Dr.DermMIA 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.

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

After 8 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.

TirzTom 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 = 4.2 (insulin resistant) → Current = 1.2 (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.

Dr.DermMIA 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.

This is my experience too, for whatever a second data point is worth. Nothing to add that would improve it.

From the other side of the consultation, briefly.

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 → 14 → 7 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.