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ForumsPharmacology & MechanismsIncretin effect in healthy vs T2DM — 12 month update Page 2

Incretin effect in healthy vs T2DM — 12 month update

marco_milano Mon, Oct 20, 2025 at 2:49 AM 28 replies 1,548 viewsPage 2 of 6
MikeFit_NJ
Senior Member
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6,543
Apr 2024
New Jersey
Oct 20, 2025 at 6:40 AM#6
RetaRick_CA said:
Complete metabolic panel trending on glycaemic control — sharing because comprehensive data helps everyone: Test Baseline Month 3 Month 6 Month 12…

Glycemic variability as the key metric for glycaemic control success: my coefficient of variation (CV) on CGM dropped from 40% to 21%. 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.

46 16LeilaHI, marcus_mpls, DeniseRN_TPA and 43 others
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TrialTracker_MD
Senior Member
2,345
15,678
Jan 2024
Maryland
Oct 20, 2025 at 8:10 AM#7
marco_milano said:
Fasting glucose improved within weeks and my HbA1c barely moved for three months, which I now understand and did not at the time.

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.

45 15stefan_berlin, Dr.EM_Chicago, pete_RVA and 42 others
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Dr.EM_Chicago
Member
567
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May 2024
Chicago, IL
Oct 20, 2025 at 9:40 AM#8
MikeFit_NJ said:
Glycemic variability as the key metric for glycaemic control success: my coefficient of variation (CV) on CGM dropped from 40% to 21%.

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.

44 14Dr.ReproEndo, lucas_SP_BR, lisa_labSD and 41 others
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MikeKY_noInsulin
Member
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1,234
Oct 2024
Louisville, KY
Oct 20, 2025 at 11:11 AM#9

A narrower follow-up, since the general answer is now clear:

What would you measure differently if you were starting again?

Last edited: Oct 20, 2025 at 2:11 PM
43 13amy_econ_NJ, bbq_ray_KC, oliver_london and 40 others
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marco_milano
Member
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Jul 2024
Milan, IT
Oct 20, 2025 at 6:26 PM#10
Dr.EM_Chicago said:
Patient selection optimization for glycaemic control: emerging predictive biomarkers for GLP-1 agonist response include: Biomarker Association…

My labs after 3 months on glycaemic control: A1C 6.1%, fasting glucose 91 mg/dL, fasting insulin 6 uIU/mL. My endo says these are "textbook perfect."

For context, my baseline A1C was 7.7% and fasting glucose was 136 mg/dL. The improvement has been dramatic and consistent.

21 19emma_london, tammy_FL, Dr.LipidDallas and 18 others
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