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ForumsMetabolic Health & DiabetesA1C target achievement rates — my results so far Page 2

A1C target achievement rates — my results so far

zoe_NC Wed, Jan 24, 2024 at 4:35 AM 14 replies 2,274 viewsPage 2 of 3
Dr.KarenChen
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Jan 24, 2024 at 3:34 PM#6
BariatricNurseD 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…

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

TestBaselineMonth 3Month 6Month 12
Glucose (fasting)1231059183
Insulin (fasting)1913116
HOMA-IR5.52.91.91.2
Uric Acid7.66.35.84.9

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.

45 15julia.endo, JessicaM_2024, TomFromTexas and 42 others
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Dr.RaviCardio
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Jan 24, 2024 at 7:54 PM#7
zoe_NC 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.

Glycemic variability as the key metric for glycaemic control success: my coefficient of variation (CV) on CGM dropped from 42% to 19%. 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.

44 14anna.melb_AU, mark_tokyo, hans_munich and 41 others
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SarahChen_PharmD
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Jan 25, 2024 at 12:14 AM#8
Dr.KarenChen said:
Complete metabolic panel trending on glycaemic control — sharing because comprehensive data helps everyone: Test Baseline Month 3 Month 6 Month 12…

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

After 10 months: periods became regular for the first time in years, testosterone levels normalized, acne cleared significantly, and — unexpectedly — I got pregnant naturally after 4 years of trying.

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.

Last edited: Jan 25, 2024 at 3:14 AM
43 13paul_denver, TinaHashiRN, robert_kc and 40 others
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josh_phd_bmore
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Jan 25, 2024 at 4:34 AM#9

One thing that is still open after dan_philly’s answer:

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

Last edited: Jan 25, 2024 at 6:34 AM
42 12KarenAZ_mom, zoe_NC, Dr.ObesityLA and 39 others
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zoe_NC
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Jan 26, 2024 at 1:22 AM#10
SarahChen_PharmD said:
PCOS success story with glycaemic control: as someone with polycystic ovary syndrome, this medication has been transformative beyond weight loss.

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: Jan 26, 2024 at 2:22 AM
26 1mike_mealprep, NicoleRaleigh, james_edin and 23 others
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