Fasting insulin levels — looking for input

PeptideChemSF 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 = 5.3 (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.

Dr.GutHealth 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: 22 → 12 → 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.

PeptideChemSF said:

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

This is my experience too, for whatever a second data point is worth. Posting only so the count is not one.

From the other side of the consultation, briefly.

Glycemic variability as the key metric for glycaemic control success: my coefficient of variation (CV) on CGM dropped from 38% to 20%. 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.