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c/t2dglp1·posted 11 months ago by u/aleksi_eriksen

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

CGM Cold Box ×4 Well Actually ×2

the glycaemic control rule is doing its job and people should stop complaining. Short post, long comment section, probably.

Certain conditions affect A1c independently of glycaemia. If a result looks inconsistent with the sensor data, that is a question for whoever manages your care rather than for this board.

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

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

If somebody has the same thing measured a different way, post it next to mine and we will see whether they agree.

5,714 up / 4,168 down58% upvoted26 commentsid xrs95d14 Aug 2025

26 comments

18 in this archive, depth 4

best — the order this archive was captured in

u/lucia_balogun74 points·11 months 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/ice_pack_auditcold chain60 points·11 months ago

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.

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u/throwaway_918246 points·11 months ago

Yes — time in range tells you about variability, which the average deliberately hides.

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u/adnan_karlsen70 points·11 months ago

Postprandial excursions typically respond earlier than fasting glucose, so the sequence people observe is not a sign that something is not working.

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u/karim_ramos41 points·11 months ago

Same. The first day of a new sensor is unreliable and people rebuild their whole week around it.

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u/fasting_insulin_fMOD35 points·11 months ago

Identifying details redacted from the exported report above.

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u/aleksi_eriksenOP23 points·11 months ago

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

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u/piotr_bruun24 points·11 months ago

What else is in the regimen?

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u/tomas_lundgren20 points·11 months ago

Disagree — that is an obesity trial endpoint and this thread is about glycaemic control.

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u/joaquin_stanescu26 points·11 months ago

Continuous monitoring shows the shape: postprandial excursions, overnight behaviour and time in range. Two people with identical A1c can have very different distributions.

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u/aleksi_eriksenOP15 points·11 months ago

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

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u/fasting_insulin_f23 points·11 months ago

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

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u/fabio_lehtinen29 points·11 months ago

a single high reading is not a trend

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[removed]13 points·11 months ago

[removed by moderator]

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u/chain_confirm_cpayments7 points·11 months ago·edited

Push back: one sensor reading is not a data point worth acting on, especially in the first day of wear.

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u/throwaway_91827 points·11 months ago·edited

a single high reading is not a trend

This is the distinction that resolves most of the confusion here — average versus shape.

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u/sunday_shot_sal6 points·11 months ago·edited

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.

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u/gustav_lindholm14 points·11 months ago

I would not compare your numbers to that population. Different baseline, different regimen, different trial.

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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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