Dr.Martinez 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…

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 = 5.1 (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.

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

Did your prescriber agree with that reading, and if not what was their objection?

raj_cambridge said:

Insulin sensitivity test (HOMA-IR) on glycaemic control — arguably the most important metabolic marker most people aren't tracking: HOMA-IR = (fasting…

My labs after 3 months on glycaemic control: A1C 5.5%, fasting glucose 75 mg/dL, fasting insulin 6 uIU/mL. My endo says these are "textbook perfect."

For context, my baseline A1C was 6.5% and fasting glucose was 130 mg/dL. The improvement has been dramatic and consistent.

raj_cambridge 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: 27 → 15 → 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.

carl_compliance said:

My labs after 3 months on glycaemic control: A1C 5.5%, fasting glucose 75 mg/dL, fasting insulin 6 uIU/mL.

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

The insulin resistance improvement (HOMA-IR) is what my endo focuses on most. Going from 4.5 to near 1.0 is a metabolic transformation.