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ForumsMetabolic Health & DiabetesIs it possible to reverse type 2 or am I dreaming — looking for input Page 2

Is it possible to reverse type 2 or am I dreaming — looking for input

A1cHero_PHX Fri, Apr 5, 2024 at 2:09 AM 50 replies 2,733 viewsPage 2 of 10
kate.chem
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Apr 5, 2024 at 5:32 AM#6
Dr.GutHealth said:
PCOS success story with glycaemic control: as someone with polycystic ovary syndrome, this medication has been transformative beyond weight loss.

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 = 5.7 (insulin resistant) → Current = 1.3 (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.

47 17steve_okc, dave_SLC, FDA_TrackerJim and 44 others
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anders_CPH
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Apr 5, 2024 at 6:51 AM#7
A1cHero_PHX said:
Fasting glucose improved within weeks and my HbA1c barely moved for three months, which I now understand and did not at the time.

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: 24 → 12 → 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.

Last edited: Apr 5, 2024 at 10:51 AM
46 16MariaRD, AussieAnna, BethLabQueen and 43 others
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CarlaRPh_TPA
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Apr 5, 2024 at 8:10 AM#8
kate.chem said:
Insulin sensitivity test (HOMA-IR) on glycaemic control — arguably the most important metabolic marker most people aren't tracking: HOMA-IR = (fasting…

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.

Last edited: Apr 5, 2024 at 12:10 PM
45 15BrianDallas92, labquiet_amy, emily_PDX and 42 others
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sarah_TO
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Apr 5, 2024 at 9:29 AM#9

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

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

44 14carl_compliance, DanielChem_CHI, marco_milano and 41 others
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A1cHero_PHX
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Apr 5, 2024 at 3:49 PM#10
CarlaRPh_TPA said:
Patient selection optimization for glycaemic control: emerging predictive biomarkers for GLP-1 agonist response include: Biomarker Association…

Glycemic variability as the key metric for glycaemic control success: my coefficient of variation (CV) on CGM dropped from 35% to 18%. 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.

38 13jason_sac26, chris_chi24, tampaLisa73 and 35 others
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