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Post by stevil on Feb 27, 2016 18:44:10 GMT -5
Thanks for the correction. I haven't researched the clinic much. I just assumed based on all the comments about it that it was more for urgent care than continuing therapy. Guess I'll have to educate myself better before talking
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Post by stevil on Feb 27, 2016 18:40:39 GMT -5
easiest, but only better than BK. I don't want either BK or a buyout right now. If a buyout comes, we want to show prospective buyers a whole hell of a lot more value than we're showing right now.
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Post by stevil on Feb 27, 2016 18:36:59 GMT -5
The point with the artificial pancreas is that you go not need to do anything other than periodically top up a pump and change a site or sensor. You can eat when and what you want without any manual dosing, you can exercise, you can live a normal life without worrying whether you are high or low. It will be expensive though and beyond most Type 1 and a few Type 2 diabetics nobody else will get it in the US. pump and a normal life? there's nothing normal with a pump.. Sorry to pick on you, but I take issue with people that talk like this on here. I have no idea if you're diabetic, but if you are, I have a hard time imagining you'd say something like this. For people like my uncle who grew up without a pump, he feels like he's a free man with his pump. I tried to tell him about Afrezza but he was perfectly content with his pump so he didn't even listen to me. Does it get better than a pump? Yes. Is no pump better than a pump? Yes. Forgive my candor, but you sound ignorant when you talk like this. And it's self-talk like this that I feel many people deceived themselves into thinking Afrezza was more than it was. Afrezza doesn't even remove the necessity of a pump for crying out loud (correction: it can for type 2s if it relieves beta exhaustion, but not type 1s)! Pumps are wonderful things! It's the closest diabetics have gotten to "normal" since the beginning of time. It's not the destination, but it's certainly a significant step in the right direction. Please don't downplay its significance.
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Post by stevil on Feb 27, 2016 18:32:31 GMT -5
I know someone that works at Lilly in the marketing/research department. I was told that they were very excited about a pump in the near future that will read blood sugar in real time and release either insulin or glucagon to keep the blood within physiological limits. It's effectively an artificial pancreas. I'm not sure if this is similar to that or not, but thought I'd share what I'd heard. They weren't allowed to divulge too many details. That's about all that I know about it. One thing that artificial pumps can't handle is glucose spikes during eating, or that is what I have read from those who follow AP closely. We do know that Sansum has done AP testing and used Afrezza as the meal time insulin. Here's the video. www.youtube.com/watch?v=GGgGjtM5ipgTrue, but there's also some sort of machinery that will bolus for you. You type in how many carbs you're about to eat, and I think it's even supposed to beep for you when the best time to eat would be. Then, if you miscalculated, or if there are any complications with metabolism, the glucagon would correct on the over or more insulin would be released on the under. In theory, it could do away with injections altogether. The only involvement would come during mealtime and all that is required is carb counting. No other maintenance is required other than making sure the vials aren't empty. I have no idea how large the device would be or how the vials will be loaded, but it sounded interesting nonetheless. I notice that I feel angst towards it because it's a threat to my investment, but I have to remember that this is about saving lives, not about making money off of people's' diseases. It's remarkable technology and very exciting what medicine is evolving into.
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Post by stevil on Feb 27, 2016 18:26:14 GMT -5
After reading through this thread, I wanted to address a few things. It seems like a lot of people are talking past each other ( peppy , agedhippie , suebeeee1 ) General physicians are fine for urgent care settings. It's usually just about stabilizing the patient and sending them home for a later follow up with either their PC or Endo, whichever they deem necessary or patient preference. The more demanding cases would obviously be handled by the endo on call, but a vast majority of them are easily handled by a general physician. agedhippie was correct in regards to ease of treatment of hypoglycemia. It's as simple as taking glucose. Problem solved in most cases, unless there is a different underlying issue. Suebeeee1 was also correct in her response, but you're arguing a different point than agedhippie was. Suebeeee's point is more relevant to long term care, whereas aged hippie was talking more about urgent care (if I'm understanding you correctly) A1c levels are an average blood glucose measurement over 3 months, not indicative of an emergent crisis. Truly, A1c and hypoglycemia aren't really all that related, unless you're chronically hypoglycemic. But that's hard to do as it's not really all that conducive to health. Hyperglycemia is more of a concern with A1c because higher levels of glucose over 3 months will lead to higher A1c levels, even if there are periods of hypoglycemia mixed in. Again, it's an average, not a one time event. The idea is to reduce hyperglycemia which will then lead to lower A1c levels. I'm pretty sure you already knew this and I'm not sure if the ADA adjusted their A1c protocols up or down. Based on what you're saying, I'd assume they raised the range to prevent hypos? Is that what you're saying? Haha suddenly I don't feel like I'm clarifying anything The clinics are aimed at hyperglycemic patients, although I'd imagine they're equipped to handle hypos also, relating to peppy's point. As suebeeee said, usually hypoglycemic people present with sleepiness, delirium, anxiety, nausea, etc. Those patients are usually treated with oral or iv glucose and generally improve fairly quickly, depending on severity. With the focus on hyperglycemia in mind, obviously insulin will be needed to decrease BG levels. In a state of ketoacidosis or hyperosmolar hyperglycemic state, time is of the essence. I'd imagine IV glucose would be used in those situations, although hopefully Afrezza will prove to be just as effective in the not so distant future and will be an alternative during those times if the patient is still alert and oriented (which was aggedhippie's point). One final thing I'd like to add- I think "young" people are featured on the website for a couple reasons 1. DKA is most common in people under 65 years old. This seems like it'd be one of the highest reasons for a visit 2. They're appealing to a younger audience- which I actually like a lot. Younger people are probably more apt to try an alternative insulin than someone who is set in their ways. Also, it's better to get a younger person hooked on your insulin therapy than an older person. More miles...
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Post by stevil on Feb 27, 2016 17:35:35 GMT -5
I know someone that works at Lilly in the marketing/research department. I was told that they were very excited about a pump in the near future that will read blood sugar in real time and release either insulin or glucagon to keep the blood within physiological limits. It's effectively an artificial pancreas.
I'm not sure if this is similar to that or not, but thought I'd share what I'd heard. They weren't allowed to divulge too many details. That's about all that I know about it.
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Post by stevil on Feb 27, 2016 17:31:06 GMT -5
I have to respectfully disagree, and I think Matt even made reference to the mistakes that were made in the contract w/sny. From day one of the contract with SNY I have been harping about having signed an exclusive contract with total lack of product control, and the lack of documented contractual commitment on behalf of sny. The contract was signed with the assumption that SNY would do what they said however the contract didn't bind them to any time line, committed sales, agenda for marketing...This in itself is a huge boo boo on managements part and it's what put us in the position we are today. I can't speak to why the other companies you have mentioned have had such poor performance, I think Janet Yellen's comments about there being a bio-tech bubble sure didn't help. With that said, everyone makes mistakes, I don't know who dropped the ball on the sny contract and at this point it really doesn't matter, what does matter is what they do going forward. I believe they are capable of righting the ship if they make smart decisions and sign good contracts. I agree with both this and mnholdem 's argument. Where we are since the SNY split is not management's fault. The market as a whole has been in a slump. It was going to happen regardless. However, added onto what jurystillout said, it's also on management that we are cash-poor and still have yet to sign a good TS deal. So many people seem to forget about our "embarrassment of riches" sitting in our vaults. If ever a case of self-indictment is to be made, Matt couldn't have said it any better. No one is to blame for where we are besides management. The fact that we're even in the position of putting all of our eggs into the Afrezza basket after 19 years of existence should tell you all you need to know about management. Many, many, many mistakes have been made along the way.
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June 7
Feb 27, 2016 17:14:00 GMT -5
blaz likes this
Post by stevil on Feb 27, 2016 17:14:00 GMT -5
Starts Ramadan.
Why is this important? Because the fastest-growing religion in the world will participate in a month-long fast.
Why is this important? Many diabetic Muslims are unable to participate in the fast if their blood sugar drops below 80 in the early hours of fasting or if it goes below 70 at any time.
I was thinking about MNKD during my clinical med class as we talked about different religions and what we needed to know about each. It may be a good idea to focus marketing with Islamic leaders and at least test the waters to see if they would be interested in spreading the word for us to members of their mosques. I know many Muslims would like to be able to participate in the fasting portion of Ramadan but are unable to do so due to difficulty with control. It's likely Afrezza would increase their chances to participate.
I know there has been talk of doing business in the Middle East, but I sincerely hope this is a topic the board has already thought of. It seems like the easiest low fruit to grab in my opinion.
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Post by stevil on Feb 27, 2016 16:42:45 GMT -5
One thing is for certain, Matt is already a step up from Hakan. It seems Hakan should have been more involved in R&D and less in CEO/marketing/partnership deals. Matt seems to be much more creative and visionary than Hakan, who, if he had any value at all, may have been better suited in daily operations. My pick would have been for Hakan to be COO and Matt to be CEO long ago, as Matt essentially was playing the communicator and forecaster anyway.
The one thing that still has been irking me as I've been thinking over it is how ill-prepared MNKD has been for far too long. Which is really surprising to me considering all the experience on the board. They basically had no contingency plans for Hakan's termination/resignation, they sounded like they were going to stay with SNY and allow them to keep them by the balls- HUGE WTF moment the more we hear about the details and disagreements. Hard sell for Matt to instill confidence- if they truly believed they could go it alone without SNY, why weren't they the ones to terminate? I know it was more advantageous for them to allow SNY to terminate as it would release them from some of the contractual agreements, but even then, they looked as though they were caught off guard when SNY announced their termination.
Sometimes all people need is the opportunity to shine. Perhaps the role of CEO will suit Matt better than his previous role now that he has to step into something bigger. He has to rise to the challenge. His energy has been positive so far and I enjoy listening to him speak, although I don't buy much of what he's shoveling yet. One thing is for sure though... There was a lot of improvement to be had. Ranging from communication to shareholders, keeping the website up to date, better presentations, better marketing strategies, actually inking partnerships, etc. The needle seems to be pointing in the right direction at the moment, but I'm not ready to anoint Matt the Savior yet. I would agree with Rob in that he appears to be the best man for the job at this juncture, but if he gets us out of the rock and hard place we currently find ourselves, I hope he hands the baton off to someone else who has a more proven track record. It'd probably be awfully hard to demote him at that point, however.
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Post by stevil on Feb 27, 2016 15:50:51 GMT -5
This appears to be a very difficult question to answer and I would suspect many here would share my viewpoint (for once).
The only way I sell at $5, and even then it would be hard to do, is if the fundamentals don't match the SP. Meaning, only rumor and speculation is driving the price.
However, if there is a fundamental reason- good financials, increasing profits, lucrative partnerships, etc, it would be madness to sell at $5. This stock has already been priced at multiples of that at one time or another.
This stock is too boom/bust for me and I've already made my bed in the depths. Come hell or high water, I'm going to ride out what I've already got in this and will only willingly sell if it appears we've clearly reached a plateau, either due to poor management, or an unwilling market.
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Post by stevil on Feb 26, 2016 18:39:09 GMT -5
Too bad there isn't an Academy Awards for medicine, philanthropy or life in general... Dr. Mann would be a fitting recipient of lifetime achievement award. Don't know how well-known/recognized this is, but he actually did receive lifetime achievement awards... And obviously deservedly so... I can only hope that people will remember me when I'm gone. No one will be able to forget this man... His life's work impacted the lives of millions. Truly amazing. www.mddionline.com/blog/devicetalk/alfred-mann-wins-mdea-lifetime-achievement-award
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Post by stevil on Feb 26, 2016 18:36:04 GMT -5
Although a couple years old, I thought this article very nicely captured the man and his life. Among the things I didn't know, he was also a poet! The things I did know are perfectly emphasized. He used the gifts he'd been given to give back. IMHO, his migration to the medical field seems an inevitability as that is where he saw the greatest opportunity to solve the biggest problems, do good and give of himself. “The secret of my success is that most people look at technology and say lets go out and find a use for this technology. I typically do the reverse. I look for a poorly met or unmet need and then find the technology to make it work.” “For me then or now, it’s never really been just about money, it’s about making a difference. Money is a tool to use effectively to accomplish things and if you do well, the money comes in.” davidovit.com/articles/Al-Mann-Article.pdfbeautiful article, thanks for sharing. His life was one well-lived. Recharged my batteries as I'm fretting over studying for neurology. It sure puts things in perspective. I doubt this man ever complained a day in his life.
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Post by stevil on Feb 24, 2016 5:15:10 GMT -5
Might be too much scientific jargon, but did a quick search and found an article from 2002!!! (amazing how much was known back then about GLP-1) It's pretty descriptive and does a good job explaining how it works if anyone is interested. diabetes.diabetesjournals.org/content/51/suppl_3/S434.full
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Post by stevil on Feb 24, 2016 5:07:24 GMT -5
Unless this combo is so effective as to stop progression it would seem all T2 are likely to eventually need prandial insulin... but I'm not a medical doctor. We were taught in my biochem class that GLP-1 has shown the ability to increase beta cell mass. In theory, this is the closest we've gotten to a cure for diabetes if it indeed does regenerate beta cells that then also function properly.
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Post by stevil on Feb 24, 2016 5:00:38 GMT -5
It's still lost on me that if SNY was trying to torpedo MNKD, why would they allow them to hang around long enough to survive? The death knell hasn't rung yet. If SNY was so afraid of the success of Afrezza, they wouldn't leave it sitting around for someone else to pick it up and wield it. Let's play Lord of the Rings. If you find the One Ring, you don't just throw it away and let someone else find it, especially for a pittance.
SNY might be the dumbest company of all time if MNKD makes a turnaround worthy of a book/movie. I'm hoping for our sakes that they are, but even Matt's confidence can't convince me that SNY made a blunder of epic proportions and Afrezza will find success quickly enough to keep us afloat.
SNY could have chosen to keep 65% of the market share they'd eventually lose anyway, or they could have bought us outright. They chose to do neither and treated us as though we weren't even worth the time to give us a full go of it on the market. The only thing that makes sense to me is SNY truly believed it wasn't worth their time/investment. Let's hope they were just dead wrong, careless, and foolish.
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