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Post by sayhey24 on Jun 14, 2017 18:52:54 GMT -5
My endo told me that Insulin resistance is reversible. It is caused by inactivity. Get active. Stay active. However, your pancreas's capacity to deliver insulin is genetically pre-determined. Use it slow or use it fast by eating more or less carbs per meal. You will only have so much insulin to secrete over your lifetime. Possible exception is that there is some evidence that "starvation mimicking" diets can regenerate beta cells in the pancreas. It is partially reversible. Weight loss will do it, as will metformin to a degree, and TZDs. The idea that only have so much insulin to secrete over your lifetime is wrong though. Your beta cells are continually dying off and being replaced with fresh cells (as are all your cells). The issue for Type 2 diabetics are that they are not being replaced as fast as they are dying off - this is not an issue with non-diabetics though. The issue with T2s is they are not producing enough insulin at meal time, which causes meal time BG spikes which then takes BG levels too high and then it takes the pancreas which is already damaged to work overtime to bring the BG down, which over time it does not. Metofrmin only makes things worse over the long term as it does not address the root cause - insufficient meal time insulin. Get the BG down into near-normal range and in 3 to 6 months most T2s will see some reversal. Only insulin can do this and afrezza is by far the best for this. Reduced carbs will lower the initial BG spike and will probably result in some weight loss but if you are spiking only insulin can bring down the sugar level. Now instead of messing up your liver and heart with TZDs a nice walk would be more helpful. Bottom line is no need for metformin or TZDs or any of the other 39 drugs introduced since 2005 if you properly treat the meal time spikes. As Dr. Edelman the big afrezza fan said the other day we have enough drugs we don't need more. Now - my understanding which may be incorrect is VDEX went directly to MNKD in late 2015 and cut a deal to buy direct. Remember they pitched 100 locations by 2018. If that is the case VDEX script numbers would not be in Symphony numbers. Then again I have seen tweets say VDEX PWDs went to other pharmacies so maybe not all VDEX numbers are in the weekly numbers. My understanding is Dachis is attempting to do something similar for a direct deal his OneDrop/Amazon plan. |
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Post by sayhey24 on Jun 14, 2017 19:17:47 GMT -5
It is partially reversible. Weight loss will do it, as will metformin to a degree, and TZDs. The idea that only have so much insulin to secrete over your lifetime is wrong though. Your beta cells are continually dying off and being replaced with fresh cells (as are all your cells). The issue for Type 2 diabetics are that they are not being replaced as fast as they are dying off - this is not an issue with non-diabetics though. Right, so what do endos know anyway. But my endo may be on to something with the more or less predetermined pancreatic insulin life expectancy if you think about the oxygen demand of the pancreas, vascular and other structural maintenance that has to compete with aging and everyday abuse...it would seem that many, especially non-obese type 2s simply outlive their beta cells (ie its not really the insulin resistance that gets them in the end) The debate about beta cell regeneration goes on. Faustman notes that mice regenerate readily. But that has not been the conventional assumption for people. The speak of needing some trick or compound. And even then it appears you may only be able to convert alpha cells to betas, which means you will have fewer alphas-whatever that implies for your health. Faustman was one of first to note residual insulin and its potential importance if the auto-immune system can be reset by BCG vaccine. She is hopeful that BCG may also facilitate some beta cell regeneration-by what process I don't think they have said (or know of) yet. My fingers and toes are crossed!! Want somewhere else to "invest" your money? They take donations. A predetermined pancreatic insulin life expectancy - interesting. What we do know is obese non-diabetics have pancreas's which have grow big clumps of extra beta cells versus obese diabetics which have lost beta cell function. There are numerous studies on this. Overall I would say your endo is going down the wrong track. We have 40+ years of studies which demonstrate beta cell regeneration will happen when blood sugar is brought back to normal levels. We also know that diabetes is partially genetic but not totally. This we know from studying twins. It does seem environment plays a part. In some causes it may be an infection in other cases something else. There are even some studies which point to BPA in some cases. The chicken-egg debate is beta cell damage vs. insulin resistance, which comes first. What we do know is glucose toxicity will kill beta cells and high sugar causes insulin resistance. Over the last few days I have read too much of Faustman's work. Her work is targeting the T1 auto-immune issue with T cells. Some T2s show an auto-immune response but for some reason their bodies can fight off the attack but it leaves the pancreas with some damaged beta-cells. |
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Post by mnkdfann on Jun 14, 2017 19:42:34 GMT -5
Now - my understanding which may be incorrect is VDEX went directly to MNKD in late 2015 and cut a deal to buy direct. Remember they pitched 100 locations by 2018. If that is the case VDEX script numbers would not be in Symphony numbers. Any idea where you saw / heard this, about VDEX buying direct? I would think MNKD would mention this - indeed, shout it from the rooftops - if it were the case. |
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Post by sayhey24 on Jun 14, 2017 19:53:54 GMT -5
Now - my understanding which may be incorrect is VDEX went directly to MNKD in late 2015 and cut a deal to buy direct. Remember they pitched 100 locations by 2018. If that is the case VDEX script numbers would not be in Symphony numbers. Any idea where you saw / heard this, about VDEX buying direct? I would think MNKD would mention this - indeed, shout it from the rooftops - if it were the case. Pfeffer did talk about this back in early 2016. They even put targeting 100 sites by the end of 2018 on the 2.0 document. It just makes sense. If I were planning to do my own Vdex I would go to Mike just like Dachis just did. The question I have had is what happened to these guys??? One site? There was something about them taking it slow, proving the protocol. It seems the protocol and afrezza work better than most ever thought, including myself. Does anyone know? |
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Post by MnkdWASmyRtrmntPlan on Jun 14, 2017 20:09:57 GMT -5
Pfeffer did talk about this back in early 2016. They even put targeting 100 sites by the end of 2018 on the 2.0 document. It just makes sense. If I were planning to do my own Vdex I would go to Mike just like Dachis just did. The question I have had is what happened to these guys??? One site? There was something about them taking it slow, proving the protocol. It seems the protocol and afrezza work better than most ever thought, including myself. Does anyone know? No, I don't know ... sorry. And, I don't know how to start looking. I just want to say that if that is true, that is fantastic news if VDEX has the protocol just about finished and are ready to start growing their 100 stores by end of 2018 with a proven Afrezza protocol. That strategy is just what the doctor ordered. I hope you are right, seyhey. |
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Post by agedhippie on Jun 14, 2017 20:15:38 GMT -5
It is partially reversible. Weight loss will do it, as will metformin to a degree, and TZDs. The idea that only have so much insulin to secrete over your lifetime is wrong though. Your beta cells are continually dying off and being replaced with fresh cells (as are all your cells). The issue for Type 2 diabetics are that they are not being replaced as fast as they are dying off - this is not an issue with non-diabetics though. Right, so what do endos know anyway. But my endo may be on to something with the more or less predetermined pancreatic insulin life expectancy if you think about the oxygen demand of the pancreas, vascular and other structural maintenance that has to compete with aging and everyday abuse...it would seem that many, especially non-obese type 2s simply outlive their beta cells (ie its not really the insulin resistance that gets them in the end) The debate about beta cell regeneration goes on. Faustman notes that mice regenerate readily. But that has not been the conventional assumption for people. The speak of needing some trick or compound. And even then it appears you may only be able to convert alpha cells to betas, which means you will have fewer alphas-whatever that implies for your health. Faustman was one of first to note residual insulin and its potential importance if the auto-immune system can be reset by BCG vaccine. She is hopeful that BCG may also facilitate some beta cell regeneration-by what process I don't think they have said (or know of) yet. My fingers and toes are crossed!! Want somewhere else to "invest" your money? They take donations. I are pretty much correct about Type 2. The transcription error means that you hit that diabetic mark at varying ages. Young thin Type 2 tend to have a more aggressive error, elderly (late 70s) have less aggressive errors. Insulin resistance overlies that transcription error and amplifies the effect which is why weight loss helps. It's worth noting that non-diabetics get insulin resistance as well but their body adjusts and builds out sufficient beta cells to cope. Residual beta cells in Type 1 turn out to be common, it's just that the level is to low to be useful in most cases. They found this when they started doing the islet transplants. Up until then the assumption was that there was just a wasteland but it turns out people had anything up to 15% of their beta cells although 10% was more typical. It appears you keep making beta cells but the immune system keeps killing them. Faustman's work follows a common thread that if you can stop the autoimmune system from killing the beta cells they will regenerate in time. The other option is to speed up the regeneration to the point that it overwhelms the autoimmune system but the danger is a cytokine storm. Mount Sinai in NYC is doing research on finding compounds that will provoke beta cell growth. They are running huge cell line libraries against an array with firefly genes grafted in so beta cell growth causes that sample to literally light up. They have a couple of compounds but there is still the cytokine storm issue. Making large donations to medical research means that the fundraisers will make the researchers talk to you about their work.  There are seriously rich people out there (definitely not me) committing eye-watering amounts of funding. The thing with diabetes is that it hits their kids and it's chronic so it remains front and center. At that point the money is simply a tool if they can get a cure for their kid. Look at the Iacocca Foundation, they have given over $17 million to to Dr Faustman for her research and raised another $10 million. Annoyingly they can cure Type 1 in mice. Interferon or BCG will do the trick. I think there are some other treatments as well. It turns out the rodent model is not a good one for human diabetes. |
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Post by sayhey24 on Jun 14, 2017 20:52:50 GMT -5
The Iacocca Foundation could have had a significantly larger impact on the lives of diabetics if they had taken that $17M and opened a bunch of Vdex clinics or bought PSA announcements on TV about the importance of treating meal time BG spikes and how afrezza is unique in this regard.
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Post by careful2invest on Jun 14, 2017 22:41:34 GMT -5
Any idea where you saw / heard this, about VDEX buying direct? I would think MNKD would mention this - indeed, shout it from the rooftops - if it were the case. Pfeffer did talk about this back in early 2016. They even put targeting 100 sites by the end of 2018 on the 2.0 document. It just makes sense. If I were planning to do my own Vdex I would go to Mike just like Dachis just did. The question I have had is what happened to these guys??? One site? There was something about them taking it slow, proving the protocol. It seems the protocol and afrezza work better than most ever thought, including myself. Does anyone know? Sayhey, If I am not mistaken, someone posting on this mb is affiliated with VDEX, (owner possibly?) And again, if my memory serves me correctly, this person stated that the original plan was to open a few locations slowly and ramp up as you stated in your post. Then came the Sanofi debacle, major upheval, and understandably some investors backed out, putting an end to Plan A. Hopefully, once MNKD gets AFREZZA a bit more secured n the marketplace, the investors in Vdex will revisit their original plan and start opening more Vdex locations. If/when AFREZZA becomes a success, Vdex should become a hot commodity! Wendy's started with just one location too! As investors and/or supporters of MNKD, none of this has gone according to any of our plan and definitely not in our time line. At least now, people are finally learning about the benefits and the revolutionary potential of AFREZZA! Albeit very slowly, but IMHO, we are finally headed in the right direction! Let's hope!! GLTA! |
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Post by mnkdfann on Jun 14, 2017 23:49:01 GMT -5
Sayhey, If I am not mistaken, someone posting on this mb is affiliated with VDEX, (owner possibly?) And again, if my memory serves me correctly, this person stated that the original plan was to open a few locations slowly and ramp up as you stated in your post. Then came the Sanofi debacle, major upheval, and understandably some investors backed out, putting an end to Plan A. Hopefully, once MNKD gets AFREZZA a bit more secured n the marketplace, the investors in Vdex will revisit their original plan and start opening more Vdex locations. If/when AFREZZA becomes a success, Vdex should become a hot commodity! Wendy's started with just one location too! I think VDEX appeared on the scene AFTER Sanofi. The earliest mentions of it I can find are these (from February 2016): mnkd.proboards.com/thread/5234/vdex-diabetes-care-centersmnkd.proboards.com/thread/5235/david-warshawsky-diabetes-mannkind-facebook |
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Post by sayhey24 on Jun 15, 2017 5:23:46 GMT -5
Vdex came after Sanofi left as part of Mannkind 2.0. I had left a number of messages awhile back trying to understand what was going on. The original plan was to open in NJ.
Are they looking for funding? It seems like the PWDs using their protocol are having great success. We know the current T2 ADA Step protocol starting with metformin is not just a failure, its a huge failure.
A few things from ADA 2017 was the afrezza discussion on how well it worked but it was too expensive and too hard to get. A bunch of the top Endos are using it themselves and some after wanting no part of it 3 years ago. Now too expensive and too hard to get is not a product problem its a marketing problem.
Based on ADA 2017 I can't see any problem raising money for a Vdex venture. The oral pill is dead. The big ask about needing CGM data widely available is now reality. Now, maybe we can get the only thing which addresses root problem with T2s, meal time spike. As Edelman said we don't need more products but rather start using what we have.
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Post by brentie on Jun 15, 2017 6:03:08 GMT -5
I believe that this was the first mention of v-dex, it was at the J P Morgan Healthcare Conference January 13, 2016 where Matt said....
Likewise another idea and this kind of plays into the how do you get the patients to use the drug properly. An opportunistic thing that kind of came along, I've been talking with the group that’s put together something I think is very innovative and will make a big difference in the field of diabetes, which is specialized diabetes care centers.
Now this is something that requires no money at all for MannKind. Our participation is really just helping them with some ideas. We’ve allowed them to use the name Afrezza and kind of -- this is in its infancy, put it that way, but they’ve actually coined this term Real Time Diabetes Management powered by Afrezza.
It’s a very interesting concept. It’s used in another disease indication quite a lot, but their concept here and they approach us for how we like because frankly they love this product. They think it’s very nicely and what they‘re talking about, which is really real time control of diabetes with the product that has the kinetics of Afrezza that plays into it very nicely.
And if you give people an easy avenue where they can go one stop shop, dropping facility and the contracts they have right now are typically with origin care facilities and in fact a few of those now it will still be pilot facilities opening up as quickly as in the next month or two.
You can go in on a patients -- if the doctors have enough time to deal with their diabetic patients and unfortunately it's all too common in the world we live in today where doctors are called upon to see a number of patients in any 15-minute block.
It’s an easy referral into something that staff pioneers and practitioners and other educators they can just walk in and get their [indiscernible] test if they need it. Walk out with the prescription for Afrezza and be managed by closely at relatively low cost.
So it’s over the -- it’s the provision of an endocrinologist, but they're not seeing an endocrinologist all the time, but they’re getting a lot of help and management and importantly its people who understand Afrezza. So it’s a nice win-win scenario for us. Again it’s an early stage program, but we think it’s going to pay big dividends.
seekingalpha.com/article/3809206-mannkinds-mnkd-ceo-matt-pfeffer-presents-34th-annual-jpmorgan-healthcare-conference
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Post by promann on Jun 15, 2017 6:30:14 GMT -5
Regardless of when we first heard of VDex it's obvious it was in the planning stages far before Sanofi announced its separation. So I think the point of this discussion was that some creditors backed out when Sanofi left could still be feasible. I'm happy to hear Vdex is doing well and 300 new on Afrezza samples per month sounds great I hope to see them turning to real scripts soon. Hopefully we will see a modest script increase tommorow this is turning into a bad week because of last weeks script report. We need script numbers up and news on getting finances to increase our runway very soon to help our suffering stock price.. July is coming and I'm hoping for fireworks with MNKD.
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Post by peppy on Jun 15, 2017 6:49:55 GMT -5
Pfeffer did talk about this back in early 2016. They even put targeting 100 sites by the end of 2018 on the 2.0 document. It just makes sense. If I were planning to do my own Vdex I would go to Mike just like Dachis just did. The question I have had is what happened to these guys??? One site? There was something about them taking it slow, proving the protocol. It seems the protocol and afrezza work better than most ever thought, including myself. Does anyone know? Sayhey, If I am not mistaken, someone posting on this mb is affiliated with VDEX, (owner possibly?) And again, if my memory serves me correctly, this person stated that the original plan was to open a few locations slowly and ramp up as you stated in your post. Then came the Sanofi debacle, major upheval, and understandably some investors backed out, putting an end to Plan A.Hopefully, once MNKD gets AFREZZA a bit more secured n the marketplace, the investors in Vdex will revisit their original plan and start opening more Vdex locations. If/when AFREZZA becomes a success, Vdex should become a hot commodity! Wendy's started with just one location too! As investors and/or supporters of MNKD, none of this has gone according to any of our plan and definitely not in our time line. At least now, people are finally learning about the benefits and the revolutionary potential of AFREZZA! Albeit very slowly, but IMHO, we are finally headed in the right direction! Let's hope!! GLTA! my memory is different. vdex came after sanofi dropped MNKD. I too got the impression somewhere, that perhaps vdex could buy afrezza directly from mnkd. Trying to remember, who, what, when, where and why? I can not remember. Was it something mike C said to a conference call regarding people buying directly from MNKD? I can not remember when the possibility of vdex buying directly from MNKD became something that I think could be a possibility. Was it, afrezza could be ordered from MNKD directly, bypassing pharmacy, and MNKD would send the afrezza out?
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Post by derek2 on Jun 15, 2017 7:22:51 GMT -5
Sayhey, If I am not mistaken, someone posting on this mb is affiliated with VDEX, (owner possibly?) And again, if my memory serves me correctly, this person stated that the original plan was to open a few locations slowly and ramp up as you stated in your post. Then came the Sanofi debacle, major upheval, and understandably some investors backed out, putting an end to Plan A.Hopefully, once MNKD gets AFREZZA a bit more secured n the marketplace, the investors in Vdex will revisit their original plan and start opening more Vdex locations. If/when AFREZZA becomes a success, Vdex should become a hot commodity! Wendy's started with just one location too! As investors and/or supporters of MNKD, none of this has gone according to any of our plan and definitely not in our time line. At least now, people are finally learning about the benefits and the revolutionary potential of AFREZZA! Albeit very slowly, but IMHO, we are finally headed in the right direction! Let's hope!! GLTA! my memory is different. vdex came after sanofi dropped MNKD. I too got the impression somewhere, that perhaps vdex could buy afrezza directly from mnkd. Trying to remember, who, what, when, where and why? I can not remember. Was it something mike C said to a conference call regarding people buying directly from MNKD? I can not remember when the possibility of vdex buying directly from MNKD became something that I think could be a possibility. Was it, afrezza could be ordered from MNKD directly, bypassing pharmacy, and MNKD would send the afrezza out?
If this was the case, MNKD would be trumpeting it from the hill tops, along with the supposed 300 Rx per month (since MNKD would know the number, as they would be supplying the Afrezza directly to vdex, correct?) Regardless, I wish vdex nothing but success, and respect @sportsrancho for her support of them and their patients. In other news, my puts will all expire worthless tomorrow (well, the $1.50's have a bit of value, but not much). That's what can happen when you bet on a short-term move. Accumulating cash to put to work on the long side _AFTER_ MNKD gets sufficient funding to last until the end of 2018. I had hoped the puts would have supplied some of that, but I'll have to use earnest money instead (not the house's money). |
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Post by peppy on Jun 15, 2017 7:38:50 GMT -5
my memory is different. vdex came after sanofi dropped MNKD. I too got the impression somewhere, that perhaps vdex could buy afrezza directly from mnkd. Trying to remember, who, what, when, where and why? I can not remember. Was it something mike C said to a conference call regarding people buying directly from MNKD? I can not remember when the possibility of vdex buying directly from MNKD became something that I think could be a possibility. Was it, afrezza could be ordered from MNKD directly, bypassing pharmacy, and MNKD would send the afrezza out?
If this was the case, MNKD would be trumpeting it from the hill tops, along with the supposed 300 Rx per month (since MNKD would know the number, as they would be supplying the Afrezza directly to vdex, correct?) Regardless, I wish vdex nothing but success, and respect @sportsrancho for her support of them and their patients. In other news, my puts will all expire worthless tomorrow (well, the $1.50's have a bit of value, but not much). That's what can happen when you bet on a short-term move.
Accumulating cash to put to work on the long side _AFTER_ MNKD gets sufficient funding to last until the end of 2018. I had hoped the puts would have supplied some of that, but I'll have to use earnest money instead (not the house's money). quote: In other news, my puts will all expire worthless tomorrow (well, the $1.50's have a bit of value, but not much). That's what can happen when you bet on a short-term move. reply: yes, expiry today, three days to settle. |
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There are seriously rich people out there (definitely not me) committing eye-watering amounts of funding. The thing with diabetes is that it hits their kids and it's chronic so it remains front and center. At that point the money is simply a tool if they can get a cure for their kid. Look at the Iacocca Foundation, they have given over $17 million to to Dr Faustman for her research and raised another $10 million.
