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

am I the only one who found hypoglycaemia harder than the injections

CGM Cold Box ×5 Long Haul ×1

Asking properly rather than in a comment on somebody else’s thread: am I the only one who found hypoglycaemia harder than the injections.

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.

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

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.

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

1,487 up / 201 down88% upvoted36 commentsid wxqakh10 Dec 2024

36 comments

24 in this archive, depth 5

best — the order this archive was captured in

u/fasting_insulin_fMOD261 points·1 year ago

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

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u/lucia_balogun113 points·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/neha_rahimi49 points·1 year ago

a single high reading is not a trend

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u/osman_ferrari182 points·1 year 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/thandi_solbergOP-33 points·1 year ago·edited

Is that a first-day sensor reading?

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u/marta_weiss92 points·1 year ago

Push back: one sensor reading is not a data point worth acting on, especially in the first day of wear.

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u/thandi_solbergOP54 points·1 year ago

What else is in the regimen?

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u/marta_weiss25 points·1 year ago

check the trial population before quoting a result at somebody

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u/thandi_solbergOP0 points·1 year ago

Are you quoting a diabetes trial or an obesity one?

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u/rasmus_kimani1 point·1 year ago

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

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u/arne_nyberg18 points·1 year ago

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

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u/karim_ramos12 points·1 year 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_goblin4 points·1 year ago

CGM shows you the shape, A1c shows you the area

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u/arne_nyberg83 points·1 year ago

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

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u/adnan_karlsen52 points·1 year ago

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

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u/nora_ramos29 points·1 year ago

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

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

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u/lucia_balogun55 points·1 year ago

hypoglycaemia risk depends far more on what else you take

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[removed]41 points·1 year ago

[removed by moderator]

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u/osman_ferrari25 points·1 year 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/camila_sandvik26 points·1 year 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/kasper_cabrera20 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/stablecoin_steve33 points·1 year ago

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

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u/plain_titration20 points·1 year ago

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

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u/amylin_amyamylin12 points·1 year ago

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

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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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