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c/t2dglp1·posted 1 year ago by u/lucia_balogun

[Meta] the T2D rule is doing its job and people should stop complaining

Question Slow Clap ×3

the T2D rule is doing its job and people should stop complaining. Nothing about this affects the ranking maths, before anyone asks.

Assumed the weight endpoints from the obesity trials applied to my situation. They are different programmes.

Time in range told me far more than the average did. Two quarters with the same A1c looked completely different on the sensor.

Panicked over a first-day sensor reading and rebuilt my week around it. It was the sensor.

If two or three other people have done the same thing we might actually learn something. Alone it is an anecdote.

646 up / 159 down80% upvoted21 commentsid x7pw9g20 Nov 2024

21 comments

15 in this archive, depth 4

best — the order this archive was captured in

u/bastian_eriksen0 points·1 year ago

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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u/farid_jansen69 points·1 year ago

Not convinced. Hypoglycaemia risk from this class alone is low; the risk you are describing comes from the combination.

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u/lucia_balogunOP48 points·1 year ago

My ALT moved and it turned out to have nothing to do with glucose at all.

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u/yannick_barros27 points·1 year ago

Small fix — insulin secretion in this class is glucose-dependent, which is precisely why the risk you describe comes from the other agent.

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u/emil_okwuosa16 points·1 year ago

Brought the whole CGM export to my appointment rather than one number. Entirely different conversation.

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u/adnan_karlsen19 points·1 year ago

Correction: that trial is the diabetes programme and the figure you quoted is its glycaemic endpoint, not a weight result.

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u/ice_pack_auditcold chain0 points·1 year ago

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

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u/bastian_eriksen1 point·1 year ago

Cosigning that postprandial excursions improve first and the fasting number is the laggard.

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u/nils_ferreira24 points·1 year ago

Agreed. A1c is an integrated average over roughly three months and treating it as a current reading causes a lot of unnecessary alarm.

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u/joaquin_stanescu6 points·1 year ago

variability matters as much as the mean

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u/slow_logbook_notes3016 points·1 year ago

Kept fingersticks alongside the sensor for two weeks to sanity-check it. Worth doing once.

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u/gustav_lindholm7 points·1 year ago

the diabetes trials report different endpoints from the obesity ones

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u/ice_pack_auditcold chain3 points·1 year ago

nothing here replaces the person managing your diabetes

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u/lucia_balogunOP9 points·1 year ago

That is a sensor value, not a plasma value, and the two are not interchangeable at that level of precision.

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u/cormac_danquah20 points·1 year ago

That A1c change is inside the assay’s variability and the interval you measured over is too short.

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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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