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Post by bill on Nov 25, 2015 12:42:09 GMT -5
From WebMD:
"For people without diabetes, the normal range for the hemoglobin A1c test is between 4% and 5.6%. Hemoglobin A1c levels between 5.7% and 6.4% indicate increased risk of diabetes, and levels of 6.5% or higher indicate diabetes. Because studies have repeatedly shown that out-of-control diabetes results in complications from the disease, the goal for people with diabetes is a hemoglobin A1c less than 7%. The higher the hemoglobin A1c, the higher the risks of developing complications related to diabetes."
It seems to me that the reason the medical community has chosen a goal of 7% for A1c is not because you can't lower it further with more insulin, but that if you did so too many patients would run too high a risk of hypoglycemia. The value seems to have been set based on available drugs/technology, not desired medical outcome.
Now that Afrezza is available, it's becoming ever clearer that the target for Afrezza users could safely be lowered to be something much close to the 4% to 5.6% normal range. The lower the A1c the lower the risks of developing complications related to diabetes. Being below 7% still exposes PWD to complications. Shouldn't physicians be encouraged to lower the target A1c levels for patients taking Afrezza; perhaps to something closer to 6%?
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Post by longinvstr on Nov 25, 2015 13:20:38 GMT -5
From WebMD:
"For people without diabetes, the normal range for the hemoglobin A1c test is between 4% and 5.6%. Hemoglobin A1c levels between 5.7% and 6.4% indicate increased risk of diabetes, and levels of 6.5% or higher indicate diabetes. Because studies have repeatedly shown that out-of-control diabetes results in complications from the disease, the goal for people with diabetes is a hemoglobin A1c less than 7%. The higher the hemoglobin A1c, the higher the risks of developing complications related to diabetes."
It seems to me that the reason the medical community has chosen a goal of 7% for A1c is not because you can't lower it further with more insulin, but that if you did so too many patients would run too high a risk of hypoglycemia. The value seems to have been set based on available drugs/technology, not desired medical outcome.
Now that Afrezza is available, it's becoming ever clearer that the target for Afrezza users could safely be lowered to be something much close to the 4% to 5.6% normal range. The lower the A1c the lower the risks of developing complications related to diabetes. Being below 7% still exposes PWD to complications. Shouldn't physicians be encouraged to lower the target A1c levels for patients taking Afrezza; perhaps to something closer to 6%?
Bingo!! The combination of a non-invasive CGM device (Google? - easy, cool, immediate & simple) and Afrezza WILL redefine diabetic compliance Que Jeopardy theme song & unshakable patience |
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Post by suebeeee1 on Nov 25, 2015 13:35:59 GMT -5
If my husband is any indication of the effectiveness of this drug, with his drop of 1.3 in the first three months, why wouldn't we fight for more "normal" numbers.
No craziness. No testing. Just breathe. Even a lazish type 2 can do it!
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Post by stevil on Nov 25, 2015 14:03:42 GMT -5
The biggest change to A1c happens in that 90-120 day window. The full name of A1c is actually hemoglobin A1c. The reason you see the biggest change in the 90-120 day window is because the test is designed to see how saturated hemoglobin is with sugar. Hemoglobin's life is only 90-120 days...
So any decreases past that point are likely due to a better understanding of how to use the medication, as well as changes to diet and exercise. This is what confuses me about why results showing superiority are taking so long (since, by all accounts, Afrezza should be lowering A1c better than other prandials). The tests only need to take up to 3 months to show this. It's been 9 since Afrezza hit the market. They should have been running simultaneous studies with several different methods to find the best results. I can't imagine the social media folk are the only ones that have been having better success with Afrezza. One would think that lower A1c numbers alone would be enough to claim superiority, since that's the benchmark for how well insulin is working.
I haven't researched as well as some of you on here, but the best I've seen Afrezza get to was in the 5.4/5.5% range (for type 1's. Let me know if this isn't accurate), so it may be expecting too much to get it sub 5, unless they somehow discover it's really hard to overdose on the stuff. Basals are also responsible for keeping A1c low. Hopefully with Toujeo being more concentrated and having better control better results are on the way.
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Post by compound26 on Nov 25, 2015 14:16:14 GMT -5
The biggest change to A1c happens in that 90-120 day window. The full name of A1c is actually hemoglobin A1c. The reason you see the biggest change in the 90-120 day window is because the test is designed to see how saturated hemoglobin is with sugar. Hemoglobin's life is only 90-120 days... So any decreases past that point are likely due to a better understanding of how to use the medication, as well as changes to diet and exercise. This is what confuses me about why results showing superiority are taking so long (since, by all accounts, Afrezza should be lowering A1c better than other prandials). The tests only need to take up to 3 months to show this. It's been 9 since Afrezza hit the market. They should have been running simultaneous studies with several different methods to find the best results. I can't imagine the social media folk are the only ones that have been having better success with Afrezza. One would think that lower A1c numbers alone would be enough to claim superiority, since that's the benchmark for how well insulin is working. I haven't researched as well as some of you on here, but the best I've seen Afrezza get to was in the 5.4/5.5% range, so it may be expecting too much to get it sub 5, unless they somehow discover it's really hard to overdose on the stuff. Basals are also responsible for keeping A1c low. Hopefully with Toujeo being more concentrated and having better control better results are on the way. So far the best A1C for Afrezza users I have seen is 4.8: www.afrezzajustbreathe.com/a1cs-of-afrezza-users/. Also it appears this guy's A1C is keeping getting better. “T1 since 1984 ……….. Hba1C: most recent 6.4, 3 months prior 7.7, 3 months prior 9.4 9.4 was prior to being on Afrezza 7.7 was the day before I got the Dexcom 6.4 was 3 months after the Dexcom Presently my Dexcom says my 3 month average is at a 5.9, lowest I’ve ever had it. Proof is in the puding as they say!” www.tudiabetes.org/forum/t/type-2-new-to-cgm-getting-a-g5-what-to-expect/48355/5 |
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Post by stevil on Nov 25, 2015 14:27:53 GMT -5
The biggest change to A1c happens in that 90-120 day window. The full name of A1c is actually hemoglobin A1c. The reason you see the biggest change in the 90-120 day window is because the test is designed to see how saturated hemoglobin is with sugar. Hemoglobin's life is only 90-120 days... So any decreases past that point are likely due to a better understanding of how to use the medication, as well as changes to diet and exercise. This is what confuses me about why results showing superiority are taking so long (since, by all accounts, Afrezza should be lowering A1c better than other prandials). The tests only need to take up to 3 months to show this. It's been 9 since Afrezza hit the market. They should have been running simultaneous studies with several different methods to find the best results. I can't imagine the social media folk are the only ones that have been having better success with Afrezza. One would think that lower A1c numbers alone would be enough to claim superiority, since that's the benchmark for how well insulin is working. I haven't researched as well as some of you on here, but the best I've seen Afrezza get to was in the 5.4/5.5% range, so it may be expecting too much to get it sub 5, unless they somehow discover it's really hard to overdose on the stuff. Basals are also responsible for keeping A1c low. Hopefully with Toujeo being more concentrated and having better control better results are on the way. So far the best A1C for Afrezza users I have seen is 4.8: www.afrezzajustbreathe.com/a1cs-of-afrezza-users/. Also it appears this guy's A1C is keeping getting better. “T1 since 1984 ……….. Hba1C: most recent 6.4, 3 months prior 7.7, 3 months prior 9.4 9.4 was prior to being on Afrezza 7.7 was the day before I got the Dexcom 6.4 was 3 months after the Dexcom Presently my Dexcom says my 3 month average is at a 5.9, lowest I’ve ever had it. Proof is in the puding as they say!” www.tudiabetes.org/forum/t/type-2-new-to-cgm-getting-a-g5-what-to-expect/48355/5We need more numbers like that then! Wow. If this proves to be the trend, I'm not sure what trouble SNY would have proving superiority |
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Post by compound26 on Nov 25, 2015 14:53:24 GMT -5
We need more numbers like that then! Wow. If this proves to be the trend, I'm not sure what trouble SNY would have proving superiority The potential is certainly there: www.afrezzajustbreathe.com/afrezza-quality-of-life/www.afrezzajustbreathe.com/bg-control-on-afrezza-monthly-and-weekly-numbers/It is not simply better control. It is better control + less effort + better quality of life.
See this comment posted in Tudiabetes.org: www.tudiabetes.org/forum/t/afrezza-on-youtube/48776/4“ It’s effortless. I’ve said it before but I’ll say it again— I had the skills, tools, motivation, and education to maintain an a1c in the low 5s without afrezza— with afrezza I do it without any of those things! It commands about 5% of my life to have perfect control of diabetes instead of 90%. I feel sorry for anyone who hasn’t tried it— there is a better way, people.” I believe the main reason our scripts are still low is the low awareness (not only of the product itself, but also, and, more importantly, its effectiveness) by both the patients and the doctors. Of course the poor insurance coverage and relatively high prices are barriers, but with higher awareness, our scripts would be many times of our current numbers even with the poor insurance coverage and relatively high prices. |
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Post by longinvstr on Nov 25, 2015 15:45:22 GMT -5
We need more numbers like that then! Wow. If this proves to be the trend, I'm not sure what trouble SNY would have proving superiority The potential is certainly there: www.afrezzajustbreathe.com/afrezza-quality-of-life/www.afrezzajustbreathe.com/bg-control-on-afrezza-monthly-and-weekly-numbers/It is not simply better control. It is better control + less effort + better quality of life.
See this comment posted in Tudiabetes.org: www.tudiabetes.org/forum/t/afrezza-on-youtube/48776/4“ It’s effortless. I’ve said it before but I’ll say it again— I had the skills, tools, motivation, and education to maintain an a1c in the low 5s without afrezza— with afrezza I do it without any of those things! It commands about 5% of my life to have perfect control of diabetes instead of 90%. I feel sorry for anyone who hasn’t tried it— there is a better way, people.” I believe the main reason our scripts are still low is the low awareness (not only of the product itself, but also, and, more importantly, its effectiveness) by both the patients and the doctors. Of course the poor insurance coverage and relatively high prices are barriers, but with higher awareness, our scripts would be many times of our current numbers even with the poor insurance coverage and relatively high prices. As widely misunderstood as our flat world w/ a revolving sun 500 years ago --> Afrezza for needle phobic, boutique/specialty drug characterization That is not the thing The thing is --> "better control + less effort + better quality of life" (read = no amputations, blindness, neuropathy, hypertension) It is for anyone with diabetes who doesn't want to work so hard managing it and would like to improve their health = more for less. Americans have earned the - more for less - label (among others) but that is an evolutionary advantage, programmed behavior that is inherant to all. Mankind is advantaged thru conservation of effort for equal/better outcomes Re-que jeopardy theme & unshakable patience |
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Post by uvula on Nov 25, 2015 16:38:50 GMT -5
Most doctors are still leery of new drugs and would rather have their patients be stable at 7 then dead at 5. We believe that afrezza is safe enough to get to 5 but the FDA and ADA have never stated this. Hopefully it is just a matter of time until they are educated or the appropriate studies are done. Very few patients are going to educate themselves and will do what their doctor tells them to do.
A similar question is whether an A1C of 4.5 is better than 5.5. If so then maybe it makes sense for nondiabetic people to use afrezza to lower their "normal" A1C levels.
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