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c/t2dglp1·posted 4 months ago by u/osman_ferrari

three years of T2D threads, summarised so you do not have to read them

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three years of T2D threads, summarised so you do not have to read them. I have gone back and forth on this for months.

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

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.

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

I will update this if the picture changes rather than quietly leaving it up.

1,557 up / 302 down84% upvoted66 commentsid xids206 Mar 2026

66 comments

27 in this archive, depth 5

best — the order this archive was captured in

u/gentle_correctionMOD111 points·4 months ago

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

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[deleted]75 points·4 months ago

[deleted]

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u/priya_weiss-3 points·4 months ago

Incretin-based agents stimulate insulin secretion in a glucose-dependent manner, which is why hypoglycaemia risk with them alone is low. Risk rises with agents that act independently of glycaemia.

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u/swirl_dont_shakereconstitution61 points·4 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/amylin_amyamylin79 points·4 months ago·edited

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

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u/rania_marchand41 points·4 months ago·edited

Are you quoting a diabetes trial or an obesity one?

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u/not_my_main_nm21 points·4 months ago

postprandial excursions are where most of the improvement shows up first

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u/osman_ferrariOP32 points·4 months ago

dose for glycaemic control is not the same conversation as dose for weight

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u/laila_wikstrom22 points·4 months ago·edited

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/neha_rahimi7 points·4 months ago

nothing here replaces the person managing your diabetes

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u/kian_solberg2 points·4 months ago

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

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u/kaia_cabrera46 points·4 months ago

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

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u/hassan_ostergaard31 points·4 months 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/joaquin_trevino29 points·4 months ago

A1c is a three-month average and it lags everything

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u/emil_okwuosa23 points·4 months ago

sensor accuracy varies and the first day of a sensor is the worst

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u/joaquin_trevino13 points·4 months ago

Is that a first-day sensor reading?

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u/gustav_lindholm27 points·4 months ago

hypoglycaemia risk depends far more on what else you take

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u/bianca_demir12 points·4 months ago

a single high reading is not a trend

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u/wanjiru_osei12 points·4 months ago

Agreed on variability. Two people with the same average can have completely different days.

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u/osman_ferrariOP9 points·4 months ago

check the trial population before quoting a result at somebody

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u/georgi_haddad0 points·4 months ago

Not convinced. Hypoglycaemia risk from this class alone is low; the risk you are describing comes from the combination.

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u/osman_ferrariOP1 point·4 months ago

Have you taken this to whoever manages your diabetes?

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u/rafael_krastev5 points·4 months ago

Agreed on variability.

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

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u/tomas_lundgren7 points·4 months 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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u/nils_ferreira5 points·4 months ago

glycaemic control and weight are two different endpoints

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u/lucia_balogun4 points·4 months 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/rafael_krastev2 points·4 months ago

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

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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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