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

[Discussion] the A1c advice in here is 2 years out of date

Discussion

the A1c advice in here is 2 years out of date. Making the case below, and I expect to lose some of it in the comments.

To save the first four comments: 2 years.

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.

Would rather be corrected in public than confident in private.

136 up / 6 down96% upvoted18 commentsid u5u9mr30 Jul 2024

18 comments

9 in this archive, depth 5

best — the order this archive was captured in

u/hassan_ostergaard9 points·1 year ago

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.

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u/gentle_correctionMOD9 points·1 year ago

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

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u/rasmus_kimaniOP5 points·1 year ago·edited

Have you taken this to whoever manages your diabetes?

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u/osman_ferrari2 points·1 year ago·edited

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

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u/arne_nyberg1 point·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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[removed]1 point·1 year ago

[removed by moderator]

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u/teodor_duarte-30 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/marta_weiss1 point·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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u/nadia_norgaard3 points·1 year ago

a single high reading is not a trend

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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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