Thanks FUD


@Chris. Actually, someone has. PGS, or Patient Glycemic Score, is a measure of the glucose variability index, time in range, and measures of hypoglycemia both below 70 and below 55, over a specific time period.

It is a difficult computation but there are some apps that do it for you, xDrip+ being one of them. When taken with the GVI (Glucose Variability Index) it is easy to gauge both the altitude and amplitude of a track.


I came back and read through the study. Thanks so much for posting this @Sam. I found a lot of comfort in reading this:

“The baseline or end-of-the-study FEV1 did not differ by treatment group.”

I found it interesting that the exclusion criteria included using Levemir.

" Major exclusion criteria included: pregnancy, any pulmonary disease, severe hypoglycemia that required assistance in the last 3 months, currently smoking or marijuana use, using insulin detemir or Neutral Protamine Hagedorn (NPH) as basal insulin, and a need for >18 U of prandial insulin per meal (Table 1)."

I was surprised that they used a 1:1 conversion for determining mealtime insulin (see Table 2 of the study). The correction doses are exactly in line with what I would use though. Later in the results portion of the study it looks like the doses were increased: " Equivalent TI units are generally 1.5 to 2.0 times the injectable insulin units to reach a similar potency in clinical practice.19,20 Bolus doses in the TI group increased about two-fold in this study, consistent with the expected dose conversion ratio based on GIR data."

The % of time in range is low though across all groups (defined as between 70-180). See graphs below.

“Patients were defined as compliant if ±90% of postmeal TI dosages were taken per protocol, with at least one of the postmeal inhalations taken if indicated per meal. The purpose of this posthoc analysis was to generate hypotheses and plan for a future, larger clinical trial.”


Looks like their results showed no weight gain! Maybe they didn’t treat themselves as much as I did :smile:

…the study was funded by Mannkind, so we may need to take the results with a grain of salt.


Silly question… Can/will anyone please elaborate on the iron deficiency comments referred to above? I have pernicious anemia. For most of my life…but I don’t comprehend the diabetes part of the relationship. Maybe I shouldn’t have skipped biology in 8th grade or something, but I have never read or heard of a correlation between the two before.


I’m not entirely sure if there’s a direct connection between the two, but studies have shown that your A1c may be higher or lower than you would expect (based on studies showing a positive linear correlation between A1c and mean glucose) because of anemia. I’ll paste a few studies below, but I haven’t read through all of them. Most conclude that iron-deficiency anemia results in a falsely elevated A1c and hemolytic anemia results in a falsely lowered A1c. I came across this possibility while wondering why my predicted A1c (based on average bg level) and actual A1c were pretty far off.

I don’t know a lot about pernicious anemia, but I think that means that you can’t digest B12 properly. I’d guess that you get B12 shots? Please correct me if I’m wrong.

A few years ago, I had insufficient B12 levels by US standards (deficient according to a few other countries) and deficient Vitamin D levels (by all standards) . It took my doctor time to figure it out, and my quality of life was significantly affected. It was like I was in a fog all the time. There were lots of issues going on. My eyesight was affected during this time frame too, but I can’t prove that it was a result of the vitamin problems and it did not get better once my levels normalized.

The fog and the other symptoms mostly left once my vitamin levels normalized by taking supplements. I’ve had my B12 levels tested since then, and they’ve been normal so I don’t think I had pernicious anemia. I wasn’t vegetarian, so there’s no reason I should’ve had a B12 problem though. The research article below indicates there’s a relationship between B12 deficiency and diabetes.

Here’s an article about the relationship between diabetes and pernicious anemia:


@Katers87 Thank you very much for the articles. Looks like I have some reading to do. My B levels have been sub threshold since I was in knickers. I take sub-lingual b 2x daily, and it’s still low. The vitamin D thing though I have a handle on thx to the weather in California.

I appreciate the articles very much!