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Post by peppy on Mar 27, 2017 18:17:32 GMT -5
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Post by sayhey24 on Mar 27, 2017 19:45:24 GMT -5
I suspect Big Pharma is putting a great deal of pressure on the doctors not to use afrezza. The amount of pressure they put on the FDA not to approve was amazing. Unless they are properly dosing their A1c results won't be better than an RAA so its easy for the doctor to change them back to an RAA.... ....Afrezza is so different from anything current doctors and insulin users have encountered they really have a hard time believing to just "Go Big" with the dose and don't worry. They have allows been taught and learned the hard way the Analogs are dangerous and R insulin is dangerous. Afrezza has to be understood as a new insulin tool. You cannot compare it to RAA PD/PK in terms of dosing. The problem is in the comparison of "units" and timing, pricing, prescription. The whole deal. It is so new and paradigm shattering that its possible that only highly intelligent and motivated patients, with the courage to ignore all the warnings and, frankly, ignorant, dosing claims of physicians and everyone else, have been able to unlock its true potential. Further, every diabetic is different, with different dietary and lifestyle needs. Afrezza use can be customized once you figure out how it works. But many will wait for the paradigm to shift, for the early adopters to blaze the trail and take the "risks" (the risks are less than those you take with RAA!). I see many here are just realizing that the dosing advice per FDA rules is the problem. Yes-follow ups are needed for any meal over 30-40 carbs unless you are getting exercise within a half hour of eating. (Afrezza with a little exercise is AMAZINGLY EFFICIENT!). My kid likes to eat high carb most often 60-100+ g carbs/meal. And he is more sedentary than I would like (computer nerd-the BEST!). Consequently he will even need a third follow up dose! Expensive if you want to eat that way but he is still growing. What we do to save on cost and prevent rises due to "non compliance" (failing to remember to check BG and take follow ups) is use an 8u for first phase after eating (exact time of delay depending upon starting blood glucose level). Simultaneous with that first puff, he takes Humalog shot at 1/2 his normal carb/insulin dose ratio. This usually does the trick. He flat lines the whole meal. Sometimes, three hours later he might still be rising (stomache slower to empty on higher carb meals). A puff of a 4 or 8u easily and quickly stops these before he spends more than half to one hour out of range. What do you all think? Is this regimen too easy? Too hard? Too risky? Good or Bad news for Investors? Should someone be punished for even talking about this? FDA, what do you think about how diabetes is really treated? About people who can improve time in range and simultaneously reduce hypo events? Oh what a mangled clustercluck we have hatched! Oh yes clustercluck well said. Thanks for the great insights. If cost were not an issue would your son tend to use afrezza more for the phase 2 release or continue to use his RAA? Is Vdex doing any monitoring? The TV show MNKD is involved in is pushing a low fat diet. Any experiences with "low fat and high carb" versus "high fat and low carb"? Hows the high fat and high carb pizza work out for him?
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Post by sportsrancho on Mar 28, 2017 6:29:28 GMT -5
I'm not posting anymore because it's almost obvious Afrezza is a niche drug. When the man that is in charge of selling The Damn product says: unfortunately a doctor that prescribe passed away......(u know The rest of The story) that Makes u wonder how The hell is possible that he said that? So, Mike is saying that just few Drs are prescribing, that If one of them get flu and doesn't work 3 days, Afrezza prescription Will Go down like The Titanic. That's outrageous and means it's time to fire BOD, MATT and MIKE and sell "If possible" The Damn company (because To me Looks like The company is just a death walking man). I'll not be unrespectful to AL memory, but, today mistakes are a consecuence of his decision. Beside I'll share with u 2 personal story: 1. If they cannot sell in The USA, Go figure how they could sell it in countries of South America. That's bring to My first example: The father in law of My business associate is on Metformin. We live in Venezuela and we traveled together to Miami 6months ago. I explained To him The benefits of Afrezza and he said: look, I'm 70 yrs old, metformin is GREAT To me, because is very cheap and I'm not sure that Afrezza really works like u said. After that, i talked To My business associate (he is a pharmacist) and he said: look, Afrezza could be great, probably is really a Good drug (he doesn't know about it until i introduced it To him) but metformin is cheap for us, so why we Will spend money for something some expensive specially when Will be impossible To buy it in Venezuela? Beside he said: My father in low is 70yrs old so he can live with diabetes and stay on metformin. 2. My mechanized worker (we call them motorizado in Venezuela) is a Very poor guy. His salary is 15usd/month (I'm not kidding) and he is a T1. One day we got a coworker birthday and saw my mechanized worker eating a piece of cake. I told him: Hey you, What are u doing? U cannot eat that. Are u going To take a metformin pill to control Your BG? You know What his answer was: Sir i take nothing To control My diabetes and i never took nothing because My doctor said T1 isn't a big deal. I looked To his eyes and the color of The pupil it's YELLOW like my piiiiiii. My associate said when we were discussing about diabetes: he is right, T1 isn't big deal...... I know, Venezuela is a damn country, plagued with ignorance so i don't expect u to understand, but, how is possible that "ignorance is so big over there"? And I'm not saying united state people is ignorant (please don't missunderstand My words) but i see that diabetics in USA are so lazy or really ignorant If they don't care about their personal situation. If a better way To live If offered and a new treatment is available At least give it an opportunity. Lazy patients, lazy Dr's, lazy Endo, lazy sales work, lazy Matt&Mike, lazy and useless BOD...... Conclusion: I'm underwater, I'll not sell (just looking for a miracle) but u have To be honest and answer this 2 simple questions To me: 1. How is possible that NOBODY out there is interested to buy the CO? How is possible that some billionaire isn't thinking To buy all the shares on the market (can do that with $120mm aprox) and be The owner of all MNKD (including patents and related tax benefits?) 2. How is possible that TS never get a REAL INTEREST and/or validation beside Afrezza? I refuse answers like: Afrezza is The validation to TS. For GOSH sake, think about Vaccine in Africa (just To do an example). Are u kidding me? Since we get FDA approval TS gets nothing......Where the Hell is Gates Foundation? This DAMN CO is just DAMN.......We got Hakan, now Matt......and Now Mike......Come on, are u serious? Mike saying: one of the big prescribers passed away......Come on..... RLS is/was smoke and mirror........Where is The inhaled pot? Sorry but i need to wirte this testament...... I read your answer and i think: a lot of you Looks very smart, u answer with very accurate details, but to me, The game is simple: TS value = current sales of Afrezza (almost phatetic). No validation To TS beside Afrezza failure...... After more than 1yr after Sanofi returned Afrezza, we're still talking about Sanofi screwing us........Conspiracy theory and so on.......Open your eyes guys..... Btw, EYES The other CO of Mr Al (RIP) probably Will need a RS too........ Oh btw, i run 2 trading company in Venezuela, selling row materials, chemical additives and if You think is difficult To sell Afrezza in The best country of The World (because i think u are The best) come To Venezuela and I'll let u know the hell in hearth.... By now, Afrezza should be a BLOCKBUSTER without any IF......... Thanks and sorry i was too long.... Op
You are correct. Everyday people in other countries would never be able to pay this for Afrezza. Sports posted an article that apidra got eu approval. apidra's price is going to become negotiable. That is the missing step on the usa. Insurance companies do not negotiate price through one big purchaser. The poor of mexico will not use afrezza in their lifetime. The physicians, perhaps so programed in their standards of care analogues, and codes, have to see us cranky overweight, etc everyday. The old type ones are not going to change. especially at this price? Basal insulin in plenty of the drawers of nursing homes.
Right now, it these prices are to be believed, price explains scripts. Same boat op. Mike and matt are smart enough to see this problem.
A picture from op:
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Post by peppy on Mar 28, 2017 6:54:35 GMT -5
This teenager lives in America correct? so he wakes up low. And because he has to, pours a bowl of cereal and milk, ? juice, or water? Now he goes to lunch. every single menu I see are burgers or sandwiches, pizza or flatbread. Beverage. then there is dinner. let's say he is home? meatloaf? a baked potato and a salad. or spaghetti ? A rotisserie chicken, buns and soup or fries? this is a 17 year old. a very controlled eater. He hasn't had a snack.
High fat low carb. the fat and proteins do get turned into glucose. the nitrogen gets cleaved in the liver, and the carbon and hydrogen in the chain do get converted to glucose. Do not under estimate the damage of high fat, usually meat and diary also oils. let's look at a high fat low card diet for a 17 year old. one egg. two sausage links. beverage. two pieces fried chicken, and a salad. meatloaf, mushrooms, salad or spinach. This person needs a personal chef.
A healthy low carb diet. breakfast. Spinach salad other leafy greens. red pepper. sunflower seeds, bacon, oil and vinegar lunch- chicken, a salad. blue cheese dressing. dinner. Beans, a chili. This person wants a cracker.
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Post by minnlearner on Mar 28, 2017 7:22:12 GMT -5
Sports: I feel your frustration. I hope you will post more I look for your post because they are informed and interesting.
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Post by peppy on Mar 28, 2017 7:46:53 GMT -5
Sports: I feel your frustration. I hope you will post more I look for your post because they are informed and interesting. in this thread op swears it he was talking about a type one. LADA? This young girl, with a healthy looking face (full, hydrated, and hair) saying in the sign she is type one.
In the moment, assuming these people are type one and truth, what would explain that these people are alive and in op example can live?
I know this is going to sound crazy, the only thing I can think of is beans. Beans the slow burn with fiber, has glucose and nitrogen (proteins). hmmm, just throwing it out into the atmosphere.
The posts looked bad in the order they came up. I want to look at this. How can type one's in countries where the people have no healthcare or healthcare insurance live? In our thinking, they only have days until the mortuary?
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Post by mnholdem on Mar 28, 2017 8:16:35 GMT -5
peppy, in your evaluation of op's comments, you may want to step back and consider the health risks associated with hyperglycemia vs hypoglycemia:
In the case of diabetes in poor third world countries, a person with Type I diabetes and insufficient/no insulin would suffer from the effects of hyperglycemia:
Hyperglycemia Complications By Mayo Clinic Staff
Long-term complications
Untreated hyperglycemia can cause long-term complications. These include: • Cardiovascular disease • Nerve damage (neuropathy) • Kidney damage (diabetic nephropathy) or kidney failure • Damage to the blood vessels of the retina (diabetic retinopathy), potentially leading to blindness • Clouding of the normally clear lens of your eye (cataract) • Feet problems caused by damaged nerves or poor blood flow that can lead to serious infections, and in some severe cases, amputation • Bone and joint problems • Skin problems, including bacterial infections, fungal infections and nonhealing wounds • Teeth and gum infections
Emergency complications
If blood sugar rises high enough or for a prolonged period of time, it can lead to two serious conditions.
• Diabetic ketoacidosis. Diabetic ketoacidosis develops when you don't have enough insulin in your body. When this happens, sugar (glucose) can't enter your cells for energy. Your blood sugar level rises, and your body begins to break down fat for energy. This process produces toxic acids known as ketones. Excess ketones accumulate in the blood and eventually "spill over" into the urine. Left untreated, diabetic ketoacidosis can lead to a diabetic coma and be life-threatening.
• Hyperglycemic hyperosmolar syndrome. This condition occurs when people produce insulin, but it doesn't work properly. Blood glucose levels may become very high — greater than 600 mg/dL (33 mmol/L). Because insulin is present but not working properly, the body can't use either glucose or fat for energy.
Glucose is then spilled into the urine, causing increased urination. Left untreated, diabetic hyperglycemic hyperosmolar syndrome can lead to life-threatening.
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If a third world patient can control blood at least enough to avoid emergency complications, death would be avoidable. However, serious long-term health problems associated with frequent severe hyperglycemia would definitely shorten the patient's life-span.
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Hypoglycemia from injecting too much insulin is much more dangerous in the short-term:
Hypoglycemia Complications By Mayo Clinic Staff
If you ignore the symptoms of hypoglycemia too long, you may lose consciousness. That's because your brain needs glucose to function properly.
Recognize the signs and symptoms of hypoglycemia early because untreated hypoglycemia can lead to:
• Seizure • Loss of consciousness • Death
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Source of medical information: www.mayoclinic.org/diseases-conditions/hyperglycemia/basics/complications/con-20034795 www.mayoclinic.org/diseases-conditions/hypoglycemia/basics/complications/con-20021103
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Post by peppy on Mar 28, 2017 8:40:46 GMT -5
heh holdem, the cure the risk. Thank you. so thinking it through further, the risk is if the cell in not getting glucose, at all the cells will die. soooo, you are saying that cell death is a long process, should be more immediate.....
in the hyperglycemia/ glucose in the blood, not getting in the cell scenario. hmmmm
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Post by sportsrancho on Mar 28, 2017 9:14:51 GMT -5
Sports: I feel your frustration. I hope you will post more I look for your post because they are informed and interesting. My money is gone, or it is on paper. At this point I'm not even thinking about it. I have to focus on making money in other stocks. I had a investor tell me he was scared to death to buy another stock. Really? Just pick one. They're almost all going up! My frustration comes from knowing how worried the people that are on Afrezza are. They can't imagine life with out it! The company as we all know has to do something to stabilize it's self. People are under so much stress. Al Mann once again built the better mousetrap...But almost nobody knows!
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Post by agedhippie on Mar 28, 2017 9:38:50 GMT -5
heh holdem, the cure the risk. Thank you. so thinking it through further, the risk is if the cell in not getting glucose, at all the cells will die. soooo, you are saying that cell death is a long process, should be more immediate.....
in the hyperglycemia/ glucose in the blood, not getting in the cell scenario. hmmmm
Cells in general do not die of hyperglycemia. The exception is the beta cells but that's a different aspect and takes a while. Also if cells are not getting the energy they need from glucose the body switches to ketosis and they get the energy from ketones instead. The exception to this is the brain which can only use glucose but obviously with hyperglycemia that is not a problem.
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Post by peppy on Mar 28, 2017 9:41:46 GMT -5
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Post by alethea on Mar 28, 2017 9:44:26 GMT -5
Sports: I feel your frustration. I hope you will post more I look for your post because they are informed and interesting. My money is gone, or it is on paper. At this point I'm not even thinking about it. I have to focus on making money in other stocks. I had a investor tell me he was scared to death to buy another stock. Really? Just pick one. They're almost all going up! My frustration comes from knowing how worried the people that are on Afrezza are. They can't imagine life with out it! The company as we all know has to do something to stabilize it's self. People are under so much stress. Al Mann once again built the better mousetrap...But almost nobody knows! I think Afrezza the Drug will survive. However it will survive in some other company's hands. MNKD the Company, MNKD the Investment is dead, Dead... DEAD. Bankruptcy is looming near on the horizon. IF (and that's a very big If) MNKD can survive, the resulting dilution will be huge.. likely another 50%. At this moment MNKD stock is worth 35 cents in pre-split terms. It will be the 15 cent stock that Goldman and Jason Karp predicted before too much longer. Think about it.
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Post by agedhippie on Mar 28, 2017 9:51:11 GMT -5
peppy, in your evaluation of op's comments, you may want to step back and consider the health risks associated with hyperglycemia vs hypoglycemia:
In the case of diabetes in poor third world countries, a person with Type I diabetes and insufficient/no insulin would suffer from the effects of hyperglycemia
They seldom get to suffer the effects of hyperglycemia under those circumstances. With no insulin a child will be dead within a day, with limited insulin they are going to end up in DKA and in their world that has a 5% mortality rate assuming they make hospital with an hour or two of onset (obviously if they don't make it they are dead). The life expectancy of a child with Type 1 in Africa is around 7 months from diagnosis precisely because of the issue of reliable insulin supplies. It would be a luxury to live long enough to experience complications.
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Post by kbrion77 on Mar 28, 2017 9:52:13 GMT -5
My money is gone, or it is on paper. At this point I'm not even thinking about it. I have to focus on making money in other stocks. I had a investor tell me he was scared to death to buy another stock. Really? Just pick one. They're almost all going up! My frustration comes from knowing how worried the people that are on Afrezza are. They can't imagine life with out it! The company as we all know has to do something to stabilize it's self. People are under so much stress. Al Mann once again built the better mousetrap...But almost nobody knows! I think Afrezza the Drug will survive. However it will survive in some other company's hands. MNKD the Company, MNKD the Investment is dead, Dead... DEAD. Bankruptcy is looming near on the horizon. IF (and that's a very big If) MNKD can survive, the resulting dilution will be huge.. likely another 50%. At this moment MNKD stock is worth 35 cents in pre-split terms. It will be the 15 cent stock that Goldman and Jason Karp predicted before too much longer. Think about it. Maybe Matt shouldn't have laughed off that Henry fella at the shareholders meeting last year.........
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Post by madog365 on Mar 28, 2017 9:52:49 GMT -5
My money is gone, or it is on paper. At this point I'm not even thinking about it. I have to focus on making money in other stocks. I had a investor tell me he was scared to death to buy another stock. Really? Just pick one. They're almost all going up! My frustration comes from knowing how worried the people that are on Afrezza are. They can't imagine life with out it! The company as we all know has to do something to stabilize it's self. People are under so much stress. Al Mann once again built the better mousetrap...But almost nobody knows! I think Afrezza the Drug will survive. However it will survive in some other company's hands. MNKD the Company, MNKD the Investment is dead, Dead... DEAD. Bankruptcy is looming near on the horizon. IF (and that's a very big If) MNKD can survive, the resulting dilution will be huge.. likely another 50%. At this moment MNKD stock is worth 35 cents in pre-split terms. It will be the 15 cent stock that Goldman and Jason Karp predicted before too much longer. Think about it. I'm quite interested in what exactly has changed in the two weeks since q4 earnings were announced to bring on this extremely negative sentiment. Were you expecting much better scripts? The PPS decline? Did something else happen?
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