amsterdam_pete 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…
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.
One thing that is still open after VendorMark’s answer:
Did your prescriber agree with that reading, and if not what was their objection?
anders_CPH 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 3 months on glycaemic control: A1C 5.2%, fasting glucose 87 mg/dL, fasting insulin 6 uIU/mL. My endo says these are "textbook perfect."
For context, my baseline A1C was 6.9% and fasting glucose was 112 mg/dL. The improvement has been dramatic and consistent.
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Shop Reference Standardsanders_CPH 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…
Patient selection optimization for glycaemic control: emerging predictive biomarkers for GLP-1 agonist response include:
| Biomarker | Association | Evidence Level |
|---|---|---|
| Baseline BMI | Higher BMI → greater absolute weight loss | Strong |
| Fasting insulin | Higher insulin → better response | Moderate |
| GLP1R gene variants | rs6923761 → variable response | Preliminary |
| Baseline hsCRP | Higher CRP → greater CV benefit | Moderate |
| Early weight loss (4 wk) | ≥3% at 4 wks → strong predictor of ≥10% at 68 wks | Strong |
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.
BariatricNurseD said:My labs after 3 months on glycaemic control: A1C 5.2%, fasting glucose 87 mg/dL, fasting insulin 6 uIU/mL.
Complete metabolic panel trending on glycaemic control — sharing because comprehensive data helps everyone:
| Test | Baseline | Month 3 | Month 6 | Month 12 |
|---|---|---|---|---|
| Glucose (fasting) | 124 | 102 | 88 | 86 |
| Insulin (fasting) | 20 | 16 | 8 | 6 |
| HOMA-IR | 4.5 | 3.5 | 1.6 | 1.3 |
| Uric Acid | 8.2 | 6.4 | 5.5 | 5.0 |
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.