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Post by bradleysbest on Mar 13, 2017 19:43:18 GMT -5
No shit Pep !
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Post by sportsrancho on Mar 13, 2017 19:45:10 GMT -5
Januvia & Farxiga are selling.....maybe DTC does work! Can you believe that chit is being prescribed?
Unbelievable. Killing you softly, with his song.
So Doc you are afraid afrezza might hurt me, and yet you are prescribing this chit? Am I stupid enough for you?
PWD see those on TV ALL the time! When ever I ask someone if they have heard about Afrezza they say no, but they are going to ask their doc for Januvia. I ask where they heard about it and they say they saw it on TV.
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Post by peppy on Mar 13, 2017 19:48:58 GMT -5
Can you believe that chit is being prescribed?
Unbelievable. Killing you softly, with his song.
So Doc you are afraid afrezza might hurt me, and yet you are prescribing this chit? Am I stupid enough for you?
PWD see those on TV ALL the time! When ever I ask someone if they have heard about Afrezza they say no, but they are going to ask their doc for Januvia. I ask where they heard about it and they say they saw it on TV. Freebies in the park, that's the ticket. That and the steps. www.screencast.com/t/nOwBa4aaA
Januvia paid for in steps.
Do you all see the package of lies we have been sold? <---- lizzy should not drink ever.
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Post by sportsrancho on Mar 13, 2017 19:54:26 GMT -5
PWD see those on TV ALL the time! When ever I ask someone if they have heard about Afrezza they say no, but they are going to ask their doc for Januvia. I ask where they heard about it and they say they saw it on TV. Freebies in the park, that's the ticket. That and the steps. www.screencast.com/t/nOwBa4aaA
Januvia paid for in steps.
Do you all see the package of lies we have been sold? <---- lizzy should not drink ever.
Link says. Comments Disabled
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Post by peppy on Mar 13, 2017 20:02:09 GMT -5
That second dose is likely key to both the cost and efficacy issues that Mike C. references. 1. Don't take the second dose (no CGM, perhaps) and you don't keep BG low enough. 2. Take that second dose and you increase usage/cost, possibly to an unacceptable level (unacceptable to the user or to their insurance) You do know how fast acting is managed by type ones right? spilt dose, stacking. or just go high and then low and live with it. Not that many choices and difficult to manage. So really how difficult is it to set a timer on an iphone and keep your glucose levels from going that high in the first place? From what I have read the diabetic figures out, when they eat pizza they need a second dose.
What is your blood glucose right now?
Mine is 147, I just ate wheat thins and drank butterscotch shapps.
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Post by derek2 on Mar 13, 2017 20:20:55 GMT -5
That second dose is likely key to both the cost and efficacy issues that Mike C. references. 1. Don't take the second dose (no CGM, perhaps) and you don't keep BG low enough. 2. Take that second dose and you increase usage/cost, possibly to an unacceptable level (unacceptable to the user or to their insurance) You do know how fast acting is managed by type ones right? spilt dose, stacking. or just go high and then low and live with it. Not that many choices and difficult to manage. So really how difficult is it to set a timer on an iphone and keep your glucose levels from going that high in the first place? From what I have read the diabetic figures out, when they eat pizza they need a second dose.
What is your blood glucose right now?
Since I started on Forxiga (spelled with an O in Canada) 2 months ago? Breakfast around 130 Lunch around 100 Supper around 120 Between meals, haven't gone over 180 in a month. I've also brought my insulin dose (both mealtime and basal) down by about 10%. The stuff is like a miracle. I had struggled for the last 2 years with having to steadily increase my insulin dose and still saw my sugars stay way out of range. Changed endos last year and she is awesome. Trulicity once a week (yuck), metformin, Forxiga & insulin. Keeping very hydrated and taking care not to invite UTI. Going well so far. I'm not trying to damn Afrezza - I was positing a possible correctable common cause for both of Mike C.'s top 2 reasons for discontinuance. Figure out how to train people to monitor for the need the corrective dose and then take the corrective dose and you solve the problem. Explain it away and you don't.
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Post by peppy on Mar 13, 2017 20:31:50 GMT -5
You do know how fast acting is managed by type ones right? spilt dose, stacking. or just go high and then low and live with it. Not that many choices and difficult to manage. So really how difficult is it to set a timer on an iphone and keep your glucose levels from going that high in the first place? From what I have read the diabetic figures out, when they eat pizza they need a second dose.
What is your blood glucose right now?
Since I started on Forxiga (spelled with an O in Canada) 2 months ago? Breakfast around 130 Lunch around 100 Supper around 120 Between meals, haven't gone over 180 in a month. I've also brought my insulin dose (both mealtime and basal) down by about 10%. The stuff is like a miracle. I had struggled for the last 2 years with having to steadily increase my insulin dose and still saw my sugars stay way out of range. Changed endos last year and she is awesome. Trulicity once a week (yuck), metformin, Forxiga & insulin. Keeping very hydrated and taking care not to invite UTI. Going well so far. I'm not trying to damn Afrezza - I was positing a possible correctable common cause for both of Mike C.'s top 2 reasons for discontinuance. Figure out how to train people to monitor for the need the corrective dose and then take the corrective dose and you solve the problem. Explain it away and you don't. Thank you for the fine response. Me, no medications. I could obviously exercise to bring my blood glucose down.
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Post by peppy on Mar 13, 2017 20:52:29 GMT -5
Since I started on Forxiga (spelled with an O in Canada) 2 months ago? Breakfast around 130 Lunch around 100 Supper around 120 Between meals, haven't gone over 180 in a month. I've also brought my insulin dose (both mealtime and basal) down by about 10%. The stuff is like a miracle. I had struggled for the last 2 years with having to steadily increase my insulin dose and still saw my sugars stay way out of range. Changed endos last year and she is awesome. Trulicity once a week (yuck), metformin, Forxiga & insulin. Keeping very hydrated and taking care not to invite UTI. Going well so far. I'm not trying to damn Afrezza - I was positing a possible correctable common cause for both of Mike C.'s top 2 reasons for discontinuance. Figure out how to train people to monitor for the need the corrective dose and then take the corrective dose and you solve the problem. Explain it away and you don't. Thank you for the fine response. Me, no medications. I could obviously exercise to bring my blood glucose down.
Derek, you are as smart as a whip. we all know it. "Dapagliflozin dose of 10 mg per day in patients with type 2 diabetes mellitus for 12 weeks resulted in excretion of approximately 70 grams of glucose in the urine per day at Week 12. so this is not milligrams, this is grams/day.
Through a osmosis system that is not supposed to allow this.
Feel Like A Number-Bob Seger www.youtube.com/watch?v=q1FRvwJP1pk
My mother said to me, she has a friend on a lot of medication, who's feet now hurt, neuropathy. (she was witching about my glucose level.) I have choices still. Cut out the high fructose corn syrup, cut out sugar, cut of some complex carbs, exercise. Today, I should not have eaten all those oatmeal raisin cookies I made, I should change the salad dressing I used, reduce the wheat thins. Do not drink butterscotch schnapps. Exercise.
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Post by rockstarrick on Mar 13, 2017 22:43:54 GMT -5
Absolutely should've been addressed in 2015 during the initial launch, (at the latest). My friend, T2, started afrezza and was taking it 20 minutes before eating because of the label, I told him he needs to take when he starts eating, and then may need a follow up depending on how fast he eats or what he eats. He couldn't get it into his head that he may need a follow up dose, wouldn't do it and wound up stopping afrezza because of an incorrect label. This is something that will take a lot of time, getting a PWD to stack insulin doses will not be easy. Mike has a lot of work to do, there are a lot of rough edges that need attention ASAP. Just to say - the label says take Afrezza at the start of the meal, not 20 minutes before the meal. Was he used to a different insulin and just carried on with that timing? That second dose is going to be a problem, people are not going to want to do it. He said he was taking as prescribed, has there been any change to the label in regards to when to take afrezza ?? He was on it immediately after launch in 2015 and was definitely taking it 10 to 20 minutes prior to starting his meal, the follow up dose was the issue that made him decide to go back to humalog. So you are saying the label is correct on when to inhale, I didn't think it was. I've heard of more than 1 pwd comment about the label being misleading. I'll call him and get it from the horses mouth.
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Post by mango on Mar 13, 2017 22:48:26 GMT -5
And I would counter that false statement with: Unfortunately, doc, you are wrong, we already have a long-term study. And, BTW, localized insulin-derived amyloidosis at the site of injection is commonly misdiagnosed as lipohypertrophy— LONG-TERM PULMONARY SAFETY ASSESSMENT OF AFREZZA IN RATS AND DOGS. Based on evaluation of H&E stained tissues, there was no evidence of amyloid deposition in any portion of the respiratory tract in either species. Inhalation of AfrezzaTM up to 104 wks in rats and 39-wks in dogs did not increase PCNA labeling in alveoli, large bronchiolar or terminal bronchiolar tissues. www.toxicology.org/pubs/docs/Tox/2011Tox.pdfDoctor: "I actually meant the long term post market human trials being required by the FDA." Answer: Confirming that injectable insulins are indeed amyloidogenic can be done immediately. In fact, it has already been done using humans and published for all to see. Numerous studies have also confirmed that Afrezza contains zero pulmonary toxicity and is also non-amyloidogenic. Feel free to try and find one study that contradicts this. Also, while you are just sitting there at your desk, use that phone to call the FDA and ask for their reported side effects from using Afrezza. Meanwhile, I will educate your patients on what you choose to hide from them.
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Post by surplusvalue on Mar 14, 2017 1:13:27 GMT -5
Just to say - the label says take Afrezza at the start of the meal, not 20 minutes before the meal. Was he used to a different insulin and just carried on with that timing? That second dose is going to be a problem, people are not going to want to do it. He said he was taking as prescribed, has there been any change to the label in regards to when to take afrezza ?? He was on it immediately after launch in 2015 and was definitely taking it 10 to 20 minutes prior to starting his meal, the follow up dose was the issue that made him decide to go back to humalog. So you are saying the label is correct on when to inhale, I didn't think it was. I've heard of more than 1 pwd comment about the label being misleading. I'll call him and get it from the horses mouth. This is a response to agedhippie and RSR. The label also says " Take AFREZZA exactly as your healthcare provider tells you to. Your healthcare provider should tell you how much AFREZZA to use and when to use it." My emphasis. So there still may be a disjuncture between what the physicians are actually telling their patients. I remember Al talking about this problem since when to take it was being influenced by the standard timing of prandial insulin not taking account of Afrezza's unique characteristics. Old habits die hard.
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Post by rockstarrick on Mar 14, 2017 1:18:49 GMT -5
He said he was taking as prescribed, has there been any change to the label in regards to when to take afrezza ?? He was on it immediately after launch in 2015 and was definitely taking it 10 to 20 minutes prior to starting his meal, the follow up dose was the issue that made him decide to go back to humalog. So you are saying the label is correct on when to inhale, I didn't think it was. I've heard of more than 1 pwd comment about the label being misleading. I'll call him and get it from the horses mouth. This is a response to agedhippie and RSR. The label also says " Take AFREZZA exactly as your healthcare provider tells you to. Your healthcare provider should tell you how much AFREZZA to use and when to use it." My emphasis. So there still may be a disjuncture between what the physicians are actually telling their patients. I remember Al talking about this problem since when to take it was being influenced by the standard timing of prandial insulin not taking account of Afrezza's unique characteristics. Old habits die hard. That may be what happened, I'll be talking to him in the morning, I'll find out and let everybody know what he said.
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Post by mango on Mar 14, 2017 7:01:23 GMT -5
This is a response to agedhippie and RSR. The label also says " Take AFREZZA exactly as your healthcare provider tells you to. Your healthcare provider should tell you how much AFREZZA to use and when to use it." My emphasis. So there still may be a disjuncture between what the physicians are actually telling their patients. I remember Al talking about this problem since when to take it was being influenced by the standard timing of prandial insulin not taking account of Afrezza's unique characteristics. Old habits die hard. That may be what happened, I'll be talking to him in the morning, I'll find out and let everybody know what he said. Are humans individuals? Wouldn't that mean all individual humans are unique? And wouldn't this mean that all individual humans have unique differences and responses to drugs? The correct dose is the right dose. The one with the most therapeutic benefit for each unique individual human. One dose does not equal everyone's dose. Nor time of dose.
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Post by rockstarrick on Mar 14, 2017 9:08:51 GMT -5
That may be what happened, I'll be talking to him in the morning, I'll find out and let everybody know what he said. Are humans individuals? Wouldn't that mean all individual humans are unique? And wouldn't this mean that all individual humans have unique differences and responses to drugs? The correct dose is the right dose. The one with the most therapeutic benefit for each unique individual human. One dose does not equal everyone's dose. Nor time of dose. That's very true, but if you are inhaling afrezza 20 minutes prior to eating and afrezza peaks in 15 minutes, I don't think you are going to see stellar results, (he didn't). I would think the timing of the second dose is what would change for individual patients. Amazing, an insulin that works so fast you need a second dose !! The lag associated with RAA's is what causes most of the problems associated with insulin therapy. Too fast, too slow, I guess it's hard to beat a healthy pancreas.
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Post by agedhippie on Mar 14, 2017 9:59:48 GMT -5
Just to say - the label says take Afrezza at the start of the meal, not 20 minutes before the meal. Was he used to a different insulin and just carried on with that timing? That second dose is going to be a problem, people are not going to want to do it. He said he was taking as prescribed, has there been any change to the label in regards to when to take afrezza ?? He was on it immediately after launch in 2015 and was definitely taking it 10 to 20 minutes prior to starting his meal, the follow up dose was the issue that made him decide to go back to humalog. So you are saying the label is correct on when to inhale, I didn't think it was. I've heard of more than 1 pwd comment about the label being misleading. I'll call him and get it from the horses mouth. He should read the prescribing information that comes with Afrezza, section 2.2, it's all there and was last revised 6/2014. 2.2 Dosage Information
Administer AFREZZA at the beginning of the meal. He is stuck with the second dose though, that's often unavoidable because of Afrezza's fast clearance.
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