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Post by sportsrancho on May 8, 2018 6:14:26 GMT -5
Prior to the availability of degludec and regular human insulin inhalation powder in the type 1 diabetic patient glycemic control with subcutaneous insulin injections was difficult to obtain due to nocturnal, pre-prandial and often severe hypoglycemia as well as post-prandial hyperglycemia and hypoglycemia due to “stacking” of insulin. A 62-year-old female with type 1 diabetes for 56 years who could not be controlled with continuous subcutaneous insulin aspart infusion obtained glycemic control without significant hypoglycemia or increased post-prandial glycemic excursions utilizing degludec insulin for basal needs and technosphere before meals and between meals if needed. The availability of degludec and technosphere insulin improved the management of brittle type 1 diabetes www.tandfonline.com/doi/abs/10.1080/00325481.2018.1472509 |
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Post by digger on May 8, 2018 6:50:19 GMT -5
Well, that, at least, should reduce the insulin expense -- "...utilizing degludec insulin for basal needs and technosphere before meals and between meals if needed." Are we sure David Bell wrote that? To me, the whole abstract reads a bit on the functionally illiterate side -- especially when I compare it to some of his others -- www.tandfonline.com/author/Bell%2C+David+S+HPlus four years ago -- www.healio.com/endocrinology/practice-management/news/online/%7B8d77a37c-cfc9-484f-85d5-8df91883f6e2%7D/5-questions-patients-will-ask-about-newly-approved-inhalable-insulin -- he said: "“We’ve had injectable insulin for 90 years. It has worked well,” he said. “Throughout the years we’ve experimented with insulin eye drops, nasal insulin, encapsulated oral insulin and even vaginal and anal suppositories. All of these things have never really worked out. Now, we’ve got a very convenient, painless system to administer insulin, especially with insulin pens and their 32-gauge needles. Frankly, I don’t see the need for this." I interpret "this" as referring to afrezza. |
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Post by peppy on May 8, 2018 6:58:55 GMT -5
Well, that, at least, should reduce the insulin expense -- "...utilizing degludec insulin for basal needs and technosphere before meals and between meals if needed." I noticed the typo or poor work as well. Heh, we post these articles and put these unknown people up as experts. |
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Post by digger on May 8, 2018 7:08:57 GMT -5
Well, that, at least, should reduce the insulin expense -- "...utilizing degludec insulin for basal needs and technosphere before meals and between meals if needed." I noticed the typo or poor work as well. Heh, we post these articles and put these unknown people up as experts. I'd still like to see the complete article. |
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Post by akemp3000 on May 8, 2018 7:37:27 GMT -5
Well, that, at least, should reduce the insulin expense -- "...utilizing degludec insulin for basal needs and technosphere before meals and between meals if needed." Are we sure David Bell wrote that? To me, the whole abstract reads a bit on the functionally illiterate side -- especially when I compare it to some of his others -- www.tandfonline.com/author/Bell%2C+David+S+HPlus four years ago -- www.healio.com/endocrinology/practice-management/news/online/%7B8d77a37c-cfc9-484f-85d5-8df91883f6e2%7D/5-questions-patients-will-ask-about-newly-approved-inhalable-insulin -- he said: "“We’ve had injectable insulin for 90 years. It has worked well,” he said. “Throughout the years we’ve experimented with insulin eye drops, nasal insulin, encapsulated oral insulin and even vaginal and anal suppositories. All of these things have never really worked out. Now, we’ve got a very convenient, painless system to administer insulin, especially with insulin pens and their 32-gauge needles. Frankly, I don’t see the need for this." I interpret "this" as referring to afrezza. Once upon a time, the public at large didn't see the need for dishwashing machines or automatic car windows as they were thought to be frivolous and needless expenses. Diabetics that either don't know about Afrezza or have not used Afrezza correctly likely don't see the need but those that have say it is life changing. Times change. |
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Post by standup on May 8, 2018 8:42:29 GMT -5
Well, that, at least, should reduce the insulin expense -- "...utilizing degludec insulin for basal needs and technosphere before meals and between meals if needed." Are we sure David Bell wrote that? To me, the whole abstract reads a bit on the functionally illiterate side -- especially when I compare it to some of his others -- www.tandfonline.com/author/Bell%2C+David+S+HPlus four years ago -- www.healio.com/endocrinology/practice-management/news/online/%7B8d77a37c-cfc9-484f-85d5-8df91883f6e2%7D/5-questions-patients-will-ask-about-newly-approved-inhalable-insulin -- he said: "“We’ve had injectable insulin for 90 years. It has worked well,” he said. “Throughout the years we’ve experimented with insulin eye drops, nasal insulin, encapsulated oral insulin and even vaginal and anal suppositories. All of these things have never really worked out. Now, we’ve got a very convenient, painless system to administer insulin, especially with insulin pens and their 32-gauge needles. Frankly, I don’t see the need for this." I interpret "this" as referring to afrezza. Once upon a time, the public at large didn't see the need for dishwashing machines or automatic car windows as they were thought to be frivolous and needless expenses. Diabetics that either don't know about Afrezza or have not used Afrezza correctly likely don't see the need but those that have say it is life changing. Times change. Dishwashing machines and automatic car windows are frivolous and needless expenses. Life changing drugs are not. |
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Post by sportsrancho on May 8, 2018 9:03:56 GMT -5
Once upon a time, the public at large didn't see the need for dishwashing machines or automatic car windows as they were thought to be frivolous and needless expenses. Diabetics that either don't know about Afrezza or have not used Afrezza correctly likely don't see the need but those that have say it is life changing. Times change. Dishwashing machines and automatic car windows are frivolous and needless expenses. Life changing drugs are not. It’s just like when people did not think they needed a smart phone... now most people cannot figure out what they would do without one. Learning curve though. Seems daunting at first, but then it opens up a whole new world! |
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Post by johnhindepost on May 8, 2018 10:38:38 GMT -5
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Post by dreamboatcruise on May 8, 2018 11:02:18 GMT -5
"between meals if needed"
Wonder if this patient was using CGM. If so, wonder if stats on TIR and hypos are given in the full article.
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Post by oldfishtowner on May 8, 2018 12:08:04 GMT -5
Dr. Bell is not on the Afrezza "Find a Doctor" list. I am assuming that he is a typical conservative endo who has finally come around to trying Afrezza and was surprised by the results. According to his biographical info on the web, Bell is in his mid 70's and has been practicing for over 40 years, so he has seen his share of patients with diabetes.
Maybe this is the change in mindset we have been waiting for among endos and the rest of the medical community, or at least the beginning of it. It may also signal that the time is ripe for the STAT presentation at the ADA meeting next month.
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Post by akemp3000 on May 8, 2018 12:22:07 GMT -5
Beginning with the ADA, Dr. Kendall should start every speech and conversation with the enormous healthcare cost of diabetes followed by a proclamation that current standards of care are NOT working sufficiently. Further, due to modern technology, A1c should now be considered an outdated measurement when compared to time-in-range...and that attention in the industry moving forward should be focused on: 1) time-in-range, 2) preventing or stopping meal-time spikes and 3) a reduction in subsequent hypoglycemia. We already know where this will lead without him even having to discuss inhaled insulin  |
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Post by celo on May 8, 2018 12:39:05 GMT -5
Great abstract. Google has his office as permanently closed. Be hard to increase scripts from his office. The light bulb about inhalable insulin must of gone on right before retirement. "I've been wrong this whole time...."
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Post by dreamboatcruise on May 8, 2018 12:44:37 GMT -5
Great abstract. Google has his office as permanently closed. Be hard to increase scripts from his office. The light bulb about inhalable insulin must of gone on right before retirement. "I've been wrong this whole time...." His own website doesn't show as closed (and it has 2018 copyright notice), though it does say not accepting new patients. |
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