Is it possible to reverse type 2 or am I dreaming — January 2024

PharmD_Rodriguez said:

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

My labs after 6 months on glycaemic control: A1C 6.1%, fasting glucose 76 mg/dL, fasting insulin 9 uIU/mL. My endo says these are "textbook perfect."

For context, my baseline A1C was 6.7% and fasting glucose was 121 mg/dL. The improvement has been dramatic and consistent.

MikeFit_NJ said:

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

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 = 6.0 (insulin resistant) → Current = 1.0 (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.

NurseKim_ATL said:

My labs after 6 months on glycaemic control: A1C 6.1%, fasting glucose 76 mg/dL, fasting insulin 9 uIU/mL.

Glycemic variability as the key metric for glycaemic control success: my coefficient of variation (CV) on CGM dropped from 40% to 21%. 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.

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

What would you measure differently if you were starting again?

Dr.AddMedPHL said:

Glycemic variability as the key metric for glycaemic control success: my coefficient of variation (CV) on CGM dropped from 40% to 21%.

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.