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Post by sellhighdrinklow on Jan 28, 2018 12:35:11 GMT -5
Depends on where my starting blood sugar level is.
160+ before the meal or even 5 to 10 minutes before starting to eat.
120 range, at start of meal.
Sub 100, 10~minutes into the meal.
These are rough figures. Depends what I'm eating. IE, if it's a salad and the main course won't arrive for 15 minutes and I'm 160+, then I'll wait on the 8- unit cartridge. However, I'm not averse to taking a 4 cartridge w the salad.
The 12 unit cartridge is another story in that it is more insulin of course and needs to be gauged as such. Eating pizza and a starting BS of 150, I have no second thoughts of taking a 12 at the start of the meal.
Also, the 150+ readings before a meal are not as often since using Afrezza.
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Post by sportsrancho on Jan 28, 2018 12:53:20 GMT -5
This thread addresses “when to inhale Afrezza”. All of the quotes above in this thread say to inhale AFTER beginning a meal except Afrezza.com says to “Take AFREZZA at the beginning of your meal.” Afrezza .com contains MannKind prescribing instructions; presumably new patients will be prescribed by their doctors to inhale Afrezza at the beginning of meals. This leads to ineffective use as described in the VDEX White Paper and contradicts Al Mann’s advice above, “I (Al Mann) believe that the first Afrezza dose really ought to be taken ten or fifteen minutes after starting to eat.” Why do MannKind prescribing instructions contradict all the info out there regarding WHEN to inhale Afrezza? This is absolutely unacceptable! I remember when Tom’s son took the directions out of the box and started to read them and Tom just tossed them in the trash. Thank god they had a MNKD long for a dad! |
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Post by MnkdWASmyRtrmntPlan on Jan 28, 2018 13:07:37 GMT -5
... Why do MannKind prescribing instructions contradict all the info out there regarding WHEN to inhale Afrezza? This is absolutely unacceptable! I remember when Tom’s son took the directions out of the box and started to read them and Tom just tossed them in the trash. Thank god they had a MNKD long for a dad! Hey Sports, you probably missed MNHoldem's answer to that question (scroll back), which makes perfect sense. Not that it is "acceptable", but it is unfortunately just another aggravation of our ineffective medical system. |
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Post by sportsrancho on Jan 28, 2018 13:13:44 GMT -5
This is absolutely unacceptable! I remember when Tom’s son took the directions out of the box and started to read them and Tom just tossed them in the trash. Thank god they had a MNKD long for a dad! Hey Sports, you probably missed MNHoldem's answer to that question (scroll back), which makes perfect sense. Not that it is "acceptable", but it is unfortunately just another aggravation of our ineffective medical system. But why? Not many things drive me crazy but this is one of them:-( |
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Post by mytakeonit on Jan 28, 2018 14:49:35 GMT -5
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Post by mnholdem on Jan 28, 2018 16:57:36 GMT -5
Hey Sports, you probably missed MNHoldem's answer to that question (scroll back), which makes perfect sense. Not that it is "acceptable", but it is unfortunately just another aggravation of our ineffective medical system. But why? Not many things drive me crazy but this is one of them:-( 100% agree!
Here's another mystery: why didn't Afrezza earn the "Ultra-Rapid Acting" classification? I recall that a ProBoard's member posted Castagna's explanation that, even when presented with irrefutable evidence of Afrezza's speed (in and out) the FDA would not create new insulin classifications without consulting the ADA and/or AACE.
Is the FDA conferring with these diabetes organizations? I would think that Novo Nordisk wants that new class for Fiasp, so it isn't just Afrezza. The problem appears to reside with an antiquated and/or corrupted medical approval system that seems to talk the talk but never walk the talk. Unless there is an outcry similar to what appears to be finally happening in this nation with the opioid epidemic, these diabetes organizations (including the FDA) will never be held accountable for permitting millions of peoples' health to be held hostage by the drug industry.
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Post by MnkdWASmyRtrmntPlan on Jan 28, 2018 18:54:43 GMT -5
Hey Sports, you probably missed MNHoldem's answer to that question (scroll back), which makes perfect sense. Not that it is "acceptable", but it is unfortunately just another aggravation of our ineffective medical system. But why? Not many things drive me crazy but this is one of them:-( Sports, I just thought that you started typing your response while MNHoldem posted his, and you never saw his response. That happens to me often. Anyway, I hope you didn't think i was disagreeing with you. I totally agree. There are so many things wrong with our medical system. Ineffectiveness like this, and much worse, greed and corruption. I wish that someday soon our entire medical system would get gutted and replaced by a holistic system based on common sense practices that is designed to help patient's health, and not designed just to make money for pharmaceutical companies. |
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bac
Lab Rat
Posts: 37
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Post by bac on Jan 31, 2018 9:54:51 GMT -5
REFERENCE YouTube video “Afrezza: Timing is Everything” by Matthew Bendall, Published on Nov 10, 2015. www.youtube.com/watch?v=z3OyXeaIQg8The author of this video lives in Australia, is in his 20’s with T1D since age four years old. He has recorded a series of YouTube videos on the use of Afrezza. In his video “Afrezza: Timing is Everything”, he states “ timing of the dose is actually more important than the dose itself.” I have brought up Afrezza timing with CEO Mike Castagna and he says MannKind is bound by the label (as explained above by mnholdem) and he (Mike) thinks Afrezza timing is not very important. Mike Castagna: “... we (MannKind) only studied it pre meal. The FDA and government would be all over us if I took your advice bc there is no data to support this. We can look at it possibly in one of our upcoming trials we are designing as that is what Fiasp did. I don’t believe our phase 3 program didn’t do well bc of meal timing but more bc people didn’t titrate dosing as directed. Appreciate the suggestion.”Beginning-of-meal Afrezza prescribing instructions during the clinical trials remain in the label to this day. As sportsrancho stated, “This is absolutely unacceptable!” Current Afrezza dosing instructions are a joke. sportsrancho: “I remember when Tom’s son took the directions out of the box and started to read them and Tom just tossed them in the trash. Thank God they had a MNKD long for a dad!” Current prescribing instructions are “Take AFREZZA at the beginning of your meal.” This is too simplistic. As commented by sellhighdrinklow above, Afrezza timing depends several factors, including starting blood sugar level and content of the meal. Message: one size does not fit all! Prescription instructions are needed that give prescribers and users information on how to dose Afrezza under various circumstances. I envision MannKind doing three things to fix Afrezza use by first-timers so that no person that tries Afrezza, discontinues because it was ineffective. They may discontinue Afrezza because of cost or lack of insurance, but not because of Afrezza efficacy. 1. Develop an Application and host it on Afrezza.com. It would accept inputs (such as user weight, T1D or T2D, starting blood glucose level, etc), user would choose one of several built-in meals and then the App would output a plot of blood glucose readings versus time (much like a Dexcom or Libre). After running this application several times, the new user would acquire a “feel” for how Afrezza effects blood glucose levels. 2. Maintain Afrezza best practices for timing and choosing appropriate dose size. 3. Work with the FDA to upgrade the current prescribing instructions for dosing Afrezza. Know precisely what the FDA requires to change dosing on the Afrezza label and be prepared to implement ASAP. |
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