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c/t2dglp1·submitted 13 days ago by u/joaquin_trevino

[Discussion] the weight conversation drowns out the glycaemic one

Discussionbranch of 6 comments

the weight conversation drowns out the glycaemic one — a position I have arrived at slowly and would like tested. 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…

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6 comments, started 12 days ago
u/stubborn_batchlist_maybe68 points·12 days ago

On hypoglycaemia, because the risk gets attributed to the wrong thing constantly.

Incretin-based agents stimulate insulin secretion in a glucose-dependent way: the effect scales with glycaemia rather than acting unconditionally. That is why monotherapy risk is low. Where risk rises substantially is in combination with agents that lower glucose independently of the current level.

Which means the question "does this cause hypos" is not answerable without knowing the rest of the regimen — and that the person who can answer it is the one who wrote the regimen. Nothing on this board is a substitute for that conversation, and the good threads here end by saying so.

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u/cormac_danquah51 points·12 days 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/stablecoin_steve18 points·12 days ago·edited

The diabetes and obesity programmes are separate, with different populations and different primary endpoints.

Adding the obvious one — bring the export, not the single number, to whoever manages this.

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[deleted]7 points·12 days ago

[deleted]

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u/camila_sandvik31 points·12 days ago

The diabetes and obesity programmes are separate, with different populations and different primary endpoints.

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

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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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