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

[Discussion] the metformin advice in here is 2 years out of date

Discussion

the metformin advice in here is 2 years out of date, which sounds obvious until you try to state the evidence for it.

Pulling the figures out of the title: 2 years. All of it is written down as it happened rather than reconstructed.

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

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.

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

75 up / 4 down95% upvoted8 commentsid yvqnx96 Jun 2025

8 comments

8 in this archive, depth 4

best — the order this archive was captured in

u/gustav_lindholm8 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/gentle_correctionMOD4 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/a1c_arcT2D3 points·1 year ago

nothing here replaces the person managing your diabetes

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u/reship_roulette2 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/georgi_haddadOP-10 points·1 year ago

nothing here replaces the person managing your diabetes

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

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u/kian_solberg6 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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[removed]4 points·1 year ago

[removed by moderator]

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u/rania_marchand1 point·1 year ago

A1c is a three-month average and it lags everything

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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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