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ForumsMetabolic Health & DiabetesGLP-1 and beta-cell preservation — regeneration evidence

GLP-1 and beta-cell preservation — regeneration evidence

Dr.MetabolicMD Sat, Jun 6, 2026 at 9:03 PM 15 replies 398 viewsPage 1 of 3
Dr.MetabolicMD
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Jun 6, 2026 at 9:03 PM#1

Read the primary source rather than the write-up and the two do not agree, so here is what is actually in it.

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 little. The improvement on this class comes from two directions — direct glucose-dependent insulin secretion and glucagon suppression, plus the indirect effect of weight loss on insulin sensitivity — and the second continues after the first has plateaued.

Where I think it is weakest: the completion rate deserves as much attention as the headline, because a large effect among those who finished is a different claim from a large effect among those enrolled.

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. I would rather have one careful answer than five confident ones.

Note on sourcing:
Figures above are from the primary publication rather than the press summary. If a number here disagrees with one you have, post yours and we will work out which of us is reading a secondary source.
36 6SleepDoc_PDX, RegAffairsDC, BiostatsBrad and 33 others
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LabKate
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Jun 6, 2026 at 9:36 PM#2
Dr.MetabolicMD 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: 27 → 13 → 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.

Last edited: Jun 7, 2026 at 12:36 AM
35 5laura_annarbor, JenMemphis, pat_auckland and 32 others
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BenResearch_OR
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Jun 6, 2026 at 10:10 PM#3
Dr.MetabolicMD 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…

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 = 4.5 (insulin resistant) → Current = 1.1 (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.

34 4Dr.NateNeph, PharmD_Rodriguez, julia.endo and 31 others
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Dr.RenalNash
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Jun 6, 2026 at 10:43 PM#4
BenResearch_OR said:
Insulin sensitivity test (HOMA-IR) on glycaemic control — arguably the most important metabolic marker most people aren't tracking: HOMA-IR = (fasting…

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

TestBaselineMonth 3Month 6Month 12
Glucose (fasting)1311019185
Insulin (fasting)2715115
HOMA-IR5.53.71.91.5
Uric Acid8.47.15.85.2

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.

33 3anders_CPH, Dr.NutriCornell, pam_stl and 30 others
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carl_compliance
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Jun 7, 2026 at 2:01 AM#5
LabKate 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…

This is my experience too, for whatever a second data point is worth. I had assumed I was the exception until I read this.

Last edited: Jun 7, 2026 at 5:01 AM
32 2dave_SLC, FDA_TrackerJim, ricardo_MIA and 29 others
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