brian12372, it is not crazy to test the low limits for yourself. I would say it is a good engineering principle and practice, because you will be in all kinds of different and unexpected situations over time. You can establish the limits you can push it now when you are in a controlled environment rather than taking unwarranted chances when you might be in an emergency or other type situation. Better now with apple juice available rather than no availability :-) .
amstelytle, the first 90 day doctor-measured A1c's will start in May, and then four and five month duration A1c's can follow after that when all the other prandial insulins are for certain out of the system. The real, much reduced, doctor-measured A1c's will get plenty of doctors' attention coming from so many differing types of diabetics with so many differing eating habits, etc.
factspls88, this is a follow-up post sam of tudiabetes wrote about an hour ago. He explains his clear reasons for preferring Afrezza instead of Novolog.
"That's the whole appeal Denise. I had superb control with novolog, there was really very little room for improvement in overall control... But with afrezza I have the same degree of control (while early in the learning process) essentially zero fear of hypoglycemia, and diabetes management takes up about 2% of my thought process instead of 50%."
badbart3, I agree Afrezza as first line treatment for type 2 diabetics is coming. I suggested to doctor.stockpicker to think about this back in October 2014. Also Al Mann in an interview in October 2013 said orals for type 2s were prescribed, because there was not a good prandial insulin. Well now we have a good prandial insulin. You will find my post about it embedded in this Yahoo link below. I tried to shorten the link, but Yahoo would not post it.
Part 1 and Part 2 is better:
stanleyttu, I have to start with some basics that you probably know, but I want to be thorough. The product you call insulin that you put in your pump is not really the chemical insulin a healthy human pancreas secretes. It is an insulin analog, that is, it is very similar to human insulin in the number of amino acids (51 to be exact), but it has some alkyl group substituted on the real human insulin molecule. Insulin analogs are very powerful, meaning they are very, very efficient (work fast) in causing glucose metabolism. Insulin analogs have to be in very low concentration (diluted) in your blood stream. If you were to inject a small dose of an insulin analog directly into a vein, your blood glucose would be metabolized in a very short time and you would get a hypoglycemic event very, very fast. So that is why you have to insert the needle or catheter under the skin. The skin gets locally saturated with the insulin analog, and it secretes slowly into your blood stream all day. Real human insulin from the pancreas is not as efficient as these insulin analogs, and that is good. Otherwise we would never have survived as the human race. Since human insulin metabolizes blood glucose more slowly, the normal pancreas dose secreted can vary a lot and still not create hyperglycemia or hypoglycemia. We all know in normal people there are high metabolism people and lower metabolism people (and everything between), and the reasons are myriad. How quickly or slowly their blood glucose is metabolized is certainly a factor.
mnholdem, no matter what Sanofi says the attributes of Toujeo are, such as, one injection per day, Sanofi is offering it at a premium price to all the basal insulins on the market. With Lantus going generic and such a large number of Lantus users, Toujeo will have a rough time with lower priced generic Lantus plus all the other basal insulins out there. I do not yet see an overpowering reason insurance companies would pay premium prices for Toujeo when lower price generic Lantus is available.
boris821, I recognize eric as Eric Fenar and his review is just like he posts on his twitter account, but on the others I cannot identify how are we to know that WebMD has verified these reviewers? I hope they do a better job than sites like yelp.
Comparing dose units for an insulin analog to dose units of Afrezza seems non-linear and not prone to a simple formula (as much as that would be desired and you would desire it). With a type 1 or type 2 diabetic using Afrezza I think of their lungs as a substitute pancreas, because the lungs secrete the identical human insulin their pancreas would secrete. The dose is up to you, and it will likely require some experimentation on your part. Based on the paper below you will likely be able to tolerate a wide range of carbohydrates once you establish a dose (or my input: a range of doses). With your pump pumping basal and bolus insulin analog, are you already getting the kind of in-range mg/dl blood glucose results that Afrezzauser is getting with his Dexcom meter? If so, you are already in very good control. If you are not in good control, you should try Afrezza. I read that brian12372 tried a 4 unit Afrezza dose first, and observed his blood glucose come down. Then at breakfast he said he tried a 12 unit dose and could feel his blood sugar lower. You will likely need to experiment too, and you may not want to do that. If you insist on a formula, you may not want to be an early adopter of Afrezza.
If you google pubmed 23046397 , you will find a paper from Sansum Diabetes Institute and Mannkind giving details of ranges of carbohydrates consumed, including no meal at all, using Afrezza. No severe cases of hypoglycemia were observed. Afrezza appears very safe in lots of dose amounts. The paper concludes with
Results in eight patients suggest that once an optimal dose of TI is determined, type 2 diabetes patients can ingest meals with a wide range of carbohydrate content or even skip meals without severe hypoglycemia. During this pilot study TI therapy improved A1C by -1.63% (P=0.00091) during 19 weeks of treatment.
I can see on my Fido quotes they are charging 29% to borrowers of MNKD shares. I have not called to see how much of that they pay the owner of the shares. When they charged 24.75% it was about 17.5% paid the owner as I recall. At 29% I would imagine Fido pays 22.5% or so. Just think about this. For those shares in taxable accounts that are on margin Fido is getting all 29% of that money!! Most of the shares that will be loaned out of these IRA type cash accounts will be borrowed by market makers who will service their options customers.
chrisdc73, I am hoping afrezzauser's doctor, Dr. Bode, who is also a diabetes research doctor at Emory, I think, will present something on the results he has seen with Afrezza. From what Sam has posted on Dr. Bode's email about reversing Sam's insulin resistance, as well as possibly reporting on Sam's soon-to-be great A1c reduction into maybe a non-diabetic range, it could reveal a lot about Afrezza to the ADA convention attendees in June.
adisa_ki, I had not looked closely at the premium for the Jan 3 and 3.50 calls. After you mentioned the premium I went back over the trade times, call option prices, premiums, etc. All these 18k + 18k calls were done at 3:42 pm shortly before the close when MNKD was trading at $5.17. The jan 3 calls traded at $2.17 for no time premium at all. The jan 3.50 calls traded at $1.85 for a $0.18 time premium. It seems no profit oriented market maker would do such a trade. I would conclude some market maker or fund is playing with itself, as if they have a big short on and just gifted themselves about 4M shares to cover. What do you surmise could be going on with jan calls that trade with no premium or with premium that is equivalent to $5 weekly calls that expire this week? (even if this is a 3/3.5 call spread I don't see that it makes a lot of sense).
Why would a practicing physician label a topic "Important factual information" on a yahoo message board? Oh, now I get it. It's like Saul Goodman telling clients he is a "criminal" lawyer.
tasermania, it is $8.5 not $8 for 2/13. it is Aug $12s not May. I don't know whether you transcribed these incorrectly, or if your data source has it mixed up. Just FYI so others do not get wrong call option numbers from your post. I checked my work just now. It looks like a lot of hedging to me.
Please notice the dot between doctor and stockpicker to recognize the legitimate doctor who posts real medical information here.
factspls88, yes, as you probably know if you have been reading sam of tudiabetes' posts about his blood glucose, his Afrezza meal timings, and his really normally great quiescent blood glucose readings just prior to meals, this sam is very insulin sensitive. He has worked very hard over the years on his blood glucose control, and he has been almost religious about counting carbohydrate grams he has for meals. It is admirable he has done that, but clearly he would rather be doing more productive and fun activities than managing and maintaining his type 1 diabetes. There are not many diabetics who would strive so diligently to maintain such tight control with Novolog. However as you can see from his passage above that I quoted from his text, with Afrezza he not only derives the same tight control with his blood glucose levels and range, but also he is no longer worried about hypoglycemia or having to spend large amounts of his time babysitting his diabetes.
Did you see that pic of the cheeseburger and fries meal he used (after a few weeks of using Afrezza) to test against Afrezza's speed to bring down his blood sugar? That was a tasty looking burger. He has stated a few times how fast and high his blood sugar can rocket with such a meal using other brand name insulins. With this challenging burger meal his Afrezza headed those excursions off at the pass fast, and brought them right back down without getting out of control. I am so happy for him!
kepler2stars, the Indian moron on the FDA panel at the Adcom was Lokesh Jain. I posted this response a few days after the Adcom.
adisa_ki, I have thought about something like that, but "they" are trading a lot at "market" prices. They don't hit a bid or ask sometimes. Whoever is selling might not let you play. If you try buying at the market for options, they can make the trade an unhappy trade result. Those two 18k jan 3/3.5 trades were market prices, so clearly a deal was known by some players with no arms to have any length - so to speak.
bmcgoo_03, Afrezza is not only a step function increase in productivity for diabetics, but also offers them far more than a step function improvement in physiological chemical control within desired blood glucose limits to prevent organ and nerve damage. If your premise about endocrinologists is correct, they are still supposed to do no harm. If Afrezza will benefit their patients over and above injected prandial insulins, they will prescribe Afrezza and have more time for other endocrine glands. Right? They have had to spend lots of their time and efforts on diabetes, because there are so many of them who have had to use roller coaster insulin. With Afrezza prandial insulin they will be able to concentrate more on all the other endocrine diseases that have not gotten as much of their attention in the past.
Godin said he is in Canada and will have to wait until Afrezza comes to Canada. He said at the end of the two year Afrezza trial his A1C was 5.9. If I were he, I would be making a run for the border.