Blood sugar used to spike to 200 after meals, now barely hits 120 — January 2024

Dr.RenalNash said:

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

My labs after 9 months on glycaemic control: A1C 5.9%, fasting glucose 89 mg/dL, fasting insulin 4 uIU/mL. My endo says these are "textbook perfect."

For context, my baseline A1C was 7.3% and fasting glucose was 134 mg/dL. The improvement has been dramatic and consistent.

DanielChem_CHI said:

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

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

After 11 months: periods became regular for the first time in a decade, testosterone levels normalized, acne cleared significantly, and — unexpectedly — my fertility specialist is optimistic about future conception.

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.

VendorMark said:

My labs after 9 months on glycaemic control: A1C 5.9%, fasting glucose 89 mg/dL, fasting insulin 4 uIU/mL.

Insulin sensitivity test (HOMA-IR) on glycaemic control — arguably the most important metabolic marker most people aren't tracking:

HOMA-IR = (fasting insulin × fasting glucose) ÷ 405

My numbers: Baseline HOMA-IR = 4.7 (insulin resistant) → Current = 1.5 (insulin sensitive)

Anything above 2.0 indicates insulin resistance. The goal is below 1.5. GLP-1 agonists address the root metabolic dysfunction, not just the symptoms. This is why they work so much better than calorie restriction alone.

One thing that is still open after Dr.GastroMayo’s answer:

How would you tell the difference between that and the alternative explanation?

KevinCompounds said:

Insulin sensitivity test (HOMA-IR) on glycaemic control — arguably the most important metabolic marker most people aren't tracking: HOMA-IR = (fasting…

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

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.