small win: glycaemic control stopped being a problem at week 17
small win: glycaemic control stopped being a problem at week 17, logged the same way every week so the comparison is at least internally fair.
Panicked over a first-day sensor reading and rebuilt my week around it. It was the sensor.
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.
Happy to answer the boring questions. Those are usually the ones worth asking.
best — the order this archive was captured in
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.
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.
hypoglycaemia risk depends far more on what else you take
Identifying details redacted from the exported report above.
Not convinced. Hypoglycaemia risk from this class alone is low; the risk you are describing comes from the combination.
nothing here replaces the person managing your diabetes
Same. The first day of a new sensor is unreliable and people rebuild their whole week around it.
Postprandial excursions typically respond earlier than fasting glucose, so the sequence people observe is not a sign that something is not working.
variability matters as much as the mean
Agreed on variability. Two people with the same average can have completely different days.
That is a sensor value, not a plasma value, and the two are not interchangeable at that level of precision.
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.
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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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.
glycaemic control and weight are two different endpoints
glycaemic control and weight are two different endpoints
Agreed, and the glucose-dependence point is the reason the risk profile reads the way it does.
A1c, CGM, or fingersticks — which are we discussing?
Correcting myself: 21 weeks between those two A1c results, which is too short an interval to interpret.
Right, and the diabetes programmes report glycaemic endpoints. Quoting an obesity trial result here is answering a different question.
Continuous monitoring shows the shape: postprandial excursions, overnight behaviour and time in range. Two people with identical A1c can have very different distributions.
- 1The diabetes and obesity programmes are separate, with different populations…9 comments in this branch · started by u/osman_ferrari