the hypoglycaemia question that gets asked weekly, answered properly
Something I keep coming back to: the hypoglycaemia question that gets asked weekly, answered properly.
My A1c moved and it turned out to have nothing to do with glucose at all.
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.
Continuous monitoring shows the shape: postprandial excursions, overnight behaviour and time in range. Two people with identical A1c can have very different distributions.
Research-use-only material is not approved for human use and nothing here should be read as a recommendation to use it.
best — the order this archive was captured in
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.
a single high reading is not a trend
Variability dropped before the average did, which was visible on the sensor and invisible on the lab result.
the fasting number is the one people fixate on and it moves last
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.
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metformin and an incretin agonist are not in competition
- 1a single high reading is not a trend6 comments in this branch · started by u/sigrid_kaufmann