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

my fasting insulin moved and I cannot work out whether metformin is why

CGM Receipts ×3 Slow Clap ×1

my fasting insulin moved and I cannot work out whether metformin is why. It is the sort of thing everyone half-believes and nobody writes down.

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

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

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

Corrections welcome, especially the pedantic ones. Pedantry is how this board earns its reputation.

2,412 up / 54 down98% upvoted46 commentsid v9vtwm3 Mar 2025

46 comments

15 in this archive, depth 3

best — the order this archive was captured in

u/cloudy_vial_carol263 points·1 year ago

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.

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u/hana_lehtinenOP170 points·1 year ago

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

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u/hana_lehtinen136 points·1 year ago

hypoglycaemia risk depends far more on what else you take

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u/marisol_moreau210 points·1 year ago·edited

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/slow_logbook_notes30126 points·1 year ago

check the trial population before quoting a result at somebody

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[removed]50 points·1 year ago

[removed by moderator]

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u/lucia_balogun82 points·1 year ago

CGM shows you the shape, A1c shows you the area

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u/nils_ferreira63 points·1 year ago

CGM shows you the shape, A1c shows you the area

This is the distinction that resolves most of the confusion here — average versus shape.

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u/hana_lehtinenOP48 points·1 year ago

What does time in range look like, not just the average?

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u/arne_nyberg66 points·1 year ago

Continuous monitoring shows the shape: postprandial excursions, overnight behaviour and time in range. Two people with identical A1c can have very different distributions.

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u/ingrid_correia35 points·1 year ago

What else is in the regimen?

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u/adnan_karlsen24 points·1 year ago

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

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u/emil_okwuosa-25 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/gentle_correctionMOD14 points·1 year ago

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

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u/tomas_lundgren16 points·1 year ago·edited

What else is in the regimen?

Disagreeing with this line: that endpoint is from the obesity programme and does not answer the question.

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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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