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ForumsMetabolic Health & DiabetesRemission of T2DM on GLP-1 — September 2026

Remission of T2DM on GLP-1 — September 2026

mike.trainer_LA Sun, Dec 21, 2025 at 6:58 PM 4 replies 946 viewsPage 1 of 1
mike.trainer_LA
Senior Member
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Apr 2024
Los Angeles, CA
Dec 21, 2025 at 6:58 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.

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

Practical detail welcome, however dull — the duller the better.

4 24Dr.AddMedPHL, newstart_MO, mia_MS2 and 1 other
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JessicaH_TX
Senior Member
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13,456
Dec 2023
Houston, TX
Dec 21, 2025 at 7:46 PM#2
mike.trainer_LA 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: Dec 21, 2025 at 11:46 PM
3 23sarah_TO, wendy_avl, jason_paloalto
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AttorneyGrant
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Apr 2024
Washington, DC
Dec 21, 2025 at 8:34 PM#3
JessicaH_TX said:
Patient selection optimization for glycaemic control: emerging predictive biomarkers for GLP-1 agonist response include: Biomarker Association…

My labs after 9 months on glycaemic control: A1C 6.2%, fasting glucose 77 mg/dL, fasting insulin 4 uIU/mL. My endo says these are "textbook perfect."

For context, my baseline A1C was 6.9% and fasting glucose was 122 mg/dL. The improvement has been dramatic and consistent.

2 22JenMemphis, pat_auckland
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wei_SG
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Nov 2024
Singapore, SG
Dec 21, 2025 at 9:22 PM#4
mike.trainer_LA said:
Fasting glucose improved within weeks and my HbA1c barely moved for three months, which I now understand and did not at the time.

This is my experience too, for whatever a second data point is worth. Nothing to add that would improve it.

1 21RetaRick_CA
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Dr.Martinez
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Dec 22, 2025 at 1:52 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)1221089086
Insulin (fasting)1816106
HOMA-IR4.53.81.81.1
Uric Acid8.56.25.74.8

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.

50 20adam_van, Dr.SurgeonPGH, rachel_ABQ and 47 others
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