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Post by sayhey24 on Feb 20, 2017 9:29:54 GMT -5
You are correct and Compound26 posted the trial info on the previous page. Pages 85 and 89 of the Afrezza FDA briefing documents: www.fda.gov/downloads/AdvisoryCommittees/CommitteesMeetingMaterials/Drugs/EndocrinologicandMetabolicDrugsAdvisoryCommittee/UCM390864.pdfBut think about the question. Does human insulin cause weight gain? This suggests to me either the sales rep did not impress upon the doctors what afrezza is and how its pharmakinetics mimic the pancreas or the doctors do not know what insulin does or do not understand the importance and uniqueness of having the same pharmakinetics as a healthy pancreas and why that is so important for proper liver function including preventing hypoglycemia. Human insulin causes weight gain. If I was a salesman I would avoid getting into mechanisms because that can invite disaster - it is sufficient to say Afrezza does not seem to according to the trials data and to give that data to the doctor. It answers their question and shuts down an objection which is the result you want. Once you get into mechanisms you are on very shaky ground because insulin is only one corner of the glucose metabolism and diabetes is a disorder of the entire glucose metabolism, not just insulin. For example an insulin release it accompanied by a glucagon release and an amylin release amongst others, and when you take insulin rather than using your own insulin all of this is missing. People focus on glucose levels because they are easily measured but they are just one aspect of diabetes. In addition to the combo releases and counter-regulations above you find if you have diabetes taking vitamin D is pretty much mandatory because in most cases you have a deficiency. Likewise B12 is a good idea. Exactly why these vitamins are deficient or now play an outsized role is a research topic, it's just that they do. These are some of the problems a salesman is going to walk into if they attempt to get debate this with endos - my bet is that most salesmen are not up to this debate so stick to the trials data and sell off that because it is defensible. The insulin secreted from the pancreas does not cause weight gain. What causes weight gain is too much food which gets converted into glucose. What also causes weight gain in out of control PWDs who are dehydrated from pissing sugar and see water retention when they start to re-hydrate. My point is the endos should know this about de-hydration. But then again you get a BP who spins whats bad as something good and the endos believe them and you get Invokana that advertises weight loss as a benefit when all they are doing is causing the PWD to de-hydrate. Here is a write-up from Joslin the sales team can carry - www.joslin.org/info/why_did_i_gain_weight_when_i_started_taking_insulin.htmlWhat causes the weight gain with the "hexamer human insulin" you are referring to and other Analogs which do not work anything like afrezza or pancreatic insulin is the constant snacking to prevent hypos. I had a colleague who at 10am every morning would drink a Mountain Dew as a preemptive strike to avoid a feared hypo. With afrezza he can now save the 290 calories. If you can save 500 to 1000 calories per day by not needing these snacks you will see weight loss. If you cut out some of the carbs you will see even more. As they start getting their sugar under control and start feeling better and you get them to exercise they should even see a little more. BTW - The pancreas releases glucagon when the concentration of glucose in the bloodstream falls too low. It actually has the opposite effect of insulin. |
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Post by agedhippie on Feb 20, 2017 15:23:50 GMT -5
Human insulin causes weight gain. If I was a salesman I would avoid getting into mechanisms because that can invite disaster - it is sufficient to say Afrezza does not seem to according to the trials data and to give that data to the doctor. It answers their question and shuts down an objection which is the result you want. Once you get into mechanisms you are on very shaky ground because insulin is only one corner of the glucose metabolism and diabetes is a disorder of the entire glucose metabolism, not just insulin. For example an insulin release it accompanied by a glucagon release and an amylin release amongst others, and when you take insulin rather than using your own insulin all of this is missing. People focus on glucose levels because they are easily measured but they are just one aspect of diabetes. In addition to the combo releases and counter-regulations above you find if you have diabetes taking vitamin D is pretty much mandatory because in most cases you have a deficiency. Likewise B12 is a good idea. Exactly why these vitamins are deficient or now play an outsized role is a research topic, it's just that they do. These are some of the problems a salesman is going to walk into if they attempt to get debate this with endos - my bet is that most salesmen are not up to this debate so stick to the trials data and sell off that because it is defensible. The insulin secreted from the pancreas does not cause weight gain. What causes weight gain is too much food which gets converted into glucose. What also causes weight gain in out of control PWDs who are dehydrated from pissing sugar and see water retention when they start to re-hydrate. My point is the endos should know this about de-hydration. But then again you get a BP who spins whats bad as something good and the endos believe them and you get Invokana that advertises weight loss as a benefit when all they are doing is causing the PWD to de-hydrate. Here is a write-up from Joslin the sales team can carry - www.joslin.org/info/why_did_i_gain_weight_when_i_started_taking_insulin.htmlWhat causes the weight gain with the "hexamer human insulin" you are referring to and other Analogs which do not work anything like afrezza or pancreatic insulin is the constant snacking to prevent hypos. I had a colleague who at 10am every morning would drink a Mountain Dew as a preemptive strike to avoid a feared hypo. With afrezza he can now save the 290 calories. If you can save 500 to 1000 calories per day by not needing these snacks you will see weight loss. If you cut out some of the carbs you will see even more. As they start getting their sugar under control and start feeling better and you get them to exercise they should even see a little more. BTW - The pancreas releases glucagon when the concentration of glucose in the bloodstream falls too low. It actually has the opposite effect of insulin. I think this is a good example of why endos rely on trial data. If you are sufficiently out of control to be continually pissing sugar and water then you really need to change your doctor because your current one is falling down on the job. Dehydration is not your problem, electrolyte imbalances are a far bigger risk under those circumstances. I have no idea where the idea that diabetics are constant snacking comes from, I don't do it and nor do most of the other diabetics I know do it. Your colleague sounds like his insulin does was way off, or maybe it was NPH. The idea it was NPH would make sense because it had a series of sharp spikes. If he was on analogs then he has screwed up his doses because a can of Mountain Dew is 46g of carbs which equates to around a 180 point rise in his levels and that is taking a lot of insulin. The pancreas also releases some glucagon with insulin as it provides energy for digestion etc. and prevents any overshoot on the insulin. |
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