5 months in and metformin is still the thing I get wrong
5 months in and metformin is still the thing I get wrong. This is a description of what happened to me and not a plan for anybody else.
Numbers, in the order they matter: 5 months.
The three numbers, and what each one can and cannot tell you.
A1c is an average over about three months, weighted to the recent weeks. It cannot show variability and it lags change. Continuous monitoring shows the shape — excursions, overnight, time in range — and is where improvement usually becomes visible first. Fingersticks are point measurements, useful for sanity-checking a sensor and for specific questions.
Most of the frustrated posts here come from expecting one of the three to answer a question that belongs to another. And all three are inputs to a conversation with whoever manages your care, which is not this board.
My triglycerides moved and it turned out to have nothing to do with glucose at all.
Tell me where this is wrong. That is the useful part of posting it.
best — the order this archive was captured in
A1c reflects average glycaemia over roughly the preceding three months, weighted towards the most recent weeks. It cannot show variability and it lags any change you make.
postprandial excursions are where most of the improvement shows up first
On hypoglycaemia, because the risk gets attributed to the wrong thing constantly.
Incretin-based agents stimulate insulin secretion in a glucose-dependent way: the effect scales with glycaemia rather than acting unconditionally. That is why monotherapy risk is low. Where risk rises substantially is in combination with agents that lower glucose independently of the current level.
Which means the question "does this cause hypos" is not answerable without knowing the rest of the regimen — and that the person who can answer it is the one who wrote the regimen. Nothing on this board is a substitute for that conversation, and the good threads here end by saying so.
The diabetes and obesity programmes are separate, with different populations and different primary endpoints. Reading a result across from one to the other is not a comparison.
A1c is a three-month average and it lags everything
Correction: that trial is the diabetes programme and the figure you quoted is its glycaemic endpoint, not a weight result.
nothing here replaces the person managing your diabetes
the fasting number is the one people fixate on and it moves last
A1c is a three-month average and it lags everything
Agreed, and the glucose-dependence point is the reason the risk profile reads the way it does.
Postprandial excursions flattened out first and the fasting number took months to follow. Nobody had told me to expect that order.
Yes — time in range tells you about variability, which the average deliberately hides.
Time in range told me far more than the average did. Two quarters with the same A1c looked completely different on the sensor.
a1c can be affected by things that have nothing to do with glucose
the diabetes trials report different endpoints from the obesity ones
glycaemic control and weight are two different endpoints
- 1On hypoglycaemia, because the risk gets attributed to the wrong thing…7 comments in this branch · started by u/graph_it_gary
- 2Postprandial excursions flattened out first and the fasting number took…6 comments in this branch · started by u/emil_okwuosa