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ForumsMetabolic Health & DiabetesPost-prandial glucose control — GLP-1 vs DPP-4 vs SGLT2i comparison

Post-prandial glucose control — GLP-1 vs DPP-4 vs SGLT2i comparison

SarahChen_PharmD Thu, May 28, 2026 at 8:19 PM 21 replies 573 viewsPage 1 of 5
SarahChen_PharmD
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May 28, 2026 at 8:19 PM#1

Read the primary source rather than the write-up and the two do not agree, so here is what is actually in it.

HbA1c reflects roughly three months of average glycaemia weighted toward the most recent weeks, which is why repeating it at six weeks tells you very little. The improvement on this class comes from two directions — direct glucose-dependent insulin secretion and glucagon suppression, plus the indirect effect of weight loss on insulin sensitivity — and the second continues after the first has plateaued.

Where I think it is weakest: the follow-up is short relative to how long people actually take these drugs, so durability is an assumption here rather than a finding.

What I am after is why A1C lags the way it does, and what to look at in the meantime if you want to know sooner. Not looking for reassurance. Looking for the part I have got wrong.

Note on sourcing:
Figures above are from the primary publication rather than the press summary. If a number here disagrees with one you have, post yours and we will work out which of us is reading a secondary source.
22 17Dr.ObesityLA, NurseKim_ATL, paul_denver and 19 others
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kate.chem
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May 28, 2026 at 8:54 PM#2
SarahChen_PharmD said:
HbA1c reflects roughly three months of average glycaemia weighted toward the most recent weeks, which is why repeating it at six weeks tells you very…

My labs after 3 months on glycaemic control: A1C 6.3%, fasting glucose 83 mg/dL, fasting insulin 8 uIU/mL. My endo says these are "textbook perfect."

For context, my baseline A1C was 8.1% and fasting glucose was 138 mg/dL. The improvement has been dramatic and consistent.

21 16VanRx_Mike, steve_okc, dave_SLC and 18 others
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JessicaH_TX
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May 28, 2026 at 9:29 PM#3
SarahChen_PharmD said:
HbA1c reflects roughly three months of average glycaemia weighted toward the most recent weeks, which is why repeating it at six weeks tells you very…

PCOS success story with glycaemic control: as someone with polycystic ovary syndrome, this medication has been transformative beyond weight loss.

After 10 months: periods became regular for the first time in years, testosterone levels normalized, acne cleared significantly, and — unexpectedly — I got pregnant naturally after 4 years of trying.

GLP-1 agonists address the insulin resistance at the root of PCOS. For PCOS patients, this isn't "just" a weight loss drug — it's treating our underlying metabolic dysfunction.

20 15kim_atl_prep, sarah_TO, wendy_avl and 17 others
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Dr.SportsMedIN
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May 28, 2026 at 10:04 PM#4
JessicaH_TX said:
PCOS success story with glycaemic control: as someone with polycystic ovary syndrome, this medication has been transformative beyond weight loss.

Complete metabolic panel trending on glycaemic control — sharing because comprehensive data helps everyone:

TestBaselineMonth 3Month 6Month 12
Glucose (fasting)1261049482
Insulin (fasting)2212105
HOMA-IR4.53.72.21.5
Uric Acid8.46.66.15.2

The insulin resistance improvement (HOMA-IR) is what my endo focuses on most. Going from 4.5 to near 1.0 is a metabolic transformation.

19 14Dr.SurgeonPGH, rachel_ABQ, traveltech_sara and 16 others
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paige_pharma
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May 29, 2026 at 1:20 AM#5
kate.chem said:
My labs after 3 months on glycaemic control: A1C 6.3%, fasting glucose 83 mg/dL, fasting insulin 8 uIU/mL.

Same pattern here, and in the same order.

Last edited: May 29, 2026 at 2:20 AM
18 13lucas_SP_BR, lisa_labSD, adam_van and 15 others
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