what changed for me between month 11 and month 20
The title is the whole question — what changed for me between month 11 and month 20 — but here is why I am asking.
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.
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.
Sensor accuracy varies across wear, and readings on the first day are the least reliable. Calibration practice and compression artefacts explain many alarming single values.
Happy to answer the boring questions. Those are usually the ones worth asking.
best — the order this archive was captured in
Postprandial excursions typically respond earlier than fasting glucose, so the sequence people observe is not a sign that something is not working.
A1c, CGM, or fingersticks — which are we discussing?
Correction: that trial is the diabetes programme and the figure you quoted is its glycaemic endpoint, not a weight result.
Variability dropped before the average did, which was visible on the sensor and invisible on the lab result.
Variability dropped before the average did, which was visible on the sensor and invisible on the lab result.
Disagreeing with this line: that endpoint is from the obesity programme and does not answer the question.
The order things move in, since nobody explains it and it worries people.
Postprandial excursions generally respond earliest. Variability tends to narrow before the average does, which is visible on a sensor and invisible on a lab result. Fasting glucose is often the laggard, and A1c — being a three-month average — is the last thing to reflect anything.
So a month in which the sensor looks better and the fasting number has not moved is the ordinary sequence, not a contradiction. Knowing that in advance would have saved me a quarter of unnecessary worry, which is why it is worth writing down.
Careful, that is a regimen change suggestion and it needs to come from whoever manages your diabetes.
Identifying details redacted from the exported report above.
Identifying details redacted from the exported report above.
This is the distinction that resolves most of the confusion here — average versus shape.
Continuous monitoring shows the shape: postprandial excursions, overnight behaviour and time in range. Two people with identical A1c can have very different distributions.
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.
A1c is a three-month average and it lags everything
What does time in range look like, not just the average?
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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postprandial excursions are where most of the improvement shows up first
nothing here replaces the person managing your diabetes
My ApoB moved and it turned out to have nothing to do with glucose at all.
Small fix — insulin secretion in this class is glucose-dependent, which is precisely why the risk you describe comes from the other agent.
Same. The first day of a new sensor is unreliable and people rebuild their whole week around it.
I would not compare your numbers to that population. Different baseline, different regimen, different trial.
metformin and an incretin agonist are not in competition
Right, and the diabetes programmes report glycaemic endpoints. Quoting an obesity trial result here is answering a different question.
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.
That A1c change is inside the assay’s variability and the interval you measured over is too short.
the diabetes trials report different endpoints from the obesity ones
Not convinced. Hypoglycaemia risk from this class alone is low; the risk you are describing comes from the combination.
That is a sensor value, not a plasma value, and the two are not interchangeable at that level of precision.
Brought the whole CGM export to my appointment rather than one number. Entirely different conversation.
sensor accuracy varies and the first day of a sensor is the worst
- 1Right, and the diabetes programmes report glycaemic endpoints. Quoting an…8 comments in this branch · started by u/bianca_demir
- 2Postprandial excursions flattened out first and the fasting number took…7 comments in this branch · started by u/britt_abubakar