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ForumsSide Effects & ManagementHypoglycemia risk with concomitant sulfonylurea use — my results so far

Hypoglycemia risk with concomitant sulfonylurea use — my results so far

mike.trainer_LA Mon, Jan 8, 2024 at 5:38 PM 34 replies 2,155 viewsPage 1 of 7
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mike.trainer_LA
Senior Member
1,567
7,234
Apr 2024
Los Angeles, CA
Jan 8, 2024 at 7:03 PM#1

I promised I'd come back and share my labs after 6 months, so here we go. For context: 45M, started at 267lbs, now 224lbs (43lbs lost). T2D diagnosed 2022, also had NAFLD and hypertension. Currently on sema 1.7mg.

MarkerBaseline (Sept 2025)6 Months (Mar 2026)Reference RangeChange
A1C7.8%5.6%<5.7%↓ 2.2 pts
Fasting Glucose168 mg/dL94 mg/dL70-100↓ 44%
Fasting Insulin28.4 μIU/mL11.2 μIU/mL2.6-24.9↓ 61%
Total Cholesterol242 mg/dL189 mg/dL<200↓ 22%
LDL158 mg/dL112 mg/dL<100 optimal↓ 29%
HDL38 mg/dL52 mg/dL>40↑ 37%
Triglycerides312 mg/dL138 mg/dL<150↓ 56%
ALT62 U/L28 U/L7-56↓ 55%
AST48 U/L24 U/L10-40↓ 50%
CRP (hs)6.8 mg/L1.4 mg/L<3.0↓ 79%
Blood Pressure148/92128/82<130/80↓ improved
Creatinine1.1 mg/dL1.0 mg/dL0.7-1.3→ stable

My doctor was genuinely emotional at this appointment lol. He said in 20 years of practice he's never seen metabolic markers improve this dramatically in 6 months without bariatric surgery.

The NAFLD is essentially resolved based on my liver enzymes and a follow-up ultrasound. He's talking about taking me off my blood pressure medication at our next visit.

I'm still on metformin but we're discussing tapering that too since my A1C is now in the non-diabetic range. Lifestyle changes alongside the medication: walking 30-45 min daily, high protein diet (~130g/day), no alcohol.

44 5Dr.AddMedPHL, newstart_MO, mia_MS2 and 41 others
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Dr.SportsMedIN
Senior Member
1,456
6,789
Feb 2024
Indianapolis, IN
Jan 8, 2024 at 7:20 PM#2

Bro. THAT TRIGLYCERIDE DROP. 312 → 138?! That's insane. And your hs-CRP going from 6.8 to 1.4 is massive — that's a huge reduction in systemic inflammation.

These are the results that make me rage when people call GLP-1 meds "vanity drugs." This isn't about looking good in a swimsuit, this is about not dying of a heart attack at 55.

Incredible work man. 👏

44 23lisa_labSD, adam_van, Dr.SurgeonPGH and 41 others
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Dr.SleepRoch
Senior Member
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5,678
Apr 2024
Rochester, MN
Jan 8, 2024 at 7:37 PM#3

Excellent results. A few clinical notes for context:

The triglyceride reduction of 56% is above what the STEP trials typically showed (~17-20% average), suggesting you may have been particularly responsive to the metabolic effects, or your dietary changes (especially cutting alcohol) contributed significantly. Alcohol is a major driver of elevated triglycerides.

The liver enzyme normalization is consistent with emerging data on semaglutide for NAFLD/NASH. There are actually ongoing trials (the ESSENCE trial) specifically studying semaglutide for NASH resolution.[1]

Regarding metformin discontinuation — I'd recommend discussing with your doctor keeping it even if A1C is normal. There's growing evidence that metformin has independent cardioprotective and potentially anti-aging effects beyond glucose control. Plus, the combination may help prevent weight regain.

One lab I'd recommend adding at your next visit: a fasting lipid panel with LDL-P (particle number) and Lp(a). Standard LDL-C doesn't tell the whole story, especially with rapid weight loss.

[1] Newsome PN, et al. "Semaglutide for NASH." N Engl J Med. 2021;384(12):1113-1124.
9 17Dr.NephBHM_UK, kim_atl_prep, sarah_TO and 6 others
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lori_vegas
Member
378
1,678
Aug 2024
Las Vegas, NV
Jan 8, 2024 at 7:54 PM#4

Saving this post. I'm 3 months in and my labs aren't as dramatic but trending in the same direction. Your CRP drop gives me hope — my inflammation markers are still high.

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jason_paloalto
Member
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890
Nov 2024
Palo Alto, CA
Jan 8, 2024 at 8:11 PM#5

This is goals. I'm at month 2 and honestly getting impatient seeing other people's results. But I know I need to trust the process.

Can I ask — did you have any side effects that affected your labs? I've heard some people get elevated lipase/amylase on sema?

Last edited: Jan 9, 2024 at 1:11 AM
49 18Dr.EndoEP, GraceAZ_72, carl_compliance and 46 others
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