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ForumsMetabolic Health & DiabetesIs it possible to reverse type 2 or am I dreaming — January 2024

Is it possible to reverse type 2 or am I dreaming — January 2024

MikeFit_NJ Sat, Feb 7, 2026 at 3:22 PM 6 replies 877 viewsPage 1 of 2
MikeFit_NJ
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Feb 7, 2026 at 3:22 PM#1

Fasting glucose improved within weeks and my HbA1c barely moved for three months, which I now understand and did not at the time.

Because it is glucose-dependent, this class carries a low intrinsic hypoglycaemia risk on its own — the risk arrives when it is combined with insulin or a sulfonylurea, which usually need reducing.

What I actually want to know is why A1C lags the way it does, and what to look at in the meantime if you want to know sooner.

Tell me what I have not thought of.

27 22LeilaHI, marcus_mpls, DeniseRN_TPA and 24 others
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PharmD_Rodriguez
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Feb 7, 2026 at 4:26 PM#2
MikeFit_NJ said:
Fasting glucose improved within weeks and my HbA1c barely moved for three months, which I now understand and did not at the time.

Patient selection optimization for glycaemic control: emerging predictive biomarkers for GLP-1 agonist response include:

BiomarkerAssociationEvidence Level
Baseline BMIHigher BMI → greater absolute weight lossStrong
Fasting insulinHigher insulin → better responseModerate
GLP1R gene variantsrs6923761 → variable responsePreliminary
Baseline hsCRPHigher CRP → greater CV benefitModerate
Early weight loss (4 wk)≥3% at 4 wks → strong predictor of ≥10% at 68 wksStrong

The 4-week early responder criterion is the most clinically actionable: if you haven't lost ≥3% by week 4 at a therapeutic dose, discuss optimization strategies with your provider.

Last edited: Feb 7, 2026 at 9:26 PM
26 21TinaHashiRN, robert_kc, dan_philly and 23 others
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LarryQC_SD
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Feb 7, 2026 at 5:30 PM#3
PharmD_Rodriguez said:
Patient selection optimization for glycaemic control: emerging predictive biomarkers for GLP-1 agonist response include: Biomarker Association…

Fasting insulin is the lab my functional medicine doctor cares about most for glycaemic control: it's a much earlier marker of metabolic dysfunction than glucose or A1C.

My fasting insulin: 23 → 15 → 7 uIU/mL over 9 months. Target is <7. By the time your fasting glucose is elevated, your insulin has been elevated for YEARS trying to compensate.

Ask your doctor to include fasting insulin in your bloodwork panel. It's cheap (~$20) and incredibly informative.

25 20TinaHashiRN, robert_kc, dan_philly and 22 others
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tony_orlando
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Feb 7, 2026 at 6:34 PM#4
MikeFit_NJ said:
Fasting glucose improved within weeks and my HbA1c barely moved for three months, which I now understand and did not at the time.

Mine went the same way, slower. Posting only so the count is not one.

24 19CanadaChris, ZaraB_AL, JakeSmashed95 and 21 others
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SarahChen_PharmD
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Feb 8, 2026 at 12:41 AM#5

From the other side of the consultation, briefly.

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

TestBaselineMonth 3Month 6Month 12
Glucose (fasting)1191059183
Insulin (fasting)2513116
HOMA-IR5.53.51.91.3
Uric Acid8.26.95.85.0

The insulin resistance improvement (HOMA-IR) is what my endo focuses on most. Going from 5.5 to near 1.0 is a metabolic transformation.

23 18robert_kc, dan_philly, MeganSA_TX and 20 others
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