Incretin effect in healthy vs T2DM — 12 month update

KevinCompounds said:

Glycemic variability as the key metric for glycaemic control success: my coefficient of variation (CV) on CGM dropped from 35% to 20%.

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: 30 → 14 → 5 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.

marco_milano 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 7 months: periods became regular for the first time in years, testosterone levels normalized, acne cleared significantly, and — unexpectedly — I got pregnant naturally after 4 years of trying.

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.

Dr.ObesityLA 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:

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.

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

Was that from a primary source or from a summary of one?

Dr.EM_Chicago said:

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

My labs after 12 months on glycaemic control: A1C 6.1%, fasting glucose 86 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.