[PSA] T2D is not what most of this community thinks it is
T2D is not what most of this community thinks it is — with the reasoning, because a rule without a reason gets ignored.
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.
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.
Postprandial excursions typically respond earlier than fasting glucose, so the sequence people observe is not a sign that something is not working.
I will update this if the picture changes rather than quietly leaving it up.
best — the order this archive was captured in
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.
Sensor accuracy varies across wear, and readings on the first day are the least reliable.
santiago_rasmussen is right that the fasting number moves last. Knowing that in advance saves months of worry.
a single high reading is not a trend
Small fix — insulin secretion in this class is glucose-dependent, which is precisely why the risk you describe comes from the other agent.
A1c is a three-month average and it lags everything
Kept fingersticks alongside the sensor for two weeks to sanity-check it. Worth doing once.
check the trial population before quoting a result at somebody
Cosigning that postprandial excursions improve first and the fasting number is the laggard.
Agreed on variability. Two people with the same average can have completely different days.
Agreed on variability.
Disagreeing with this line: that endpoint is from the obesity programme and does not answer the question.
How long between the two A1c measurements?
Right, and the diabetes programmes report glycaemic endpoints. Quoting an obesity trial result here is answering a different question.
Postprandial excursions flattened out first and the fasting number took months to follow. Nobody had told me to expect that order.
A1c, CGM, or fingersticks — which are we discussing?
Assumed the weight endpoints from the obesity trials applied to my situation. They are different programmes.
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.
Left up. It distinguishes the sensor data from the lab result, which most posts here do not.
the diabetes trials report different endpoints from the obesity ones
the diabetes trials report different endpoints from the obesity ones
Adding the obvious one — bring the export, not the single number, to whoever manages this.
Push back: one sensor reading is not a data point worth acting on, especially in the first day of wear.
Are you quoting a diabetes trial or an obesity one?
sensor accuracy varies and the first day of a sensor is the worst
the fasting number is the one people fixate on and it moves last
variability matters as much as the mean
nothing here replaces the person managing your diabetes
That is a sensor value, not a plasma value, and the two are not interchangeable at that level of precision.
Continuous monitoring shows the shape: postprandial excursions, overnight behaviour and time in range. Two people with identical A1c can have very different distributions.
Fasting or postprandial?
Yes — the person managing your diabetes is the one to talk to, and this board is explicit about that.
Correction: that trial is the diabetes programme and the figure you quoted is its glycaemic endpoint, not a weight result.
- 1Sensor accuracy varies across wear, and readings on the first day are the…15 comments in this branch · started by u/santiago_rasmussen
- 2A1c reflects average glycaemia over roughly the preceding three months,…6 comments in this branch · started by u/gentle_correction