unpopular opinion: most of what gets said here about CGM is guesswork
unpopular opinion: most of what gets said here about CGM is guesswork. I have gone back and forth on this for months.
The three numbers, and what each one can and cannot tell you.
A1c is an average over about three months, weighted to the recent weeks. It cannot show variability and it lags change. Continuous monitoring shows the shape — excursions, overnight, time in range — and is where improvement usually becomes visible first. Fingersticks are point measurements, useful for sanity-checking a sensor and for specific questions.
Most of the frustrated posts here come from expecting one of the three to answer a question that belongs to another. And all three are inputs to a conversation with whoever manages your care, which is not this board.
Variability dropped before the average did, which was visible on the sensor and invisible on the lab result.
Kept fingersticks alongside the sensor for two weeks to sanity-check it. Worth doing once.
Tell me where this is wrong. That is the useful part of posting it.
best — the order this archive was captured in
Retitled — the original quoted an obesity endpoint as a glycaemic one.
Retitled — the original quoted an obesity endpoint as a glycaemic one.
a1c_arc is right that the fasting number moves last. Knowing that in advance saves months of worry.
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.
dose for glycaemic control is not the same conversation as dose for weight
Careful, that is a regimen change suggestion and it needs to come from whoever manages your diabetes.
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.
Correction: that trial is the diabetes programme and the figure you quoted is its glycaemic endpoint, not a weight result.
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.
a1c can be affected by things that have nothing to do with glucose
Right, and the diabetes programmes report glycaemic endpoints. Quoting an obesity trial result here is answering a different question.
My A1c moved and it turned out to have nothing to do with glucose at all.
Same. The first day of a new sensor is unreliable and people rebuild their whole week around it.
My A1c moved and it turned out to have nothing to do with glucose at all.
This is the distinction that resolves most of the confusion here — average versus shape.
This is the distinction that resolves most of the confusion here — average versus shape.
Disagreeing with this line: that endpoint is from the obesity programme and does not answer the question.
Disagreeing with this line: that endpoint is from the obesity programme and does not answer the question.
Agreed, and the glucose-dependence point is the reason the risk profile reads the way it does.
nothing here replaces the person managing your diabetes
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.
What else is in the regimen?
Postprandial excursions flattened out first and the fasting number took months to follow. Nobody had told me to expect that order.
variability matters as much as the mean
That A1c change is inside the assay’s variability and the interval you measured over is too short.
- 1The diabetes and obesity programmes are separate, with different populations…10 comments in this branch · started by u/emil_okwuosa