Blood sugar used to spike to 200 after meals, now barely hits 120 — need advice

HealthEcon_DC said:

HbA1c reflects roughly three months of average glycaemia weighted toward the most recent weeks, which is why repeating it at six weeks tells you very…

My labs after 3 months on glycaemic control: A1C 5.9%, fasting glucose 79 mg/dL, fasting insulin 4 uIU/mL. My endo says these are "textbook perfect."

For context, my baseline A1C was 7.3% and fasting glucose was 134 mg/dL. The improvement has been dramatic and consistent.

Following on from EndoResFellow — and this may be the naive question:

What would you measure differently if you were starting again?

DanielChem_CHI said:

My labs after 3 months on glycaemic control: A1C 5.9%, fasting glucose 79 mg/dL, fasting insulin 4 uIU/mL.

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: 29 → 13 → 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.

DanielChem_CHI said:

My labs after 3 months on glycaemic control: A1C 5.9%, fasting glucose 79 mg/dL, fasting insulin 4 uIU/mL.

PCOS success story with glycaemic control: as someone with polycystic ovary syndrome, this medication has been transformative beyond weight loss.

After 11 months: periods became regular for the first time in a decade, testosterone levels normalized, acne cleared significantly, and — unexpectedly — my fertility specialist is optimistic about future conception.

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.

lisa_labSD 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.