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Post by sayhey24 on Feb 24, 2017 19:19:37 GMT -5
post your continuous glucose monitor screens for a week. I want to see how high and low you are going.
those occasional sometimes once a day 70mg/dl's I see. Aged can you feel that?
On a side note, blood glucose running 70 mg/dl or below? drink an apple juice box. Eat an orange. Down a skittle.
I still want to see your screens. I can feel 70 most of the time. The trick is to tell if it's a real low or just hunger. I use Skittles or glucose tablets, they are faster than juices for me. Mostly it's Skittles though because they take longer to eat. The problem is I can eat my 15g of glucose really fast and then I have to wait 15 minutes which is hard, the temptation is to eat more because the glucose hasn't hit yet and your body is still ring the alarms. Skittles are fast but keep you occupied if you eat them individually so it burns time and makes overeating less likely. With a bad (for me) low in the 40s I have been known to try and eat the entire contents of the refrigerator - you go into a food frenzy and if a portion of ice cream is good then the entire tub must be excellent, oh and look there is a liter of juice, oooh biscuits... The ensuing high is bad, but the feeling of nausea from what you ate is worse My number have slipped - My year end A1c was 7.1 which is off from 6.3 before that. I need to get a new transmitter (yes I am idle) but once I have done that I will post some screens. I do much better on a CGM because it prods me to dose properly! Aged - do you use afrezza, never used it, used it but didn't like it or something else?
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Post by agedhippie on Feb 24, 2017 19:29:02 GMT -5
Never used it. I inquired about it once but my endo said no and largely I go with what he says. I am dithering about getting my PCP to prescribe despite that.
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Post by sayhey24 on Feb 24, 2017 20:24:24 GMT -5
Never used it. I inquired about it once but my endo said no and largely I go with what he says. I am dithering about getting my PCP to prescribe despite that. It would be interesting to get your experiences. I hope you persist. I was diagnosed as early T2 and doctor suggested metformin or "maybe some walking until it gets worse". I suggested a better plan, early insulin intervention using afrezza. Currently using nothing but low carb but not crazy diet and exercise. FBG is now always sub 100. I have some beta loss but most was recovered. I don't know how long it will last but I gave my Libre to my friend as I only test a few times a week.
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Post by mango on Feb 24, 2017 20:42:45 GMT -5
Never used it. I inquired about it once but my endo said no and largely I go with what he says. I am dithering about getting my PCP to prescribe despite that. Why did your endo say no?
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Post by agedhippie on Feb 25, 2017 11:22:40 GMT -5
Never used it. I inquired about it once but my endo said no and largely I go with what he says. I am dithering about getting my PCP to prescribe despite that. It would be interesting to get your experiences. I hope you persist. I was diagnosed as early T2 and doctor suggested metformin or "maybe some walking until it gets worse". I suggested a better plan, early insulin intervention using afrezza. Currently using nothing but low carb but not crazy diet and exercise. FBG is now always sub 100. I have some beta loss but most was recovered. I don't know how long it will last but I gave my Libre to my friend as I only test a few times a week. I have an appointment with my endo next week so I will ask again. Your approach sounds good and if you have a FBG below 100 then personally I would avoid taking anything. At that level your beta cells are not being stressed so early insulin would not really gain you much in my opinion. You will likely continue to lose beta cells with time since that's what the underlying mechanism of Type 2 is (there is a fixed decline which is untreatable and a variable decline on top that is treatable - early insulin helps give back the variable loss). Make the most of not have to take anything, it won't last (says the little ray of sunshine )
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Post by agedhippie on Feb 25, 2017 11:35:31 GMT -5
Never used it. I inquired about it once but my endo said no and largely I go with what he says. I am dithering about getting my PCP to prescribe despite that. Why did your endo say no? They had a concern about pulmonary fibrosis (interestingly they had no concern at all with cancer -I asked specifically).They had put quite a lot of people onto Exubera when it came out and they thought that they were starting to see an uptick in pulmonary fibrosis. Pfizers would not give them the data they asked for when they were assessing this. At that point Exubera was withdrawn so it didn't matter. Their concern is that Afrezza will exhibit the same characteristics so they were holding back for the lung safety trial results. Now I think they may change as they are already thinking about it as a rescue inhaler for corrections (there was an internal talk on this last May) so there could be movement.
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Post by lennymnkd on Feb 25, 2017 12:17:24 GMT -5
How long was Exubera prescribed for / long enough to develope pulmonary fibrosis ? ?
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Post by peppy on Feb 25, 2017 12:37:09 GMT -5
How long was Exubera prescribed for / long enough to develope pulmonary fibrosis ? ? www.accessdata.fda.gov/drugsatfda_docs/nda/2006/021868s000_PharmR.pdf
reading the fda approval information. A difference I see. In the exubera primary pharmadynamics; "Insulin receptors are found in most tissues including lung." Suggesting to my understanding, proteins in the cells of the trachea, "receptors" are "proteins" were to take in the insulin?
Technosphere, to the alveoli. the exchange happens there. The insulin into the blood stream. you know the exchange, O2 <-> CO2
Am I reading these correctly?
Additionally here is the list of ingredients in exubera. 20 insulin plus
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Post by agedhippie on Feb 25, 2017 17:51:18 GMT -5
How long was Exubera prescribed for / long enough to develope pulmonary fibrosis ? ? It's not certain that it did cause fibrosis, they just said they thought it might have. The fact that Pfizer clammed up when they asked made them think it might well have been real. This rather poisoned the well for Afrezza by made them more cautious than they might otherwise have been (thins time we wait and see). On this topic - when do the extended lung trials have to start that the FDA mandated?
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Post by peppy on Feb 26, 2017 10:49:40 GMT -5
How long was Exubera prescribed for / long enough to develope pulmonary fibrosis ? ? www.accessdata.fda.gov/drugsatfda_docs/nda/2006/021868s000_PharmR.pdf
reading the fda approval information. A difference I see. In the exubera primary pharmadynamics; "Insulin receptors are found in most tissues including lung." Suggesting to my understanding, proteins in the cells of the trachea, "receptors" are "proteins" were to take in the insulin?
Technosphere, to the alveoli. the exchange happens there. The insulin into the blood stream. you know the exchange, O2 <-> CO2
Am I reading these correctly?
Additionally here is the list of ingredients in exubera. 20 insulin plus
I am surprised. the exubera ingredients reads like a food label. What is surprising me is, "No comment from the peanut gallery." Are you shocked? Did you know all along? Does it make you wonder?
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Post by sayhey24 on Feb 26, 2017 14:29:40 GMT -5
www.accessdata.fda.gov/drugsatfda_docs/nda/2006/021868s000_PharmR.pdf
reading the fda approval information. A difference I see. In the exubera primary pharmadynamics; "Insulin receptors are found in most tissues including lung." Suggesting to my understanding, proteins in the cells of the trachea, "receptors" are "proteins" were to take in the insulin?
Technosphere, to the alveoli. the exchange happens there. The insulin into the blood stream. you know the exchange, O2 <-> CO2
Am I reading these correctly?
Additionally here is the list of ingredients in exubera. 20 insulin plus
I am surprised. the exubera ingredients reads like a food label. What is surprising me is, "No comment from the peanut gallery." Are you shocked? Did you know all along? Does it make you wonder?
I am sure you have read this before but its always a good second read - keep in mind FDKP is a nano particle and passes through the lung lining. This is night and day from Exubera www.mannkindcorp.com/Collateral/Documents/English-US/Innovation%20In%20Drug%20Delivery%20by%20Inhalation.pdf"The fumaryl diketopiperazine (FDKP) is absorbed but not metabolised, and is excreted intact, primarily in urine. FDKP does not directly facilitate drug absorption, but functions solely as the particle matrix. Taken together, these unique features contribute to the distinctive pharmacokinetic profiles of drugs administered as Technosphere powders." Awhile back I met by chance a fellow who represented himself as the lead chemist for Exubera development. I was talking to him on a different subject. We got into a long discussion on Exubera and afrezza safety, especially cancer. It was his opinion that while Exubera had no safety issues and no chance of causing cancer, FDKP and monomer were as safe as you can get. He did say that in his opinion the Exubera FUD was to try and kill afrezza from getting to market and he felt that very strongly. If you look at the Adcom document when the FDA talks of lung safety its always about something with Exubera, i.e "while we saw no indications with afrezza we saw this with Exubera". Again, your Exubera food label is nothing like the FDKP nano particle. As knowledgeable as AgedHippie is, I would really like to his/her opinion after using afrezza. If Exubera's chemist is correct and now we are starting to see user results after 2 years and no concerns I have seen, maybe his/her doctor will change their mind.
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Post by peppy on Mar 2, 2017 23:10:22 GMT -5
To our MNKD sales team.
Hello, my fake name, and nickname is peppy. It is up to you all now. We all want to make money, you to live, me to recoup the investment. Here is what I want to say. The refill rate, so difficult to understand what was going on. Then I looked and there it is in front of my face, look at this data. See the increase in afrezza doses between week 1 and week 12? These people are getting 3 month prescriptions? so by the end of three months the dose has gone up so much they think it isn't working? is my hypothesis.
You all probably know and have a way to address this already. here is what my little brain thinks. We have to tell the physician, so the physician can tell the diabetic what to expect. That is all I can think of to do.
I am sure you are all on top of this and I am dust in the wind. I am good with that. Such a fine insulin. You are our team. Good luck to us all. pep
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Post by mnholdem on Mar 3, 2017 9:36:09 GMT -5
"We all want...you to live..."
That sounds like a threat, peppy.
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Post by peppy on Mar 3, 2017 10:02:13 GMT -5
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Post by dreamboatcruise on Mar 3, 2017 16:50:04 GMT -5
"We all want...you to live..."
That sounds like a threat, peppy. Is that our new sales rep strategy for docs... "Mannkind wants everyone to live... prescribing Afrezza could be a life saver... Capiche?" Ray Liotta could be the corporate spokesperson.
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