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Post by sayhey24 on Mar 29, 2017 19:28:27 GMT -5
There are some misconceptions about the Bernstein diets, fat, and carbs. The reason that Bernstein emphasizes fat is because it is an ultra-low carb diet. He recommends 30g of carbs per day which is not much more than an apple. This means you are getting about 120 calories from carbs and the remaining 1500+ must come from protein or fat. Fat is calorie dense so it helps cover that gap - it would take a couple of pounds of grilled chicken a day otherwise. Normal numbers are quite common on the diet as is serious weight loss. Bernstein still uses basal (he is Type 1 so he would die if he didn't) but hardly uses any mealtime insulin. I have never used the diet myself, it really doesn't appeal, but I know people who have and it certainly seems to work. This sums up Bernstein very well. The entire concept is to never get the glucose spike. If Bernstien still wants to follow it, more power to him. For his corrections he would probably do better with afrezza. For everyone else, afrezza pretty much obsoletes his diet. It should really be all about moderation. The lower the fat the better and the same with the carbs but you don't need to beat yourself up over it with afrezza. Let the monomer insulin do what it is naturally made to do. The last time I saw Bernstein he looked like he needed a good meal. The thing about Bernstein is he is an engineer. I am a little surprised he not been a big supporter of afrezza. As a big promoter of meters, I would have thought he would be wearing both a Dexcom and a Libre and getting that good meal while test driving afrezza. Maybe Mike C should pay him a visit with a titration pack.
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Post by dreamboatcruise on Mar 29, 2017 19:46:59 GMT -5
There are some misconceptions about the Bernstein diets, fat, and carbs. The reason that Bernstein emphasizes fat is because it is an ultra-low carb diet. He recommends 30g of carbs per day which is not much more than an apple. This means you are getting about 120 calories from carbs and the remaining 1500+ must come from protein or fat. Fat is calorie dense so it helps cover that gap - it would take a couple of pounds of grilled chicken a day otherwise. Normal numbers are quite common on the diet as is serious weight loss. Bernstein still uses basal (he is Type 1 so he would die if he didn't) but hardly uses any mealtime insulin. I have never used the diet myself, it really doesn't appeal, but I know people who have and it certainly seems to work. This sums up Bernstein very well. The entire concept is to never get the glucose spike. If Bernstien still wants to follow it, more power to him. For his corrections he would probably do better with afrezza. For everyone else, afrezza pretty much obsoletes his diet. It should really be all about moderation. The lower the fat the better and the same with the carbs but you don't need to beat yourself up over it with afrezza. Let the monomer insulin do what it is naturally made to do. The last time I saw Bernstein he looked like he needed a good meal. The thing about Bernstein is he is an engineer. I am a little surprised he not been a big supporter of afrezza. As a big promoter of meters, I would have thought he would be wearing both a Dexcom and a Libre and getting that good meal while test driving afrezza. Maybe Mike C should pay him a visit with a titration pack.Well, there are some looking for change in management... illegally distributing pharmaceuticals would probably be a quick way of getting a new CCO.
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Post by sayhey24 on Mar 29, 2017 20:21:51 GMT -5
This sums up Bernstein very well. The entire concept is to never get the glucose spike. If Bernstien still wants to follow it, more power to him. For his corrections he would probably do better with afrezza. For everyone else, afrezza pretty much obsoletes his diet. It should really be all about moderation. The lower the fat the better and the same with the carbs but you don't need to beat yourself up over it with afrezza. Let the monomer insulin do what it is naturally made to do. The last time I saw Bernstein he looked like he needed a good meal. The thing about Bernstein is he is an engineer. I am a little surprised he not been a big supporter of afrezza. As a big promoter of meters, I would have thought he would be wearing both a Dexcom and a Libre and getting that good meal while test driving afrezza. Maybe Mike C should pay him a visit with a titration pack.Well, there are some looking for change in management... illegally distributing pharmaceuticals would probably be a quick way of getting a new CCO. At this point maybe some change is needed but the last time I checked Bernstein was both an engineer and M.D. Maybe Mike should rent a u-haul and drive it to Bernstein's filled with "titration" samples. At this point the guy representing the company from "G"hina at the shareholders meeting looks like a great deal. Its all so bizarre. The Mann Foundation has the biggest to lose here and they have to be smart people yet business as usual at MNKD; no sales; no cash; no progress; no worries. It like MNKD is in a alternative universe. One product I think the Endo's would prescribe would be a afrezza for corrections, called it afrezza-ER; nope, no interest
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Post by jpg on Mar 29, 2017 20:39:56 GMT -5
Well, there are some looking for change in management... illegally distributing pharmaceuticals would probably be a quick way of getting a new CCO. At this point maybe some change is needed but the last time I checked Bernstein was both an engineer and M.D. Maybe Mike should rent a u-haul and drive it to Bernstein's filled with "titration" samples. At this point the guy representing the company from "G"hina at the shareholders meeting looks like a great deal. Its all so bizarre. The Mann Foundation has the biggest to lose here and they have to be smart people yet business as usual at MNKD; no sales; no cash; no progress; no worries. It like MNKD is in a alternative universe. One product I think the Endo's would prescribe would be a afrezza for corrections, called it afrezza-ER; nope, no interest Again completely agree. They just seem to be passively letting this go away without a fight. A correction study would have been one of the easiest, cheapest and quickest studies to set up and be able to market using off label marketing rules. It's as if management wants to give this to Deerfield? Maybe Deerfield will know what to do with this asset?
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Post by lookingforlogic on Mar 30, 2017 8:36:18 GMT -5
I have just read couple of this moping and complaining posts and I am just shaking with anger and disbelieve how little you people here know about a tremendous power of negative in sales and marketing. You can be the best salesman in the company while presenting to excited family the best product available on the marked and just when they are ready to happily sign the contract the bell rings and some uneducated dude (friend from the bar you just play pool with) walks in and asks what are you buying, and then gives the advice like "you do not need it (I know somebody as stupid as I am and he regretted buying it, just think about it). So here you are a Michael Jordan of sales in your company and you are loosing the sale.
With the power and amount of negative Mnkd has to deal with, the BOD is doing spectacular job. Selling 10 scripts a week would be great achievement.
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Post by agedhippie on Mar 30, 2017 8:59:37 GMT -5
There are some misconceptions about the Bernstein diets, fat, and carbs. The reason that Bernstein emphasizes fat is because it is an ultra-low carb diet. He recommends 30g of carbs per day which is not much more than an apple. This means you are getting about 120 calories from carbs and the remaining 1500+ must come from protein or fat. Fat is calorie dense so it helps cover that gap - it would take a couple of pounds of grilled chicken a day otherwise. Normal numbers are quite common on the diet as is serious weight loss. Bernstein still uses basal (he is Type 1 so he would die if he didn't) but hardly uses any mealtime insulin. I have never used the diet myself, it really doesn't appeal, but I know people who have and it certainly seems to work. This sums up Bernstein very well. The entire concept is to never get the glucose spike. If Bernstien still wants to follow it, more power to him. For his corrections he would probably do better with afrezza. For everyone else, afrezza pretty much obsoletes his diet. It should really be all about moderation. The lower the fat the better and the same with the carbs but you don't need to beat yourself up over it with afrezza. Let the monomer insulin do what it is naturally made to do. The last time I saw Bernstein he looked like he needed a good meal. The thing about Bernstein is he is an engineer. I am a little surprised he not been a big supporter of afrezza. As a big promoter of meters, I would have thought he would be wearing both a Dexcom and a Libre and getting that good meal while test driving afrezza. Maybe Mike C should pay him a visit with a titration pack. That is not actually correct. His focus is on what he calls the law of small numbers. If you eat almost no carbs your levels are going to move very little and when they do move they are easy to stop and require minimal insulin to correct which makes for predictable results. I doubt he would see Afrezza as useful since he achieves his results with Humalog so it's difficult to see what Afrezza could add for him. He is both a nutritionist and and endocrinologist so his diet is sound, it's just that it is far to restrictive for me. The people on it seem to do very well and are happy with it.
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Post by zuegirdor on Mar 30, 2017 11:20:51 GMT -5
we need the 4,8,12 unit tritation packs. we need the 4,8,12 unit titration packs priced correctly. your son is our target audience. Since MNKD seems to be going out of business, make that insulin into monomeric human insulin start the show, and lower the price on the titration pack. The pack.
Yes, we keep going round and round on pricing and packaging. In addition to insurance coverage and the need to have help when learning to titrate. Taking a 4 + 8 is exactly the same as a 12 which has 30units(4 has 10 and the 8 has 20). You will only get about 40% of the usable insulin due to loss in device, mouth and throat. It clearly sounds you are under dosing on the initial puff and following Sport's friend outline you probably want to try. With afrezza you are better to take more than less and let the liver do its job but I would get the titrating done with out the RAA which is bringing in a whole set of different variables and will impact the livers ability to correct a low. The reason I asked about fat and carbs is, in theory with afrezza if you take enough on the initial dose with a low fat diet you shouldn't need a second dose. afrezza can handle the carbs spike which an RAA can't. Bernstein's diet is ideal for the RAA because of the slowed digestion and lower glucose spike which mimics the RAA profile but has been obsoleted by afrezza which mimics the pancreas. The slowed digestion may require a second afrezza dose depending on the carbs as you see with the pizza. Best of luck, I wish afrezza was much more affordable for you. Would help if our Kaiser insurance would cover it! I don't mean to complain too much about price since I know not all have the same insurance issue. We, at least, have not been challenged on pre-auth or had pharmacy supply trouble.
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Post by zuegirdor on Mar 30, 2017 11:24:47 GMT -5
This sums up Bernstein very well. The entire concept is to never get the glucose spike. If Bernstien still wants to follow it, more power to him. For his corrections he would probably do better with afrezza. For everyone else, afrezza pretty much obsoletes his diet. It should really be all about moderation. The lower the fat the better and the same with the carbs but you don't need to beat yourself up over it with afrezza. Let the monomer insulin do what it is naturally made to do. The last time I saw Bernstein he looked like he needed a good meal. The thing about Bernstein is he is an engineer. I am a little surprised he not been a big supporter of afrezza. As a big promoter of meters, I would have thought he would be wearing both a Dexcom and a Libre and getting that good meal while test driving afrezza. Maybe Mike C should pay him a visit with a titration pack.Well, there are some looking for change in management... illegally distributing pharmaceuticals would probably be a quick way of getting a new CCO. Bernstien is also a doctor- an endocrinologist, I beleive!
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Post by zuegirdor on Mar 30, 2017 11:29:21 GMT -5
At this point maybe some change is needed but the last time I checked Bernstein was both an engineer and M.D. Maybe Mike should rent a u-haul and drive it to Bernstein's filled with "titration" samples. At this point the guy representing the company from "G"hina at the shareholders meeting looks like a great deal. Its all so bizarre. The Mann Foundation has the biggest to lose here and they have to be smart people yet business as usual at MNKD; no sales; no cash; no progress; no worries. It like MNKD is in a alternative universe. One product I think the Endo's would prescribe would be a afrezza for corrections, called it afrezza-ER; nope, no interest Again completely agree. They just seem to be passively letting this go away without a fight. A correction study would have been one of the easiest, cheapest and quickest studies to set up and be able to market using off label marketing rules. This is a great idea.How hard could it be to run a correction study. Use that new virtual patient model to test the effect of corrections on HbA1c! You know, the simulation on dose improvements that is on the Afrezza research paper site... Mike C are you listenting?
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Post by lakers on Mar 30, 2017 11:45:25 GMT -5
At this point maybe some change is needed but the last time I checked Bernstein was both an engineer and M.D. Maybe Mike should rent a u-haul and drive it to Bernstein's filled with "titration" samples. At this point the guy representing the company from "G"hina at the shareholders meeting looks like a great deal. Its all so bizarre. The Mann Foundation has the biggest to lose here and they have to be smart people yet business as usual at MNKD; no sales; no cash; no progress; no worries. It like MNKD is in a alternative universe. One product I think the Endo's would prescribe would be a afrezza for corrections, called it afrezza-ER; nope, no interest Again completely agree. They just seem to be passively letting this go away without a fight. A correction study would have been one of the easiest, cheapest and quickest studies to set up and be able to market using off label marketing rules. It's as if management wants to give this to Deerfield? Maybe Deerfield will know what to do with this asset? Liane said, I don't see a large role for Afrezza for hyperglycemia severe enough to warrant an ER visit (DKA and HHS). First off, severe hyperglycemia involves several metabolic imbalances, not just blood sugar. These are hypovolemia, acidemia, and electrolyte imbalances. You have to be very careful how quickly you tackle all of these. And secondly, a patient in the ER or the ICU, is going to have IV access, and insulin can be given and finely tuned by that route. Read more: mnkd.proboards.com/thread/2610/afrezza-emergency-room-hyperglycemia#ixzz4cpQDuxlF
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Post by jpg on Mar 30, 2017 11:48:17 GMT -5
Again completely agree. They just seem to be passively letting this go away without a fight. A correction study would have been one of the easiest, cheapest and quickest studies to set up and be able to market using off label marketing rules. It's as if management wants to give this to Deerfield? Maybe Deerfield will know what to do with this asset? Liane said, I don't see a large role for Afrezza for hyperglycemia severe enough to warrant an ER visit (DKA and HHS). First off, severe hyperglycemia involves several metabolic imbalances, not just blood sugar. These are hypovolemia, acidemia, and electrolyte imbalances. You have to be very careful how quickly you tackle all of these. And secondly, a patient in the ER or the ICU, is going to have IV access, and insulin can be given and finely tuned by that route. Read more: mnkd.proboards.com/thread/2610/afrezza-emergency-room-hyperglycemia#ixzz4cpQDuxlFNot in the ER or ICU. In daily normal corrections for very high nimners.
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Post by zuegirdor on Mar 30, 2017 11:56:56 GMT -5
This sums up Bernstein very well. The entire concept is to never get the glucose spike. If Bernstien still wants to follow it, more power to him. For his corrections he would probably do better with afrezza. For everyone else, afrezza pretty much obsoletes his diet. It should really be all about moderation. The lower the fat the better and the same with the carbs but you don't need to beat yourself up over it with afrezza. Let the monomer insulin do what it is naturally made to do. The last time I saw Bernstein he looked like he needed a good meal. The thing about Bernstein is he is an engineer. I am a little surprised he not been a big supporter of afrezza. As a big promoter of meters, I would have thought he would be wearing both a Dexcom and a Libre and getting that good meal while test driving afrezza. Maybe Mike C should pay him a visit with a titration pack. That is not actually correct. His focus is on what he calls the law of small numbers. If you eat almost no carbs your levels are going to move very little and when they do move they are easy to stop and require minimal insulin to correct which makes for predictable results. I doubt he would see Afrezza as useful since he achieves his results with Humalog so it's difficult to see what Afrezza could add for him. He is both a nutritionist and and endocrinologist so his diet is sound, it's just that it is far to restrictive for me. The people on it seem to do very well and are happy with it. I have no references to back me up but I hypothesize that not everyone has the genetic capacity to stay on Keto diet. The last 10,000 years of agriculture may have selected for increasing human dependence on high carbohydrate vegetable based diets. The transition form hunter gatherer to pastoralists and farmers probably proceeded at different rates in different locations and with some relation to the die out of the mega-fauna in northern latitudes. These gene pools are now mixed and expression of the relevant genes somewhat randomized. My father was pure blooded Spaniard from the hard Scrabble hill country of Spain. I seldom saw him sit down to a meal of carbs as big as I prefer. He would always choose salami or sardines over chips or bread for a snack. And perhaps most tellingly, he almost never ate sweets! He was lean through out his life but a big consumer of fat-which we kids thought was kind of gross. We thought his diet reflected the fact that he grew up somewhat poor during the depression. I have since come to realize that his family actually did rather well being tied to land, living the old ways after immigrating to Northern California and working in agriculture. There are a lot of Basques in Ca. that are "pastoralists" to this day. I suspect my dad shares some of those genes. I apparently don't have what it takes to go Keto since I am also half British Islander. My son, however seems to tolerate low carb better than I or my wife. Keto may be a workable option for him once he is done growing. But he will take all the carbs we will give him too. There is a lot that would have to go into an analysis of diet as a driver of genetic selection in humans- childhood nutrition deficiencies and competitiveness of parents in search of food for their young with respect to the leveling of fitness class via socio-economic functions and processes. But to cleave further from topic here risks banishment.
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Post by mnkdfann on Mar 30, 2017 12:58:19 GMT -5
I apparently don't have what it takes to go Keto since I am also half British Islander. My son, however seems to tolerate low carb better than I or my wife. When you say tolerate, do you mean in the sense of preference and self-selection to eat low carb? Or you do you mean his body actually won't tolerate low carb without experiencing digestive problems etc.? I sort of think if people generally had access to personal chefs and dieticians and unlimited food budgets and had a daily life schedule that accommodated such things, that nearly all of us could / would benefit from (and enjoy!) any of several possible low carb and / or vegetarian diets that are out there. I understand some feel a preference for eating carbs, but my experience (and that of some friends) suggests to me that one can break the carb habit in time (and often not as much time as you might think).
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Post by zuegirdor on Mar 30, 2017 14:39:51 GMT -5
I apparently don't have what it takes to go Keto since I am also half British Islander. My son, however seems to tolerate low carb better than I or my wife. When you say tolerate, do you mean in the sense of preference and self-selection to eat low carb? Or you do you mean his body actually won't tolerate low carb without experiencing digestive problems etc.? I sort of think if people generally had access to personal chefs and dieticians and unlimited food budgets and had a daily life schedule that accommodated such things, that nearly all of us could / would benefit from (and enjoy!) any of several possible low carb and / or vegetarian diets that are out there. I understand some feel a preference for eating carbs, but my experience (and that of some friends) suggests to me that one can break the carb habit in time (and often not as much time as you might think). I should have used "crave" rather than tolerate. Perhaps a lifetime of more rather than less carbs has jaded me? I am down to about 150g per day now of necessity. My son could probably make do with 100 or less but we encourage him to eat more since there is some evidence that too few carbs stunts adolescent growth. And he does not mind eating more...which Afrezza lets him do with far fewer risks than injected. I must admit though, that he seems to need more time for gastric emptying with higher Carb. I have been thinking of asking him to eat fewer carbs as his growth may be topping out. waiting for next check-up. You could be right about transition to different diets - importance of savoriness, presentation and scheduling of replacement foods. I still crave carbs. Two things that make it easier are 1)distraction and 2)fear of diabetes
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Post by agedhippie on Mar 30, 2017 16:41:08 GMT -5
When you say tolerate, do you mean in the sense of preference and self-selection to eat low carb? Or you do you mean his body actually won't tolerate low carb without experiencing digestive problems etc.? I sort of think if people generally had access to personal chefs and dieticians and unlimited food budgets and had a daily life schedule that accommodated such things, that nearly all of us could / would benefit from (and enjoy!) any of several possible low carb and / or vegetarian diets that are out there. I understand some feel a preference for eating carbs, but my experience (and that of some friends) suggests to me that one can break the carb habit in time (and often not as much time as you might think). I should have used "crave" rather than tolerate. Perhaps a lifetime of more rather than less carbs has jaded me? I am down to about 150g per day now of necessity. My son could probably make do with 100 or less but we encourage him to eat more since there is some evidence that too few carbs stunts adolescent growth. And he does not mind eating more...which Afrezza lets him do with far fewer risks than injected. I must admit though, that he seems to need more time for gastric emptying with higher Carb. I have been thinking of asking him to eat fewer carbs as his growth may be topping out. waiting for next check-up. You could be right about transition to different diets - importance of savoriness, presentation and scheduling of replacement foods. I still crave carbs. Two things that make it easier are 1)distraction and 2)fear of diabetes If you get off carbs for a couple of weeks you stop craving them. As soon as you eat any quantity the cravings kick in again. You also feel mildly ill during the transition (see carb flu). This is all second hand as I have never done it myself. Possibly the reason your father ate fat was because you only need to eat a little to make you feel full so it is ideal in poorer communities. I remember beef dripping sandwiches - the butcher used to cook beef and the cooled rendered fat was spread on bread. I feel slightly ill thinking of it now, but at the time it was good!
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