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ForumsMetabolic Health & DiabetesHas anyone dealt with insulin sensitivity vs insulin secretion? Page 2

Has anyone dealt with insulin sensitivity vs insulin secretion?

MikeKY_noInsulin Tue, Nov 25, 2025 at 9:06 PM 9 replies 1,005 viewsPage 2 of 2
Dr.AddMedPHL
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Nov 26, 2025 at 5:47 PM#6
Dr.ObesityMed said:
Insulin sensitivity test (HOMA-IR) on glycaemic control — arguably the most important metabolic marker most people aren't tracking: HOMA-IR = (fasting…

Glycemic variability as the key metric for glycaemic control success: my coefficient of variation (CV) on CGM dropped from 35% to 22%. Target is <36%, with <30% being ideal.

Why this matters more than average glucose: large glucose swings cause oxidative stress, endothelial damage, and promote advanced glycation end-products (AGEs). A flat glucose line at 95 mg/dL is metabolically healthier than oscillating between 60 and 160, even if the average is the same.

1 21FitDadDave
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VendorMark
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Nov 27, 2025 at 2:00 AM#7
MikeKY_noInsulin said:
A1C went from 7.4 to 5.6 over nine months and my prescriber was more interested in the fasting insulin, which I did not expect.

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

After 12 months: periods became regular for the first time in ever, testosterone levels normalized, acne cleared significantly, and — unexpectedly — my hormonal symptoms have almost completely resolved.

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.

Last edited: Nov 27, 2025 at 4:00 AM
50 20KristenIndy, MarkLI_maint, Dr.PeteFamMed and 47 others
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Dr.KarenChen
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Nov 27, 2025 at 10:14 AM#8
Dr.AddMedPHL said:
Glycemic variability as the key metric for glycaemic control success: my coefficient of variation (CV) on CGM dropped from 35% to 22%.

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: Nov 27, 2025 at 4:14 PM
49 19TomFromTexas, mike.trainer_LA, sarah_nash92 and 46 others
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KarenAZ_mom
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Nov 27, 2025 at 6:28 PM#9

A narrower follow-up, since the general answer is now clear:

How long did you give it before you decided it was working?

Last edited: Nov 27, 2025 at 11:28 PM
48 18LibrarianMeg, bri_stats, pete_manc_UK and 45 others
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MikeKY_noInsulin
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Nov 29, 2025 at 9:59 AM#10
Dr.KarenChen 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 5.4%, fasting glucose 89 mg/dL, fasting insulin 8 uIU/mL. My endo says these are "textbook perfect."

For context, my baseline A1C was 7.3% and fasting glucose was 114 mg/dL. The improvement has been dramatic and consistent.

16 14bbq_ray_KC, oliver_london, tane_welly and 13 others
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