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ADA
Jan 27, 2018 8:09:26 GMT -5
via mobile
Post by golfeveryday on Jan 27, 2018 8:09:26 GMT -5
Abbott in not in the drug business they are in the CGM and supply business. They would not be a buy in partner / perhaps They might pay MannKind to market to Dr’s their new freestyle +1 on not on the drug business. They spun off their drug business in 2013 (AbbVie Inc - ABBV) so they are unlikely to go there again. Abbott has been selling into the diabetic meter markets for over 20 years so they may feel they don't need the help Abbott still sells pharmaceuticals.
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Post by sayhey24 on Jan 27, 2018 9:14:14 GMT -5
ADA 2018 is going to be all about CGMs and Cloud Monitoring. Sam the Care lead on the Onduo.com site says "Great job logging your breakfast this morning! Let's explore some ideas to lower your post-breakfast glucose."
I'll give them an idea - afrezza. In fact my idea will actually work. Some live demos using the Libre standing on a ladder with a bullhorn at the MNKD ADA booth and showing how afrezza can "Stop the Spike" and get back to baseline might get some attention.
There is not much growth in the diabetes new drug space. Tresiba is it for basal. afrezza is it for the prandials and first line T2 treatment. Its now about who can reach and coach the PWD 24/7.
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ADA
Jan 27, 2018 9:35:57 GMT -5
via mobile
Post by golfeveryday on Jan 27, 2018 9:35:57 GMT -5
ADA 2018 is going to be all about CGMs and Cloud Monitoring. Sam the Care lead on the Onduo.com site says "Great job logging your breakfast this morning! Let's explore some ideas to lower your post-breakfast glucose." I'll give them an idea - afrezza. In fact my idea will actually work. Some live demos using the Libre standing on a ladder with a bullhorn at the MNKD ADA booth and showing how afrezza can "Stop the Spike" and get back to baseline might get some attention. There is not much growth in the diabetes new drug space. Tresiba is it for basal. afrezza is it for the prandials and first line T2 treatment. Its now about who can reach and coach the PWD 24/7. big time agree with you!
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Post by akemp3000 on Jan 27, 2018 9:36:56 GMT -5
"Stop the Spike" should become the worldwide mantra.
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ADA
Jan 27, 2018 10:32:16 GMT -5
Post by lennymnkd on Jan 27, 2018 10:32:16 GMT -5
I’m all for the ladder approach! 😀👍 give me the bullhorn and ladder I’ll do it ! I️ will even wear a volleyball outfit .
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ADA
Jan 27, 2018 10:38:39 GMT -5
Post by agedhippie on Jan 27, 2018 10:38:39 GMT -5
"Stop the Spike" should become the worldwide mantra. The problem with "Stop the spike" is that it's possible to get similar results with a Dexcom and RAA. Now the difference as I read it is that with Afrezza is you can eat almost anything and avoid a spike where as with RAA you have to be a lot more careful. The issue is that this ruins the message. Doctors are well aware (I would hope) that with a LCHF diet you can get a flat graph so I would bet that they think the Afrezza results are just the outcome from the same approach. Tudiabetes has the Flatliners club for where people post their 14 and 30 day results (the gray bars are the variability at each time slot over the period). There are even a couple of Afrezza posts there!
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Post by lennymnkd on Jan 27, 2018 11:30:30 GMT -5
Aged; I️ think your selling short the advantages and convenience of of inhaled insulin / everyone has become programmed to think it no longer matters .and especially the scientific advantages to numerous to post ... one being Alfa cell inhibiting glucagon/gulcose cascade for faster onset ,,, etc . Science that should not be taken for granted.
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Post by sayhey24 on Jan 27, 2018 11:45:27 GMT -5
"Stop the Spike" should become the worldwide mantra. The problem with "Stop the spike" is that it's possible to get similar results with a Dexcom and RAA. Now the difference as I read it is that with Afrezza is you can eat almost anything and avoid a spike where as with RAA you have to be a lot more careful. The issue is that this ruins the message. Doctors are well aware (I would hope) that with a LCHF diet you can get a flat graph so I would bet that they think the Afrezza results are just the outcome from the same approach. Tudiabetes has the Flatliners club for where people post their 14 and 30 day results (the gray bars are the variability at each time slot over the period). There are even a couple of Afrezza posts there! Its possible to "Stop the Spike" with any insulin if timed right and absorbed fast enough. Bernstein has shown for years you can also "Prevent the Spike" with certain foods but whats possible and probable are two different things. People eat carbs, people take metformin and people have post meal spikes of 200+. After talking with a lot of doctors, I don't think most doctors even understand diabetes let alone think afrezza results and LCHF diets are the same. They are not. afrezza aids the beta cells functionality, blocks the alpha cells and gets the liver back in sync. LCHF never lets the BG rise in the first place. afrezza action and LFHC are two very different actions with the same outcome. These same people in the 200+ club end up having huge heart disease issues. Lose toes and feat after taking the orals and are a big mess. Enough is enough. Give them the afrezza first, stop the progression and cut the insurance costs. Let them live to 65+ and let Medicare deal with all the new old people.
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ADA
Jan 27, 2018 12:01:25 GMT -5
Post by agedhippie on Jan 27, 2018 12:01:25 GMT -5
Aged; I️ think your selling short the advantages and convenience of of inhaled insulin / everyone has become programmed to think it no longer matters .and especially the scientific advantages to numerous to post ... one being Alfa cell inhibiting glucagon/gulcose cascade for faster onset ,,, etc . Science that should not be taken for granted. I think there are a lot of advantages to Afrezza, but what I am pointing out is what it looks like from the other side. The rep finally gets to see the doctor and he has to give his 30 second pitch, he needs to be able to recite the patient benefits and the deliverable results. A lot of things that get claimed on this board are nowhere near settled science and there are just as many papers against as there are for and you can bet the reps for the products that the doctor is already prescribing know them all. So what are the benefits? Fast onset so you can dose after the meal. Soft dosing in that you don't need to be precise (+/- 2U is fine). Fast clearance to reduce hypo risk. My line would be, "Do you need an easy to dose insulin that you can take after the meal and which clears in a couple of hours to reduce risk?" Now the patient is not going to get optimum results with that approach but they will get comparable results. That's all that matters - the rest is just noise.
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Post by sayhey24 on Jan 27, 2018 14:08:58 GMT -5
What PCP wants to hear about an easy to dose insulin? They have been taught "insulin is dangerous" Ralph DeFronzo has built an entire career on "insulin is dangerous".
My pitch is a bit harder " Do you want to potentially stop the progression and save your PWDs from all the complications including heart disease and death?" Easy, "Stop the Spike, get "back to baseline" asap, "keep TIR near non-diabetic" and the body will do the rest.
We have 40+ years of early insulin intervention studies, they all same the same that early use of insulin is best. None were done with afrezza which would only improve their results. We have the AACE which says insulin is the most potent agent.
This science is settled. There are only TWO things which can consistently "Stop the Spike" - a healthy pancreas AND afrezza. There is no need to play Russian Roulette with an insulin needle.
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Post by agedhippie on Jan 27, 2018 17:36:26 GMT -5
What PCP wants to hear about an easy to dose insulin? They have been taught "insulin is dangerous" Ralph DeFronzo has built an entire career on "insulin is dangerous". My pitch is a bit harder " Do you want to potentially stop the progression and save your PWDs from all the complications including heart disease and death?" Easy, "Stop the Spike, get "back to baseline" asap, "keep TIR near non-diabetic" and the body will do the rest. We have 40+ years of early insulin intervention studies, they all same the same that early use of insulin is best. None were done with afrezza which would only improve their results. We have the AACE which says insulin is the most potent agent. This science is settled. There are only TWO things which can consistently "Stop the Spike" - a healthy pancreas AND afrezza. There is no need to play Russian Roulette with an insulin needle. I suspect most PCPs want to hear that there is an easy to dose insulin. My PCP has anyone who needs to go on insulin go to an endo and expect there are a lot like that. There is a perception that it is hard to titrate and it is better that an expert does it. Being able to manage insulin without involving an endo would be a plus I would think (but I might be wrong as I have nothing to base that on other than gut feeling). None of the points you bring up can be used by reps since they are counter to the label. There are no trials to support any of that with Afrezza. This may change with STAT but even that has to wait for a label change. The reps have to work within the label, those are the FDA rules.
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Post by lennymnkd on Jan 27, 2018 17:58:43 GMT -5
Makeing VDEX all that more important; ,maybe they are on to something/ and in our favor as well .
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ADA
Jan 27, 2018 18:50:36 GMT -5
Post by dreamboatcruise on Jan 27, 2018 18:50:36 GMT -5
What PCP wants to hear about an easy to dose insulin? They have been taught "insulin is dangerous" Ralph DeFronzo has built an entire career on "insulin is dangerous". My pitch is a bit harder " Do you want to potentially stop the progression and save your PWDs from all the complications including heart disease and death?" Easy, "Stop the Spike, get "back to baseline" asap, "keep TIR near non-diabetic" and the body will do the rest. We have 40+ years of early insulin intervention studies, they all same the same that early use of insulin is best. None were done with afrezza which would only improve their results. We have the AACE which says insulin is the most potent agent. This science is settled. There are only TWO things which can consistently "Stop the Spike" - a healthy pancreas AND afrezza. There is no need to play Russian Roulette with an insulin needle. I suspect most PCPs want to hear that there is an easy to dose insulin. My PCP has anyone who needs to go on insulin go to an endo and expect there are a lot like that. There is a perception that it is hard to titrate and it is better that an expert does it. Being able to manage insulin without involving an endo would be a plus I would think (but I might be wrong as I have nothing to base that on other than gut feeling). None of the points you bring up can be used by reps since they are counter to the label. There are no trials to support any of that with Afrezza. This may change with STAT but even that has to wait for a label change. The reps have to work within the label, those are the FDA rules. I'd also think that sales reps would be spinning their wheels if they were trying to advocate treatment regimes contrary to ADA guidelines.
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ADA
Jan 28, 2018 10:18:49 GMT -5
Post by agedhippie on Jan 28, 2018 10:18:49 GMT -5
I suspect most PCPs want to hear that there is an easy to dose insulin. My PCP has anyone who needs to go on insulin go to an endo and expect there are a lot like that. There is a perception that it is hard to titrate and it is better that an expert does it. Being able to manage insulin without involving an endo would be a plus I would think (but I might be wrong as I have nothing to base that on other than gut feeling). None of the points you bring up can be used by reps since they are counter to the label. There are no trials to support any of that with Afrezza. This may change with STAT but even that has to wait for a label change. The reps have to work within the label, those are the FDA rules. I'd also think that sales reps would be spinning their wheels if they were trying to advocate treatment regimes contrary to ADA guidelines. Yes, very few doctors are going to go contrary to the standard of care because of the risk. Until the standard of care changes people can say what they like but metformin is here to stay as the first line treatment and prandial insulin will remain the last resort.
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Post by golfeveryday on Jan 28, 2018 10:24:59 GMT -5
I'd also think that sales reps would be spinning their wheels if they were trying to advocate treatment regimes contrary to ADA guidelines. Yes, very few doctors are going to go contrary to the standard of care because of the risk. Until the standard of care changes people can say what they like but metformin is here to stay as the first line treatment and prandial insulin will remain the last resort. but, CGM will quickly shed light on the inadequacy of current treatments and the standard of care will change.
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