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ForumsMetabolic Health & DiabetesHas anyone dealt with insulin sensitivity vs insulin secretion?

Has anyone dealt with insulin sensitivity vs insulin secretion?

MikeKY_noInsulin Tue, Nov 25, 2025 at 9:06 PM 9 replies 1,005 viewsPage 1 of 2
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MikeKY_noInsulin
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Nov 25, 2025 at 9:06 PM#1

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.

Because it is glucose-dependent, this class carries a low intrinsic hypoglycaemia risk on its own — the risk arrives when it is combined with insulin or a sulfonylurea, which usually need reducing.

What I am trying to establish is why A1C lags the way it does, and what to look at in the meantime if you want to know sooner.

I have searched first, so if this is covered somewhere point me at it and I will read it.

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Dr.ObesityMed
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Nov 25, 2025 at 10:31 PM#2
MikeKY_noInsulin 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.

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 = 6.1 (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.

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kate.chem
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Nov 25, 2025 at 11:56 PM#3
Dr.ObesityMed said:
Insulin sensitivity test (HOMA-IR) on glycaemic control — arguably the most important metabolic marker most people aren't tracking: HOMA-IR = (fasting…

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: 26 → 14 → 6 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: Nov 26, 2025 at 2:56 AM
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A1cHero_PHX
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Nov 26, 2025 at 1:21 AM#4
MikeKY_noInsulin 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.

This matches mine closely enough to be worth saying so out loud.

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TinaHashiRN
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Nov 26, 2025 at 9:34 AM#5

From the other side of the consultation, briefly.

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

TestBaselineMonth 3Month 6Month 12
Glucose (fasting)1251039387
Insulin (fasting)211797
HOMA-IR5.53.62.11.4
Uric Acid8.36.56.05.1

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.

Last edited: Nov 26, 2025 at 3:34 PM
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