claudia_zurich said:

FLOW is the relevant trial and it reported a meaningful reduction in kidney-disease progression and related death in people with type 2 diabetes and…

All true, with one condition: that curve is for people who reached the dose on schedule. Anyone who slowed the ladder for tolerability is on a different, flatter curve, and comparing yourself with the published mean will make you feel like a non-responder when you are not.

ingrid_STO said:

Albumin binding above 99% is the whole reason weekly dosing works, and it is also why the trough matters more than the peak.

This is exactly what I could not find anywhere else. Sending this to two other people who asked me the same thing last week.

claudia_zurich said:

FLOW is the relevant trial and it reported a meaningful reduction in kidney-disease progression and related death in people with type 2 diabetes and…

Filing a mild objection. Mild because I might be wrong; an objection because nobody has addressed the case that does not fit. The trial means are being read too generously in this thread. STEP populations were selected, supported, and titrated by protocol, and the real-world curves are consistently a few points worse. That difference is not noise, it is what happens when you remove the study infrastructure.

Adding the numbers, since they settle part of this. Worth knowing that eGFR estimates depend on creatinine, and creatinine depends on muscle mass. Losing muscle raises eGFR artificially, which flatters the number while the kidney is unchanged.

Moderator note: reminder that nothing in this thread is medical advice, and that clinical claims need a source. Report rather than reply if it drifts again.