Could education really be all that's needed?
Feb 27, 2018 22:37:15 GMT -5
sportsrancho, esstan2001, and 4 more like this
Post by bill on Feb 27, 2018 22:37:15 GMT -5
Is it possible that the real problem in getting endocrinologists, physicians, and PWDs to buy into Afrezza is an education problem?
My hypothesis is that there are many undereducated health care professionals and PWDs that mistakenly believe PWDs can't use enough insulin to keep them "near normal" or "healthy" because of the risk of hypoglycemia and death. All insulin products other than Afrezza act so long that most efforts to consume enough insulin to be "normal" result in too high a risk of hypoglycemia.
Some PWDs try to get around that by carefully monitoring carbohydrates and using CGMs. They can live at the edge by being very disciplined. Others just use less (too little) insulin to reduce the risk of hypos. The latter group accept the meal-time spikes and higher than normal average and time-in-range blood glucose levels, but increase their risks for short to long-term health problems.
Essentially, most PWDs believe and/or behave like they're faced with a Hobson's choice--attempts to be "normal" by taking enough insulin to be normal don't work because of hypos. Therefore they believe the best they can do is accept higher than normal blood glucose levels and the health problems that come with that. That's been going on for so long that's its become an "abnormal normal."
Afrezza has two unique characteristics; it induces a phase one insulin response which avoids / limits mealtime spikes AND it leaves one's system much more rapidly than the subcutaneous rapid acting analogs. That's important because PWDs CAN now safely use higher doses of prandial and basal insulin to lower the time-in-range and average blood glucose levels to something pretty close to those without diabetes without increasing their hypo risk--particularly if they use a CGM. The "CAN" still requires proper dosing, and many may not achieve that without training and a CGM.
Unless endos, physicians, and patients understand this, Afrezza only has its inhalable characteristic to distinguish itself.
My best guess is that Afrezza solves a problem that everyone has put in the "too hard to do" category for so long that they've forgotten what the problem was, and why it is so hard to solve. Afrezza would still be a miracle drug if it only had its rapid acting characteristics without the Phase 1 response because it allows PWDs to more easily and reliably "solve the insulin hypo math problem"--might be an interesting mobile game/simulation in there somewhere.
If the above is correct perhaps MNKD can solve the Afrezza marketing / sales problem through an aggressive educational campaign. The characteristics of Afrezza are well-known. What's not well-known is why they are critical to improving the health and quality of life for PWDs.
Thoughts?
My hypothesis is that there are many undereducated health care professionals and PWDs that mistakenly believe PWDs can't use enough insulin to keep them "near normal" or "healthy" because of the risk of hypoglycemia and death. All insulin products other than Afrezza act so long that most efforts to consume enough insulin to be "normal" result in too high a risk of hypoglycemia.
Some PWDs try to get around that by carefully monitoring carbohydrates and using CGMs. They can live at the edge by being very disciplined. Others just use less (too little) insulin to reduce the risk of hypos. The latter group accept the meal-time spikes and higher than normal average and time-in-range blood glucose levels, but increase their risks for short to long-term health problems.
Essentially, most PWDs believe and/or behave like they're faced with a Hobson's choice--attempts to be "normal" by taking enough insulin to be normal don't work because of hypos. Therefore they believe the best they can do is accept higher than normal blood glucose levels and the health problems that come with that. That's been going on for so long that's its become an "abnormal normal."
Afrezza has two unique characteristics; it induces a phase one insulin response which avoids / limits mealtime spikes AND it leaves one's system much more rapidly than the subcutaneous rapid acting analogs. That's important because PWDs CAN now safely use higher doses of prandial and basal insulin to lower the time-in-range and average blood glucose levels to something pretty close to those without diabetes without increasing their hypo risk--particularly if they use a CGM. The "CAN" still requires proper dosing, and many may not achieve that without training and a CGM.
Unless endos, physicians, and patients understand this, Afrezza only has its inhalable characteristic to distinguish itself.
My best guess is that Afrezza solves a problem that everyone has put in the "too hard to do" category for so long that they've forgotten what the problem was, and why it is so hard to solve. Afrezza would still be a miracle drug if it only had its rapid acting characteristics without the Phase 1 response because it allows PWDs to more easily and reliably "solve the insulin hypo math problem"--might be an interesting mobile game/simulation in there somewhere.
If the above is correct perhaps MNKD can solve the Afrezza marketing / sales problem through an aggressive educational campaign. The characteristics of Afrezza are well-known. What's not well-known is why they are critical to improving the health and quality of life for PWDs.
Thoughts?
