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Post by careful2invest on Mar 14, 2017 12:24:43 GMT -5
From the webcast...
"Continuous glucose monitoring is becoming more and more predominant, more and more common. Dexcom recently got approval to have their meters used in Medicare, which is a big step. But it’s become better known that if you really want to know what’s going on with your blood glucose unless you’re really like pricking yourselves and taking your readings very, very frequently, CGM or continuous glucose monitoring, is the way to go. So it’s becoming more and more prevalent with new innovations coming along. Abbott has a new system that’s going to be much cheaper, probably better suited for the type-2 market than type-1. But you’re seeing these new innovations come along and you’ll often read about things and so many entities like Google and so forth are experimenting with new ways to do this and it’s getting better and better.
That all plays very nicely in the hands of Afrezza because now you have something you can actually react to the information you’re getting. Obviously you’re too high with the traditional injected insulin, if you try to correct a too high also find yourself chasing the curve. So by the time the insulin starts working, there are things down again then you crash. With Afrezza, it’s so fast-in and so fast-out, you can make corrections on fly like that and really do something with the information you’re getting with your CGM. So it’s a very nice partnering, watch my hands gestures [ph]."
That just lit up a little hopium that MNKD is actually on the case... Google?
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Post by agedhippie on Mar 14, 2017 13:05:30 GMT -5
That all plays very nicely in the hands of Afrezza because now you have something you can actually react to the information you’re getting. Obviously you’re too high with the traditional injected insulin, if you try to correct a too high also find yourself chasing the curve. So by the time the insulin starts working, there are things down again then you crash. With Afrezza, it’s so fast-in and so fast-out, you can make corrections on fly like that and really do something with the information you’re getting with your CGM. So it’s a very nice partnering, watch my hands gestures [ph]." Technically this is wrong and I have no idea what you are talking about with "chasing the curve". So to explain what happens when you high:- 1) Calculate the correction you need based on your correction factor (for example mine is 30pts per unit so 120pt drop is 4u). 2) Adjust if you are really high, over 350, because this introduces insulin resistance - I use 25pts per unit then. 3) Now, in bold capitals, deduct insulin on board. Pumps and some meters will do this for you and if you do it you can happily stack insulin. 4) Get on with your life while the levels drop. 5) After a couple of hours check and repeat if necessary. That's it. If by the time the insulin starts working things are already normal then it's time to go back for a refresher course on how to use insulin. I do like the idea of Afrezza for corrections though because at that point I don't have to worry about digestion, it's simply squashing a number in which case there is no gain in the slower action of injected insulin. |
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Post by brotherm1 on Mar 14, 2017 13:10:44 GMT -5
So Mr Hippie- why do you spend so much time on this board ? Not implying anything, but just really want to know. Please
tell
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Post by careful2invest on Mar 14, 2017 13:36:17 GMT -5
So Mr Hippie- why do you spend so much time on this board ? Not implying anything, but just really want to know. Please tell To what I posted... That was a quote from Matt P from the webcast. And might I add something to the skepticism about mr hippie, I can almost expect a negative from mr. Hippie every time I or almost anyone else writes or posts anything positive about AFREZZA or MNKD! Look back at his post history if you doubt my word. Enough said! |
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Post by buyitonsale on Mar 14, 2017 13:49:08 GMT -5
Mike C also mentioned CGM in his latest interview. I am not counting on anything yet, even though it does make sense for Afrezza to participate in this "very nice partnering".
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Post by silentknight on Mar 14, 2017 13:54:21 GMT -5
From the webcast... "Continuous glucose monitoring is becoming more and more predominant, more and more common. Dexcom recently got approval to have their meters used in Medicare, which is a big step. But it’s become better known that if you really want to know what’s going on with your blood glucose unless you’re really like pricking yourselves and taking your readings very, very frequently, CGM or continuous glucose monitoring, is the way to go. So it’s becoming more and more prevalent with new innovations coming along. Abbott has a new system that’s going to be much cheaper, probably better suited for the type-2 market than type-1. But you’re seeing these new innovations come along and you’ll often read about things and so many entities like Google and so forth are experimenting with new ways to do this and it’s getting better and better. That all plays very nicely in the hands of Afrezza because now you have something you can actually react to the information you’re getting. Obviously you’re too high with the traditional injected insulin, if you try to correct a too high also find yourself chasing the curve. So by the time the insulin starts working, there are things down again then you crash. With Afrezza, it’s so fast-in and so fast-out, you can make corrections on fly like that and really do something with the information you’re getting with your CGM. So it’s a very nice partnering, watch my hands gestures [ph]." That just lit up a little hopium that MNKD is actually on the case... Google? I didn't hear anything from Matt yesterday, or read anything in your quote that would lead me to believe that MNKD is in any way in a different position now than before in terms of working with any outside entity related to CGMs. We might see something regarding the planned time-in-range study later on but simply stating that a CGM works well with Afrezza is nothing new. Patients utilizing CGMs have been post ing amazing results with Afrezza for some time now. Matt didn't provide any substantive new information at all yesterday. I'm not sure how anyone could read into it like that but this board will do what it does and speculate wildly anyway. Raising expectations unnecessarily has only served to leave lots of people disappointed in the past when none of it comes to fruition. |
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Post by sayhey24 on Mar 14, 2017 14:43:46 GMT -5
So Mr Hippie- why do you spend so much time on this board ? Not implying anything, but just really want to know. Please tell To what I posted... That was a quote from Matt P from the webcast. And might I add something to the skepticism about mr hippie, I can almost expect a negative from mr. Hippie every time I or almost anyone else writes or posts anything positive about AFREZZA or MNKD! Look back at his post history if you doubt my word. Enough said! Brotherm1 - you nailed this guy last week. I have no problem implying something. A few weeks back I asked him if he ever used afrezza. He said no but he was going to get his PCP to prescribe him afrezza. Later he said he went to his endo who was going to give it to him, but gave it to someone else. At that point I chalked this guy as a fake doing his best to spread soft FUD. Knowing what he knows getting afrezza would not have been a problem. Now, I think its great news Matt likes Dexcom and Google, me too. I also thought it was telling when Mike C was walking around with a G5. |
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Post by peppy on Mar 14, 2017 14:57:09 GMT -5
That all plays very nicely in the hands of Afrezza because now you have something you can actually react to the information you’re getting. Obviously you’re too high with the traditional injected insulin, if you try to correct a too high also find yourself chasing the curve. So by the time the insulin starts working, there are things down again then you crash. With Afrezza, it’s so fast-in and so fast-out, you can make corrections on fly like that and really do something with the information you’re getting with your CGM. So it’s a very nice partnering, watch my hands gestures [ph]." Technically this is wrong and I have no idea what you are talking about with "chasing the curve". So to explain what happens when you high:- 1) Calculate the correction you need based on your correction factor (for example mine is 30pts per unit so 120pt drop is 4u). 2) Adjust if you are really high, over 350, because this introduces insulin resistance - I use 25pts per unit then. 3) Now, in bold capitals, deduct insulin on board. Pumps and some meters will do this for you and if you do it you can happily stack insulin. 4) Get on with your life while the levels drop. 5) After a couple of hours check and repeat if necessary. That's it. If by the time the insulin starts working things are already normal then it's time to go back for a refresher course on how to use insulin. I do like the idea of Afrezza for corrections though because at that point I don't have to worry about digestion, it's simply squashing a number in which case there is no gain in the slower action of injected insulin. Quote: 1) Calculate the correction you need based on your correction factor (for example mine is 30pts per unit so 120pt drop is 4u). Reply: thank you aged! Afrezza article: (scroll down to 5 of 36) Patients who are motivated to manage their blood glucose levels
through frequent monitoring—and who understand the effect of
different doses of Afrezza—do extremely well when using it. Once
a patient understands his or her individual dose response (eg, “a
4-unit cartridge reduces my glucose by 30 mg/dL in 90 minutes”),
frequent blood glucose monitoring or continuous glucose monitoring
provides data that can be acted upon quickly with little risk of
“insulin stacking.” ajmc.s3.amazonaws.com/_media/_pdf/EBDM0916.pdf
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Post by lennymnkd on Mar 14, 2017 15:17:15 GMT -5
Hi sayhey.. made a couple of comment on the cgm : a few days ago with you .. both of us were thinking Dexcom/ what do make of that plug for Abbott being cheaper ? Is the Dexcom theory down the tube .
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Post by peppy on Mar 14, 2017 15:21:43 GMT -5
Technically this is wrong and I have no idea what you are talking about with "chasing the curve". So to explain what happens when you high:- 1) Calculate the correction you need based on your correction factor (for example mine is 30pts per unit so 120pt drop is 4u). 2) Adjust if you are really high, over 350, because this introduces insulin resistance - I use 25pts per unit then. 3) Now, in bold capitals, deduct insulin on board. Pumps and some meters will do this for you and if you do it you can happily stack insulin. 4) Get on with your life while the levels drop. 5) After a couple of hours check and repeat if necessary. That's it. If by the time the insulin starts working things are already normal then it's time to go back for a refresher course on how to use insulin. I do like the idea of Afrezza for corrections though because at that point I don't have to worry about digestion, it's simply squashing a number in which case there is no gain in the slower action of injected insulin. Quote: 1) Calculate the correction you need based on your correction factor (for example mine is 30pts per unit so 120pt drop is 4u). Reply: thank you aged! Afrezza article: (scroll down to 5 of 36) Patients who are motivated to manage their blood glucose levels
through frequent monitoring—and who understand the effect of
different doses of Afrezza—do extremely well when using it. Once
a patient understands his or her individual dose response (eg, “a
4-unit cartridge reduces my glucose by 30 mg/dL in 90 minutes”),
frequent blood glucose monitoring or continuous glucose monitoring
provides data that can be acted upon quickly with little risk of
“insulin stacking.” ajmc.s3.amazonaws.com/_media/_pdf/EBDM0916.pdf
Quote: Technically this is wrong and I have no idea what you are talking about with "chasing the curve". So to explain what happens when you high:-
1) Calculate the correction you need based on your correction factor (for example mine is 30pts per unit so 120pt drop is 4u).
2) Adjust if you are really high, over 350, because this introduces insulin resistance - I use 25pts per unit then.
3) Now, in bold capitals, deduct insulin on board. Pumps and some meters will do this for you and if you do it you can happily stack insulin.
4) Get on with your life while the levels drop.
5) After a couple of hours check and repeat if necessary.
That's it. If by the time the insulin starts working things are already normal then it's time to go back for a refresher course on how to use insulin. I do like the idea of Afrezza for corrections though because at that point I don't have to worry about digestion, it's simply squashing a number in which case there is no gain in the slower action of injected insulin.
REPLY: So really how difficult do you think learning to use Afrezza is? Matt B figured it out perfectly.
This video covers my experiences with Afrezza dose timing, and why I think timing is the most important aspect of dosing – even more important than the size.
I have previously mentioned the importance of dosage timing when taking Afrezza, but have not gone into much detail. So I thought it would be worthwhile talking about what I have learned so far about timing.
As a general rule, I dose about 10 minutes after I start eating, which is before my glucose levels start to rise from the meal. As I mention in the video, the best time to dose seems to depend on the fat content of the meal. And for some high fat meals, a follow up dose of Afrezza is neccesary.
I have found the same rule also applies if a follow-up dose is required. It is important to have the follow-up dose before the levels begin to rise out of range. If I had a CGM with alerts, I would use this to notify me as soon as it levels began to increase. That way I wouldn’t miss the optimum time for the follow-up.
It is worth remembering that much, much more Afrezza is needed to correct high glucose levels than to cover meals. As the video details, if I wait too long to dose, the dose required may be four times higher!
afrezzadownunder.com/
www.afrezzajustbreathe.com/
edit: My words paraphrasing: the second dose no sooner than 45 mins after the first if glucose levels hit 120 to 130 mg.
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Post by dreamboatcruise on Mar 14, 2017 16:10:04 GMT -5
So Mr Hippie- why do you spend so much time on this board ? Not implying anything, but just really want to know. Please tell Because some of us appreciate his in depth knowledge of diabetes and personal experience with it... just guessing. I would think that could be asked of many people here. If someone isn't interested in hearing information that questions their own beliefs then what is the point of reading this other as something to occupy one's time. That could apply to those that own the stock as well as those that don't. Why do I spend so much time here currently?... because right now I don't have anything better to do. Yippie for everyone else  |
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Post by dreamboatcruise on Mar 14, 2017 16:16:04 GMT -5
Hi sayhey.. made a couple of comment on the cgm : a few days ago with you .. both of us were thinking Dexcom/ what do make of that plug for Abbott being cheaper ? Is the Dexcom theory down the tube . Down the tube? ? No... hold onto your dreams. It's an open ended theory, so by definition it can't be proven wrong. It can always be right around the corner. So don't let your dream die. |
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Post by agedhippie on Mar 14, 2017 16:16:24 GMT -5
Quote: 1) Calculate the correction you need based on your correction factor (for example mine is 30pts per unit so 120pt drop is 4u). Reply: thank you aged! Afrezza article: (scroll down to 5 of 36) Patients who are motivated to manage their blood glucose levels
through frequent monitoring—and who understand the effect of
different doses of Afrezza—do extremely well when using it. Once
a patient understands his or her individual dose response (eg, “a
4-unit cartridge reduces my glucose by 30 mg/dL in 90 minutes”),
frequent blood glucose monitoring or continuous glucose monitoring
provides data that can be acted upon quickly with little risk of
“insulin stacking.” ajmc.s3.amazonaws.com/_media/_pdf/EBDM0916.pdf
Quote: Technically this is wrong and I have no idea what you are talking about with "chasing the curve". So to explain what happens when you high:-
1) Calculate the correction you need based on your correction factor (for example mine is 30pts per unit so 120pt drop is 4u).
2) Adjust if you are really high, over 350, because this introduces insulin resistance - I use 25pts per unit then.
3) Now, in bold capitals, deduct insulin on board. Pumps and some meters will do this for you and if you do it you can happily stack insulin.
4) Get on with your life while the levels drop.
5) After a couple of hours check and repeat if necessary.
That's it. If by the time the insulin starts working things are already normal then it's time to go back for a refresher course on how to use insulin. I do like the idea of Afrezza for corrections though because at that point I don't have to worry about digestion, it's simply squashing a number in which case there is no gain in the slower action of injected insulin.
REPLY: So really how difficult do you think learning to use Afrezza is? Matt B figured it out perfectly.
This video covers my experiences with Afrezza dose timing, and why I think timing is the most important aspect of dosing – even more important than the size.
I have previously mentioned the importance of dosage timing when taking Afrezza, but have not gone into much detail. So I thought it would be worthwhile talking about what I have learned so far about timing.
As a general rule, I dose about 10 minutes after I start eating, which is before my glucose levels start to rise from the meal. As I mention in the video, the best time to dose seems to depend on the fat content of the meal. And for some high fat meals, a follow up dose of Afrezza is neccesary.
I have found the same rule also applies if a follow-up dose is required. It is important to have the follow-up dose before the levels begin to rise out of range. If I had a CGM with alerts, I would use this to notify me as soon as it levels began to increase. That way I wouldn’t miss the optimum time for the follow-up.
It is worth remembering that much, much more Afrezza is needed to correct high glucose levels than to cover meals. As the video details, if I wait too long to dose, the dose required may be four times higher!
afrezzadownunder.com/
www.afrezzajustbreathe.com/
edit: My words paraphrasing: the second dose no sooner than 45 mins after the first if glucose levels hit 120 to 130 mg.
I don't think it is difficult to sort out the dosing, but it is different and it requires application. I see something similar in my work - people are confident they can do something and attempt it unaided but they almost inevitably hit a problem. They fall back to their comfort zone which is their existing practice and postpone the change. They still intend to go forwards but they never do. The only way to fix this is to hand hold them through the change although 90% will tell you it's unnecessary at first. My suspicion is that is what you are seeing with Afrezza - "it's insulin, I've used it for decades, I can do this". Then it doesn't behave the same, they stop dead and revert to their current insulin. They never make the jump although they still intend to one day, but that day never comes. How to fix that is harder - one option which I would use is to set up monthly face to face workshops in big locations for new users. You may only get a few, but that is an improvement because they will make the jump. Use the nurses for this. Things like the video are interesting academically, but not material. If you think you know how insulin works you are not going to be scouring the network for advice. It is held to be axiomatic that diabetes is different for everyone so what works for one person will not necessarily work for another. This means another persons experience, unless you personally know them which is different, has low applicability. There are whole careers built on this levels of trust stuff ! |
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Post by dreamboatcruise on Mar 14, 2017 16:22:28 GMT -5
I don't think it is difficult to sort out the dosing, but it is different and it requires application. I see something similar in my work - people are confident they can do something and attempt it unaided but they almost inevitably hit a problem. They fall back to their comfort zone which is their existing practice and postpone the change. They still intend to go forwards but they never do. The only way to fix this is to hand hold them through the change although 90% will tell you it's unnecessary at first. My suspicion is that is what you are seeing with Afrezza - "it's insulin, I've used it for decades, I can do this". Then it doesn't behave the same, they stop dead and revert to their current insulin. They never make the jump although they still intend to one day, but that day never comes. How to fix that is harder - one option which I would use is to set up monthly face to face workshops in big locations for new users. You may only get a few, but that is an improvement because they will make the jump. Use the nurses for this.Things like the video are interesting academically, but not material. If you think you know how insulin works you are not going to be scouring the network for advice. It is held to be axiomatic that diabetes is different for everyone so what works for one person will not necessarily work for another. This means another persons experience, unless you personally know them which is different, has low applicability. There are whole careers built on this levels of trust stuff ! I was thinking exactly this same thing recently. I was even wondering if MNKD could host these as dinners for some period of time. Would that be some form of unallowed bribery/kickback in the FDA's eyes? |
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Post by agedhippie on Mar 14, 2017 16:32:31 GMT -5
So Mr Hippie- why do you spend so much time on this board ? Not implying anything, but just really want to know. Please tell Because I find the discussion interesting and I have the time. My work involves sitting around for months and then a few days of blind panic for which I am paid fairly well. My aim, actually, is more to raise the level of understanding as to what it means to be a Type 1 diabetic and how diabetics think because you hear some really odd things from non-diabetics. If you are investing in Mannkind for Afrezza this is your target market so if you want to make an informed decision you really need to understand it. |
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