Dr.EndoEP said:Steady state is the thing most people miss.
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.
lucas_SP_BR said:Agreed, though "tolerable" needs defining.
That reframing is the part I needed.
Dr.EndoEP said:Steady state is the thing most people miss.
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.
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View ResultsDr.PainCLE said:Mildly reduced kidney function at baseline, which changes several of the standard answers and is rarely addressed in these threads.
GFR trending upward on renal function — encouraging for those with mild CKD concerns:
Baseline eGFR: 70 → Month 6: 78 → Month 12: 85
The FLOW trial confirmed renal benefits of semaglutide: 24% reduction in kidney disease progression. My nephrologist is now actively recommending GLP-1 therapy for appropriate CKD patients. This could be a paradigm shift in nephrology.