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c/t2dglp1·posted 1 year ago by u/iman_castellanos

what would you tell week-1 you about CGM

Caution Long Haul ×2 Cold Box ×3

what would you tell week-1 you about CGM. I am not trying to be the "source?" guy. I would just like a source.

Panicked over a first-day sensor reading and rebuilt my week around it. It was the sensor.

Brought the whole CGM export to my appointment rather than one number. Entirely different conversation.

Assumed the weight endpoints from the obesity trials applied to my situation. They are different programmes.

Tell me where this is wrong. That is the useful part of posting it.

1,843 up / 79 down96% upvoted39 commentsid xhsnge27 Jul 2025

39 comments

30 in this archive, depth 6

best — the order this archive was captured in

u/ice_pack_auditcold chain207 points·1 year ago

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.

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u/iman_castellanosOP157 points·1 year ago

Is that a first-day sensor reading?

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u/kaia_cabrera94 points·1 year ago

Time in range told me far more than the average did. Two quarters with the same A1c looked completely different on the sensor.

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u/nhs_waitlist_nUK36 points·1 year ago

Yes — the person managing your diabetes is the one to talk to, and this board is explicit about that.

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u/nhs_waitlist_nUK-17 points·1 year ago

That A1c change is inside the assay’s variability and the interval you measured over is too short.

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u/iman_castellanosOP61 points·1 year ago

Small fix — insulin secretion in this class is glucose-dependent, which is precisely why the risk you describe comes from the other agent.

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u/appeal_letter_al144 points·1 year ago

Careful, that is a regimen change suggestion and it needs to come from whoever manages your diabetes.

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u/tired_ledger_notes38 points·1 year ago

This. Hypoglycaemia risk in this class is driven mostly by the other agents in the regimen.

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u/britt_abubakar98 points·1 year ago

That is a sensor value, not a plasma value, and the two are not interchangeable at that level of precision.

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u/iman_castellanosOP49 points·1 year ago

How long between the two A1c measurements?

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u/ice_pack_auditcold chain11 points·1 year ago

time in range is the more informative number and it is newer

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u/arne_nyberg28 points·1 year ago

Correction: that trial is the diabetes programme and the figure you quoted is its glycaemic endpoint, not a weight result.

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u/arne_nyberg147 points·1 year ago

Disagree — that is an obesity trial endpoint and this thread is about glycaemic control.

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u/gentle_correctionMOD76 points·1 year ago

Retitled — the original quoted an obesity endpoint as a glycaemic one.

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u/marta_weiss95 points·1 year ago

Agreed. A1c is an integrated average over roughly three months and treating it as a current reading causes a lot of unnecessary alarm.

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[removed]71 points·1 year ago

[removed by moderator]

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u/lyophile_lou29 points·1 year ago

nothing here replaces the person managing your diabetes

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u/rasmus_kimani112 points·1 year ago

Postprandial excursions typically respond earlier than fasting glucose, so the sequence people observe is not a sign that something is not working.

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u/aleksi_eriksen92 points·1 year ago

postprandial excursions are where most of the improvement shows up first

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u/katrin_girard88 points·1 year ago

a1c can be affected by things that have nothing to do with glucose

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u/osman_ferrari68 points·1 year ago

Certain conditions affect A1c independently of glycaemia. If a result looks inconsistent with the sensor data, that is a question for whoever manages your care rather than for this board.

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u/tomas_lundgren49 points·1 year ago

My hs-CRP moved and it turned out to have nothing to do with glucose at all.

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u/runa_grimaldi16 points·12 months ago

the fasting number is the one people fixate on and it moves last

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u/tired_ledger_notes48 points·1 year ago

Kept fingersticks alongside the sensor for two weeks to sanity-check it. Worth doing once.

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u/step_count_stan40 points·1 year ago

a1c can be affected by things that have nothing to do with glucose

Agreed, and the glucose-dependence point is the reason the risk profile reads the way it does.

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u/katrin_girard49 points·12 months ago

Variability dropped before the average did, which was visible on the sensor and invisible on the lab result.

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u/hugo_norgaard33 points·1 year ago

variability matters as much as the mean

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u/georgi_haddad43 points·1 year ago

Postprandial excursions flattened out first and the fasting number took months to follow. Nobody had told me to expect that order.

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u/tomas_lokken19 points·1 year ago

I would not compare your numbers to that population. Different baseline, different regimen, different trial.

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About c/t2dglp1

Type 2 diabetes as the original indication: A1c trajectories, CGM traces, hypoglycaemia risk when stacked with sulfonylureas or insulin, metformin combinations, and why the weight-loss conversation sometimes drowns out the glycaemic one.

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