traveltech_sara said:

The glucagon component looks paradoxical and is not.

Genuinely useful, thank you. I had the facts and not the framework. Printing the relevant bit and taking it with me.

Adding the clinical framing, because it changes how the question reads. The useful move here is to separate what is established from what is widely repeated. Those two sets overlap less than the confident tone of most write-ups suggests, and the second set is where nearly all the disagreement on this board comes from.

NurseLeah_Nash said:

The gap between trial results and real-world results is consistent and it is not fraud.

Filing a mild objection. Mild because I might be wrong; an objection because nobody has addressed the case that does not fit. I would add the less popular caveat: these trial populations under-represented several groups, older adults and the highest BMI categories among them. The results probably generalise, and "probably" should be stated as an assumption rather than dropped.

Ask again with the specifics and you will get a better answer than this one.

One concrete data point for the thread. A quick sanity check on any figure quoted here: is it mean or median, is it intention-to-treat or completers, and what was the comparator. Three questions, and they resolve most disagreements in these threads.

Worth separating that from the trial evidence, which this thread keeps folding into the same question. They behave differently and the advice does not transfer.

That is the short version; the long version is somebody else's post.

Moderator note: good thread. Keeping it here rather than moving it, because the question is general enough to be useful. Carry on.