|
Post by agedhippie on Sept 29, 2017 18:53:12 GMT -5
My focus is on the outcome. If FIasp gives me that outcome why would I care about physiological matches? It's your life and your body and you can do whatever you want with it. Yes!!! Diabetics really hate people telling them how to manage their diabetes. After decades we tend to feel we have some sort of handle on it, we know what we are prepared to do and how engaged we are prepared to be to manage things. Would Afrezza give me better numbers? Almost certainly and although I have toyed with the idea it requires a higher level of engagement than I have today and that is not something I am prepared to do (probably why I haven't jumped up and down on my endo as much as I could have). Ignoring comfort levels leads to burnout and that kills far faster than diabetes. Now if I can get an insulin that lets me get a better outcome than I have today without change then that works for me. I don't care if it is inhales, injected, or oral. The positive side to diabetes as a long game is that what I do today or even over the next year has very little impact on the development of complications - it's the decades that matter so I have time to decide when new things appear. The only thing I would jump on instantly would be a working AP.
|
|
|
Post by sayhey24 on Sept 29, 2017 19:02:40 GMT -5
sounds good, and the other side, the length? Lots of people are keen on the quick out and I find myself conflicted. For corrections I really like the idea of fast clearance because I just want my levels down so I want it over with and a short tail. For meals though I would rather have an insulin with long tail because I don't want to take a follow up dose. I think it's why in the blogs and boards you see people using Afrezza for corrections and RAA for meals. The main reason T1s are using afrezza for corrections is because its so damn fast just like a healthy pancreas, its very predictable just like a healthy pancreas and its so damn expensive. Here is a good review from Gary Scheiner who is now publicly speaking on the benefits of afrezza and one of the real T1 experts. To sum up his Fiasp review - Duration of action - Sorry, no difference and Speed - it ain't no afrezza. He started as a correction user with afrezza but afrezza works so damn well it grows on you. integrateddiabetes.com/review-of-fiasp-insulin-and-how-it-compares-with-other-fast-insulins/BTW - this is from a guy who wanted no part of afrezza two years ago. Wow, have times changed and every day it gets harder for the endo to keep the CGM numbers hidden from the PWD.
|
|
|
Post by dreamboatcruise on Sept 29, 2017 19:07:47 GMT -5
Lots of people are keen on the quick out and I find myself conflicted. For corrections I really like the idea of fast clearance because I just want my levels down so I want it over with and a short tail. For meals though I would rather have an insulin with long tail because I don't want to take a follow up dose. I think it's why in the blogs and boards you see people using Afrezza for corrections and RAA for meals. The main reason T1s are using afrezza for corrections is because its so damn fast just like a healthy pancreas, its very predictable just like a healthy pancreas and its so damn expensive. Here is a good review from Gary Scheiner who is now publicly speaking on the benefits of afrezza and one of the real T1 experts. To sum up his Fiasp review - Duration of action - Sorry, no difference and Speed - it ain't no afrezza. He started as a correction user with afrezza but afrezza works so damn well it grows on you. integrateddiabetes.com/review-of-fiasp-insulin-and-how-it-compares-with-other-fast-insulins/BTW - this is from a guy who wanted no part of afrezza two years ago. Wow, have times changed and every day it gets harder for the endo to keep the CGM numbers hidden from the PWD.Think it's more like endos having a hard time GETTING cgms for their PWDs. The notion any are hiding something from their patients seems silly. Not everybody is involved in some grand conspiracy against MNKD.
|
|
|
Post by sayhey24 on Sept 29, 2017 19:20:59 GMT -5
DBC - how many T1s have 24/7 profiles and really know their numbers? How many T2s know their numbers let alone have a 24/7 profile - maybe close to none? If the T2s did they would be asking their PCP, what is this metformin doing for me?
The PWD says to the doc -I take the 1500 pill, I eat lunch and my BG zooms to 220. At dinner its still 180 and then I eat and it zooms to 250. Should I be worried about that mirovascular damage which starts at 140 everyone is talking about? Doc, should I be worrying about a heart attack?
What does the doctor say - don't worry about the numbers, pretend you never saw them like the old days and you will be just fine. Do a little more walking and lose 10 pounds. I will see you next month so you can pay me again, got to go now, very busy you know.
|
|
|
Post by agedhippie on Sept 29, 2017 19:23:23 GMT -5
Lots of people are keen on the quick out and I find myself conflicted. For corrections I really like the idea of fast clearance because I just want my levels down so I want it over with and a short tail. For meals though I would rather have an insulin with long tail because I don't want to take a follow up dose. I think it's why in the blogs and boards you see people using Afrezza for corrections and RAA for meals. The main reason T1s are using afrezza for corrections is because its so damn fast just like a healthy pancreas, its very predictable just like a healthy pancreas and its so damn expensive. Here is a good review from Gary Scheiner who is now publicly speaking on the benefits of afrezza and one of the real T1 experts. To sum up his Fiasp review - Duration of action - Sorry, no difference and Speed - it ain't no afrezza. He started as a correction user with afrezza but afrezza works so damn well it grows on you. integrateddiabetes.com/review-of-fiasp-insulin-and-how-it-compares-with-other-fast-insulins/BTW - this is from a guy who wanted no part of afrezza two years ago. Wow, have times changed and every day it gets harder for the endo to keep the CGM numbers hidden from the PWD. You missed the point rather. I want a fast in/out insulin like Afrezza for corrections. I want a slow out insulin like FIasp for meals. In the same article you quote Gary says he finds FIasp knocks 40 points off the post meal peak which looks good to me. I did have a good laugh at the idea of endos trying to keep CGMs away from diabetics. I think you meant insurers who are still succeeding to a large extent.
|
|
|
Post by dreamboatcruise on Sept 29, 2017 19:36:38 GMT -5
DBC - how many T1s have 24/7 profiles and really know their numbers? How many T2s know their numbers let alone have a 24/7 profile - maybe close to none? If the T2s did they would be asking their PCP, what is this metformin doing for me? The PWD says to the doc -I take the 1500 pill, I eat lunch and my BG zooms to 220. At dinner its still 180 and then I eat and it zooms to 250. Should I be worried about that mirovascular damage which starts at 140 everyone is talking about? Doc, should I be worrying about a heart attack? What does the doctor say - don't worry about the numbers, pretend you never saw them like the old days and you will be just fine. Do a little more walking and lose 10 pounds. I will see you next month so you can pay me again, got to go now, very busy you know. Show me one endo that is the reason a PWD wanting a CGM doesn't get it? It's the insurance companies that have been the problem. I don't have diabetes so I haven't even had one anecdotal discussion with an endo. At best you have one person's experience with the details of conversation. Do you have diabetes... did you have that discussion and get that response, or is that purely made up to make endos sound evil or incompetent? I'd assume the latter because it doesn't at all seem like the tone of ANY discussions I've had with any of my doctors... and sadly I've had more than my share over the last five decades. If that really was discussion you had with your endo... get a new one. If not, please don't make up fake dialog.
|
|
|
Post by sayhey24 on Sept 29, 2017 20:26:50 GMT -5
DBC - how many T1s have 24/7 profiles and really know their numbers? How many T2s know their numbers let alone have a 24/7 profile - maybe close to none? If the T2s did they would be asking their PCP, what is this metformin doing for me? The PWD says to the doc -I take the 1500 pill, I eat lunch and my BG zooms to 220. At dinner its still 180 and then I eat and it zooms to 250. Should I be worried about that mirovascular damage which starts at 140 everyone is talking about? Doc, should I be worrying about a heart attack? What does the doctor say - don't worry about the numbers, pretend you never saw them like the old days and you will be just fine. Do a little more walking and lose 10 pounds. I will see you next month so you can pay me again, got to go now, very busy you know. Show me one endo that is the reason a PWD wanting a CGM doesn't get it? It's the insurance companies that have been the problem. I don't have diabetes so I haven't even had one anecdotal discussion with an endo. At best you have one person's experience with the details of conversation. Do you have diabetes... did you have that discussion and get that response, or is that purely made up to make endos sound evil or incompetent? I'd assume the latter because it doesn't at all seem like the tone of ANY discussions I've had with any of my doctors... and sadly I've had more than my share over the last five decades. If that really was discussion you had with your endo... get a new one. If not, please don't make up fake dialog. Its not the insurance companies its the fact CGMs have been too damn expensive. If a CGM sensor was $20 and lasted 2 weeks would the insurance companies approve?? I will share with you an interesting discussion I had with a major company's health team. Like all big companies they are self insured but use a well known managed care provider. They told me the biggest expense they have by-far is diabetes. To be honest, I was shocked. I knew it was big but not what they shared with me. I came to talk about diabetes but in the first 5 minutes they did a 12 year frustration dump on attempt after attempt to do something about the diabetics but they have failed time and time again. Who knew? IMO, forget the endo's and the PCPs, 40% of the health insurance funding is through major companies looking to reduce costs. Costs!, freaking diabetes is blowing their costs sky high. If Al Mann was right and if what the VDex guys are saying is right it seems like a no brainer, IF what these people were telling me is true. BTW - I fully believed them. If so, it makes all the more sense Aetna is doing what it is doing with Apple and the rest on these new wellness pilots. Stop the progression and in some cases reverse the beta cell damage, are you kidding me. Show them how the orals are costing them a fortune and just making their employees worse and worse, costing more and more. That IMO BTW is a no-brainer. By the time ADA 2018 rolls around and all the smart guys come with their "Cloud Diabetes" I bet more than a few pilots will already be up and running without these guys.
|
|
|
Post by agedhippie on Sept 30, 2017 8:28:27 GMT -5
Its not the insurance companies its the fact CGMs have been too damn expensive. If a CGM sensor was $20 and lasted 2 weeks would the insurance companies approve?? I will share with you an interesting discussion I had with a major company's health team. Like all big companies they are self insured but use a well known managed care provider. They told me the biggest expense they have by-far is diabetes. To be honest, I was shocked. I knew it was big but not what they shared with me. I came to talk about diabetes but in the first 5 minutes they did a 12 year frustration dump on attempt after attempt to do something about the diabetics but they have failed time and time again. Who knew? It's correct, diabetes is a huge expense. If you want further evidence look at the single payer systems - their biggest concern is the cost of diabetes testing and treatment. The problem is that it is widespread, and chronic. Leaving Type 1 on one side for the moment, the size of the Type 2 market forces the use of sub-optimal second line treatments simply because you cannot afford optimal treatment. This is why moving from Metformin to insulin as a first line treatment will remain rare. Metformin is good in that role, and the cost differential is shattering. Metformin is $10 for 3 months, Humalog is $380 (Afrezza would be more), now multiply that by the number of Type 2s - I don't see how you can fund that.
|
|
|
Post by peppy on Sept 30, 2017 8:59:27 GMT -5
Its not the insurance companies its the fact CGMs have been too damn expensive. If a CGM sensor was $20 and lasted 2 weeks would the insurance companies approve?? I will share with you an interesting discussion I had with a major company's health team. Like all big companies they are self insured but use a well known managed care provider. They told me the biggest expense they have by-far is diabetes. To be honest, I was shocked. I knew it was big but not what they shared with me. I came to talk about diabetes but in the first 5 minutes they did a 12 year frustration dump on attempt after attempt to do something about the diabetics but they have failed time and time again. Who knew? It's correct, diabetes is a huge expense. If you want further evidence look at the single payer systems - their biggest concern is the cost of diabetes testing and treatment. The problem is that it is widespread, and chronic. Leaving Type 1 on one side for the moment, the size of the Type 2 market forces the use of sub-optimal second line treatments simply because you cannot afford optimal treatment. This is why moving from Metformin to insulin as a first line treatment will remain rare. Metformin is good in that role, and the cost differential is shattering. Metformin is $10 for 3 months, Humalog is $380 (Afrezza would be more), now multiply that by the number of Type 2s - I don't see how you can fund that. quote: the size of the Type 2 market forces the use of sub-optimal second line treatments simply because you cannot afford optimal treatment. This is why moving from Metformin to insulin as a first line treatment will remain rare.
reply: It the food. It has always been the food. The USA, all this dis ease. Aisles of chips, pretzels and baked goods. Taste buds stolen by additives. There is a saying, if slaughter houses had windows we would all be vegetarian.
So get them sick and have them pay for it the rest of their lives.
|
|
|
Post by dejude42 on Sept 30, 2017 10:00:30 GMT -5
To Quote and Reply
Fact: Diabetes is real: death and destruction of the human body become the results if untreated. Individuals pancreas destroyed, limbs removed and a life that some compare to a living hell. I am not a diabetic, but I have lost classmates, dear friends and know many that suffer the daily fears of living with this disease.
The human race builds homes on Ocean fronts and Islands, cities on fault lines and near volcanoes. Pollution poisons are environment: oxygen levels questionable, Carbon warming real or not, and are food/water quality unknown. Are these real or fake liabilities?
As a human diabetics, I am sure they worry about these problems. It is easy to judge from the outside. Someone else gets cancer, someone else lives there, and its someone else error of judgement. Birth does not give us the ability to select are genes, race, or style of life.
Life lived gives the ability of choice. Education brings the wisdom. A society that cares brings humanity.
Nothing in life is absolute and death is a certainty to any life form. Diabetic obtain an aid or freedom through Afrezza. No person wakes up and says, "Today and for the rest of my life: I wish to be a diabetic."
Judgement and fixes by self opinion usually have alternate motives. A society that cares supports and desires reaches the obtainable goals for each individual. Methods that solve the problems of the moment, while allowing the future to bring new ideals.
|
|
|
Post by agedhippie on Sept 30, 2017 11:16:14 GMT -5
It's correct, diabetes is a huge expense. If you want further evidence look at the single payer systems - their biggest concern is the cost of diabetes testing and treatment. The problem is that it is widespread, and chronic. Leaving Type 1 on one side for the moment, the size of the Type 2 market forces the use of sub-optimal second line treatments simply because you cannot afford optimal treatment. This is why moving from Metformin to insulin as a first line treatment will remain rare. Metformin is good in that role, and the cost differential is shattering. Metformin is $10 for 3 months, Humalog is $380 (Afrezza would be more), now multiply that by the number of Type 2s - I don't see how you can fund that. quote: the size of the Type 2 market forces the use of sub-optimal second line treatments simply because you cannot afford optimal treatment. This is why moving from Metformin to insulin as a first line treatment will remain rare.
reply: It the food. It has always been the food. The USA, all this dis ease. Aisles of chips, pretzels and baked goods. Taste buds stolen by additives. There is a saying, if slaughter houses had windows we would all be vegetarian.
So get them sick and have them pay for it the rest of their lives.
Now that is the truth. Two things that shocked me when I first got here; HFCS in bread , and the size of portions . And I am *very* picky about the source of any meat I eat.
|
|