chmith,

That was an awesome 1st post and a great perspective on how the T1 trial will provide far more information than we thought. As you know, I am not an endo. And like you, I do not manage the day-to-day details of the disease - though you get to resuscitate them every once in awhile (brings back memories of my paramedic days).

It's a no-brainer the benefit of Afrezza to T1s. It's a no-brainer the benefit to insulin-dependent T2's (I'm using the traditional old-fashioned distinctions). But we both know that early stage T2s, pre-diabetics, however we want to lump them, would all benefit from earlier rather than later insulin therapy.

I didn't catch the nuance you did in the study design. Kudos! But my decision to invest in MNKD was based solely on the enormous size of that population that would benefit from earlier intervention. This will not be just be "non-inferior", it will be superior management. This is a game-changer.

Reminds me of former patient who moved out of the area. She had a 40+ year history of T1. She no longer had any good injection sites remaining due to all the scarring. So her response to injected insulin was very erractic. I remember my last visit with her before she left the area. It was ~ 1 month before the most recent PDUFA. I told her about Afrezza and my hopes for its approval. Sadly, I had to call her the following month and tell her about the CRL.

So anyway, glad to see you posting on the board.