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c/t2dglp1·posted 6 months ago by u/joaquin_trevino

hypoglycaemia: the version I wish someone had shown me in week 1

CGM Receipts ×4 Slow Clap ×2

Reporting in. hypoglycaemia: the version I wish someone had shown me in week 1.

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.

Happy to answer the boring questions. Those are usually the ones worth asking.

2,511 up / 867 down74% upvoted46 commentsid wefda419 Jan 2026

46 comments

13 in this archive, depth 4

best — the order this archive was captured in

u/a1c_arcT2D182 points·6 months 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/joaquin_trevinoOP126 points·6 months ago

CGM shows you the shape, A1c shows you the area

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u/enzo_danquah88 points·6 months ago

nothing here replaces the person managing your diabetes

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u/santiago_rasmussen57 points·6 months ago

Variability dropped before the average did, which was visible on the sensor and invisible on the lab result.

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u/joaquin_trevinoOP133 points·6 months ago

the diabetes trials report different endpoints from the obesity ones

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u/sanne_laurent151 points·6 months ago·edited

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/appeal_letter_al124 points·6 months ago

A1c, CGM, or fingersticks — which are we discussing?

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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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