancing insulin therapy by both HCPs and patients. In particular, HCPs avoid intensifying mealtime insulin for a host of reasons and patients are often resistant to advancing insulin therapy primarily because of common misconceptions. This workshop will feature concise, didactic presentations and will utilize an electronic audience response system (ARS) for interactive case-based learning. Importantly, the ARS questions will include clinical decision-making steps where multiple answers may be appropriate in order to facilitate discussions between faculty and participants and more effectively translate evidence to practice.
Acknowledgment of Commercial Support:
This activity is supported by an educational grant from sanofi-aventis U.S.tcoyd.org/index.php/continuing-medical-education/cme-2015-practical-strategies.html |
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Post by xoxoxoxo on Oct 13, 2015 18:18:40 GMT -5
I have some first hand experience with this place... While this article is really good (minus the picture), you have to understand these 2 people work at the Lennon Diabetes Center at the Stephanie Tubbs Jones Health Center. my.clevelandclinic.org/locations_directions/Regional-Locations/stjhc/specialties/diabetesThey do lots of education, but it's basically patient education/diabetic support group stuff. What we really need are the 13 doctors at the diabetes center under the Endocrinology & Metabolism Institute to get this message. They're the ones who actually prescribe insulin, not the educators at the Lennon Diabetes Center. my.clevelandclinic.org/services/endocrinology-metabolism/departments-centers/diabetes-centerSomewhere in my post history shows my story of going to the diabetes center at the cleveland clinic with my dad. It's great to see a few months later that they're learning, but we need the message to get to the prescribers not just the educators. This was mid July and the doctors had just been visited for the first time by a rep who gave them all a presentation. My thread from before: mnkd.proboards.com/thread/3016/experience-endo |
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Post by jpg on Oct 13, 2015 21:05:45 GMT -5
I have some first hand experience with this place... While this article is really good (minus the picture), you have to understand these 2 people work at the Lennon Diabetes Center at the Stephanie Tubbs Jones Health Center. my.clevelandclinic.org/locations_directions/Regional-Locations/stjhc/specialties/diabetesThey do lots of education, but it's basically patient education/diabetic support group stuff. What we really need are the 13 doctors at the diabetes center under the Endocrinology & Metabolism Institute to get this message. They're the ones who actually prescribe insulin, not the educators at the Lennon Diabetes Center. my.clevelandclinic.org/services/endocrinology-metabolism/departments-centers/diabetes-centerSomewhere in my post history shows my story of going to the diabetes center at the cleveland clinic with my dad. It's great to see a few months later that they're learning, but we need the message to get to the prescribers not just the educators. This was mid July and the doctors had just been visited for the first time by a rep who gave them all a presentation. My thread from before: mnkd.proboards.com/thread/3016/experience-endoI would not underestimate the power of diabetic educators at one of the most prestigious hospitals in the US trying and posting a basically glowing review about Afrezza. Physicians are obviously human (except for a few who think they are gods: an attempt at medical humour...) and react much more strongly to personal experience than we think. I know that if someone 'in the know' I work with suggest a therapy because it is really effective I am 10 times (at least) more likely to give it a try. We don't change our prescription patterns quickly but when we do it tends to be sticky. In the case of Afrezza I think that will be a very powerful thing. |
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Post by xoxoxoxo on Oct 13, 2015 21:37:38 GMT -5
I'm not underestimating anything. I hate to say it, but harrys is correct about the doctors at the cleveland clinic. They're in no hurry to try a new therapy and will probably be one of the last groups to get on board. But hey, I've been there and my dad goes regularly so what do I know.
They don't even like CGMs because they think the data isn't useful because it lags regular blood pricks.
It's fantastic to see the educators, but don't expect them to cause an uptick in scripts anytime soon.
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Post by harryx1 on Oct 14, 2015 14:18:57 GMT -5
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Post by compound26 on Oct 14, 2015 14:26:15 GMT -5
harryx1, thanks! The first link got the correct photo of Afrezza! The second still has an incorrect one. |
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Post by brentie on Oct 14, 2015 18:16:04 GMT -5
A CME Dinner Program Series Practical Strategies to Address Postprandial Hyperglycemia in Type 1 and Type 2 Diabetes: An Important Aspect of Overall Diabetes Care The Med-IQ/Taking Control Of Your Diabetes Practical Strategies to Address Postprandial Hyperglycemia evening series will be offered in ten different cities during the 2015 year. The importance of postprandial glucose control has long been overlooked. In type 1 diabetes,there is an unmet need for ultra fast-acting insulins to more effectively and efficiently control postmeal glucose values while simultaneously limiting delayed hypoglycemia. In addition to controlling postprandial glucose values, there is a need to treat incidental hyperglycemia between meals, which points to the demand for a rapid-on, rapid-off insulin. In type 2 diabetes, the endogenous ability of the pancreas to secrete insulin diminishes over time. Initiation of prandial insulin in type 2’s, typically after basal insulin has been added, is often a stepwise approach and, unfortunately, education and training for health care providers (HCPs) regarding how best to initiate and titrate prandial insulin has been broadly deficient or absent. With the advent and availability of new insulin preparations, including inhaled insulin, there is the urgent need for HCP education on all aspects of glycemic control with insulin-- including initiation, titration and ongoing adjustment.
In type 2 diabetes, there is also a marked behavioral resistance to advancing insulin therapy by both HCPs and patients. In particular, HCPs avoid intensifying mealtime insulin for a host of reasons and patients are often resistant to advancing insulin therapy primarily because of common misconceptions. This workshop will feature concise, didactic presentations and will utilize an electronic audience response system (ARS) for interactive case-based learning. Importantly, the ARS questions will include clinical decision-making steps where multiple answers may be appropriate in order to facilitate discussions between faculty and participants and more effectively translate evidence to practice.
Acknowledgment of Commercial Support:
This activity is supported by an educational grant from sanofi-aventis U.S.tcoyd.org/index.php/continuing-medical-education/cme-2015-practical-strategies.htmlBobw spotted this. It's the slides from the July 9th presentation. If you start at page 30, there's 4 slides on Toujeo and then pages 32-40 are about Afrezza. Steven Edelman was one of the presenters. tcoyd.org/PDF/2015-Anaheim-Dinner-CME-Slide-Decks.pdf |
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Post by jpg on Oct 14, 2015 20:33:28 GMT -5
What are you talking about? A little info can get you in trouble but will just about make it seem as if you know 'medical stuff'... Unrelated concepts at best (and you misspelled stent). I hope you're not a cardiologist... ever heard of "prevention" vs. "unnecessary invasive intervention". These are two concepts you should understand if you are investing in biotech. Hi Harrys, Found this interesting NEJM article about diabetics and stents (published today!). I know you will like it. It might help you clarify the difference between carotid and coronary stents and show the literature is a bit more complex (and sophisticated) than you seem to have assumed. Enjoy! www.nejm.org/doi/full/10.1056/NEJMoa1510188Paclitaxel-Eluting versus Everolimus-Eluting Coronary Stents in Diabetes the TUXEDO Investigators October 14, 2015 BACKGROUND The choice of drug-eluting stent in the treatment of patients with diabetes mellitus and coronary artery disease who are undergoing percutaneous coronary intervention (PCI) has been debated. Previous studies comparing paclitaxel-eluting stents with stents eluting rapamycin (now called sirolimus) or its analogues (everolimus or zotarolimus) have produced contradictory results, ranging from equivalence between stent types to superiority of everolimus-eluting stents. METHODS We randomly assigned 1830 patients with diabetes mellitus and coronary artery disease who were undergoing PCI to receive either a paclitaxel-eluting stent or an everolimus-eluting stent. We used a noninferiority trial design with a noninferiority margin of 4 percentage points for the upper boundary of the 95% confidence interval of the risk difference. The primary end point was target-vessel failure, which was defined as a composite of cardiac death, target-vessel myocardial infarction, or ischemia-driven target-vessel revascularization at the 1-year follow-up. RESULTS At 1 year, paclitaxel-eluting stents did not meet the criterion for noninferiority to everolimus-eluting stents with respect to the primary end point (rate of target-vessel failure, 5.6% vs. 2.9%; risk difference, 2.7 percentage points [95% confidence interval, 0.8 to 4.5]; relative risk, 1.89 [95% confidence interval, 1.20 to 2.99]; P=0.38 for noninferiority). There was a significantly higher 1-year rate in the paclitaxel-eluting stent group than in the everolimus-eluting stent group of target-vessel failure (P=0.005), spontaneous myocardial infarction (3.2% vs. 1.2%, P=0.004), stent thrombosis (2.1% vs. 0.4%, P=0.002), target-vessel revascularization (3.4% vs. 1.2%, P=0.002), and target-lesion revascularization (3.4% vs. 1.2%, P=0.002). CONCLUSIONS In patients with diabetes mellitus and coronary artery disease undergoing PCI, paclitaxel-eluting stents were not shown to be noninferior to everolimus-eluting stents, and they resulted in higher rates of target-vessel failure, myocardial infarction, stent thrombosis, and target-vessel revascularization at 1 year. (Funded by Boston Scientific; TUXEDO–India Clinical Trials Registry–India number, CTRI/2011/06/001830). |
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Post by suebeeee1 on Oct 14, 2015 21:17:17 GMT -5
Both articles seem to have been translated into another language and then transferred back. The first article "med.news.am" seems to be a Eastern European/Turkish Language site and I have no idea about the other...except that it seem to written in bad English. Does that tell us that Afrezza is being made available to these countries? |
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Post by jgv on Oct 14, 2015 21:16:56 GMT -5
It is highly unlikely the practitioners at the Cleveland Clinic will be some of the first to adopt Afrezza. Many of the practitioners there are dinosaurs and their advice to patients is super conservative and plagued with medical dogma. It is a VERY conservative health organization. Who killed the Coronary Artery Calcium Scan in lieu of the medieval stint....? Once again... The things you say are totally without merit. The Cleveland clinic is a premiere academic teaching hospital. I have collaborated on research with MDs from the institution and have colleagues who work there. The things you say are absurd!!! Some of its departments are the best in the world!!!! The fact that you site the CA Ca++ stent is further demonstration you are an investor with ZERO medical knowledge. It is absolutely golden that they are using Affrezza. It's further support for the usefulness of the product. As a matter of fact, most medical change occurs at the level of the academic institution and then trickles out to community physicians. I love that you say "many" of their practitioners are dinosaurs and they are "plagued" with dogma. Is that why they are using a new drug like Affreza?? Nothing you say ever adds up. LOL. Like I've said RE: posts from you in the past.... Just because you write it doesn't make it true.... And what you've written here is 100% false!! |
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