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c/t2dglp1·posted 3 months ago by u/sten_palacios

anyone else notice T2D kicking in around week 89

Caution Clean Column ×3

Reporting in. anyone else notice T2D kicking in around week 89.

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.

My ApoB moved and it turned out to have nothing to do with glucose at all.

Please do not ask me what dose you should be on. I genuinely do not know and neither does anyone else here.

813 up / 76 down91% upvoted54 commentsid ymc6tw15 Apr 2026

54 comments

21 in this archive, depth 4

best — the order this archive was captured in

u/fabio_lehtinen78 points·3 months ago

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.

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u/jonas_cardoso-17 points·3 months ago

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.

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u/nils_ferreira1 point·3 months ago

hypoglycaemia risk depends far more on what else you take

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u/tomas_kimani23 points·3 months ago

glycaemic control and weight are two different endpoints

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u/sock_puppet_spotter10 points·3 months ago

Right, and the diabetes programmes report glycaemic endpoints. Quoting an obesity trial result here is answering a different question.

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u/runa_grimaldi58 points·3 months 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/teodor_duarte0 points·3 months ago

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

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

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[deleted]1 point·3 months ago

[deleted]

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u/sten_palaciosOP1 point·3 months ago·edited

Fasting or postprandial?

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u/kaia_cabrera1 point·3 months ago

check the trial population before quoting a result at somebody

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u/ferran_batista0 points·3 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/gradient_goblin0 points·3 months ago

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

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u/nhs_waitlist_nUK1 point·3 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/enzo_danquah1 point·3 months ago

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

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u/sten_palaciosOP1 point·3 months 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/camila_sandvik1 point·3 months ago

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

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u/tomas_lundgren19 points·3 months ago

Yes — time in range tells you about variability, which the average deliberately hides.

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u/gradient_goblin28 points·3 months ago

Cosigning that postprandial excursions improve first and the fasting number is the laggard.

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u/fasting_insulin_fMOD9 points·3 months ago

Left up. It distinguishes the sensor data from the lab result, which most posts here do not.

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u/tired_ledger_notes6 points·3 months ago

How long between the two A1c measurements?

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u/sunday_shot_sal7 points·3 months ago·edited

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

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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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