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Evidence-based GLP-1 & peptide discussion since 2023
ForumsMetabolic Health & DiabetesIs it possible to reverse type 2 or am I dreaming

Is it possible to reverse type 2 or am I dreaming

steve_okc Mon, May 11, 2026 at 8:28 PM 13 replies 519 viewsPage 1 of 3
steve_okc
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Oklahoma City, OK
May 11, 2026 at 8:28 PM#1

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.

What I actually want to know 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.

8 3NauseaFreeNow, SteveThurs, B12Beth and 5 others
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PharmD_Rodriguez
Senior Member
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Jan 2024
Miami, FL
May 11, 2026 at 8:36 PM#2
steve_okc 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.

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: May 12, 2026 at 1:36 AM
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RickReta_CO
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Jan 2025
Colorado
May 11, 2026 at 8:44 PM#3
PharmD_Rodriguez said:
Patient selection optimization for glycaemic control: emerging predictive biomarkers for GLP-1 agonist response include: Biomarker Association…

My labs after 9 months on glycaemic control: A1C 6.3%, fasting glucose 93 mg/dL, fasting insulin 8 uIU/mL. My endo says these are "textbook perfect."

For context, my baseline A1C was 8.1% and fasting glucose was 138 mg/dL. The improvement has been dramatic and consistent.

6 1hyun_seoul, jim_asheville, matt_MKE and 3 others
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MariaRD
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Jun 2024
New Mexico
May 11, 2026 at 8:52 PM#4
steve_okc 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.

Can confirm. Same sequence, different timescale. I had assumed I was the exception until I read this.

Last edited: May 11, 2026 at 9:52 PM
5 0rick_sfbay, maria_elpaso, anders_CPH and 2 others
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Dr.SurgeonPGH
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Mar 2024
Pittsburgh, PA
May 11, 2026 at 9:35 PM#5

Adding the clinical framing, because it changes how the question reads.

Glycemic variability as the key metric for glycaemic control success: my coefficient of variation (CV) on CGM dropped from 37% 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.

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