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ForumsMetabolic Health & DiabetesHas anyone dealt with prediabetic and scared - will this actually prevent diabetes??

Has anyone dealt with prediabetic and scared - will this actually prevent diabetes??

Dr.RaviCardio Tue, Feb 11, 2025 at 10:10 PM 14 replies 1,634 viewsPage 1 of 3
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Dr.RaviCardio
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Feb 11, 2025 at 10:10 PM#1

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

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

Numbers rather than impressions, if you have them.

28 23pete_manc_UK, anna.melb_AU, mark_tokyo and 25 others
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InsuranceTom
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Feb 11, 2025 at 10:18 PM#2
Dr.RaviCardio said:
Fasting glucose improved within weeks and my HbA1c barely moved for three months, which I now understand and did not at the time.

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

BiomarkerAssociationEvidence Level
Baseline BMIHigher BMI → greater absolute weight lossStrong
Fasting insulinHigher insulin → better responseModerate
GLP1R gene variantsrs6923761 → variable responsePreliminary
Baseline hsCRPHigher CRP → greater CV benefitModerate
Early weight loss (4 wk)≥3% at 4 wks → strong predictor of ≥10% at 68 wksStrong

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.

27 22lucas_SP_BR, lisa_labSD, adam_van and 24 others
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zoe_NC
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Nov 2024
Charlotte, NC
Feb 11, 2025 at 10:26 PM#3
InsuranceTom said:
Patient selection optimization for glycaemic control: emerging predictive biomarkers for GLP-1 agonist response include: Biomarker Association…

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

TestBaselineMonth 3Month 6Month 12
Glucose (fasting)1251078985
Insulin (fasting)211595
HOMA-IR5.53.11.71.4
Uric Acid7.86.55.65.1

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.

26 21james_edin, FranDenver, Dr.BariatricHTX and 23 others
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maria_elpaso
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Feb 11, 2025 at 10:34 PM#4
Dr.RaviCardio 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 matches mine closely enough to be worth saying so out loud. The detail I would add is minor and it is already implied above.

Last edited: Feb 12, 2025 at 4:34 AM
25 20HPLC_Greg, LibrarianMeg, bri_stats and 22 others
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KevinCompounds
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Feb 11, 2025 at 11:16 PM#5

From the other side of the consultation, briefly.

My labs after 6 months on glycaemic control: A1C 5.9%, fasting glucose 84 mg/dL, fasting insulin 7 uIU/mL. My endo says these are "textbook perfect."

For context, my baseline A1C was 8.3% and fasting glucose was 119 mg/dL. The improvement has been dramatic and consistent.

Last edited: Feb 12, 2025 at 1:16 AM
24 19NurseAsh_DET, BenResearch_OR, MikeKY_noInsulin and 21 others
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