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ForumsMetabolic Health & DiabetesIs it possible to reverse type 2 or am I dreaming — 12 month update

Is it possible to reverse type 2 or am I dreaming — 12 month update

tane_welly Tue, Sep 2, 2025 at 2:37 PM 7 replies 1,221 viewsPage 1 of 2
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tane_welly
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Sep 2024
Wellington, NZ
Sep 2, 2025 at 2:37 PM#1

Writing this once so I can stop repeating it across threads. It is about glycaemic control, and it is deliberately narrow — everything I am not confident about is marked as such.

What is actually established

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 little. The improvement on this class comes from two directions — direct glucose-dependent insulin secretion and glucagon suppression, plus the indirect effect of weight loss on insulin sensitivity — and the second continues after the first has plateaued.

The condition it depends on

The caveat that HbA1c is unreliable in anaemia, haemoglobinopathies and recent blood loss, all of which are commoner than people assume. If it disagrees with fasting glucose or a CGM, that is worth chasing.

The practical version

Because it is glucose-dependent, this class carries a low intrinsic hypoglycaemia risk on its own — the risk arrives when it is combined with insulin or a sulfonylurea, which usually need reducing.

What I am not sure about

What I am trying to establish is why A1C lags the way it does, and what to look at in the meantime if you want to know sooner. I have searched first, so if this is covered somewhere point me at it and I will read it.

— tane_welly · corrections welcome and will be edited into this post with credit
40 10GraceAZ_72, carl_compliance, DanielChem_CHI and 37 others
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Dr.PainCLE
Senior Member
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6,234
Mar 2024
Cleveland, OH
Sep 2, 2025 at 3:19 PM#2
tane_welly 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…

My labs after 9 months on glycaemic control: A1C 5.8%, fasting glucose 93 mg/dL, fasting insulin 6 uIU/mL. My endo says these are "textbook perfect."

For context, my baseline A1C was 8.1% and fasting glucose was 118 mg/dL. The improvement has been dramatic and consistent.

39 9tane_welly, Dr.PathRoch, mona_PHX and 36 others
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anders_CPH
Senior Member
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Feb 2024
Copenhagen, DK
Sep 2, 2025 at 4:01 PM#3
tane_welly 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…

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

TestBaselineMonth 3Month 6Month 12
Glucose (fasting)1291039387
Insulin (fasting)251797
HOMA-IR5.53.02.11.3
Uric Acid7.76.96.05.0

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.

Last edited: Sep 2, 2025 at 8:01 PM
38 8AussieAnna, BethLabQueen, ChrisMacros and 35 others
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newstart_MO
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Feb 2026
Springfield, MO
Sep 2, 2025 at 4:43 PM#4
anders_CPH 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 37% 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.

Last edited: Sep 2, 2025 at 10:43 PM
37 7TrialNerd_Beth, HPLC_Greg, LibrarianMeg and 34 others
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RickReta_CO
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Jan 2025
Colorado
Sep 2, 2025 at 8:40 PM#5
Dr.PainCLE said:
My labs after 9 months on glycaemic control: A1C 5.8%, fasting glucose 93 mg/dL, fasting insulin 6 uIU/mL.

Can confirm. Same sequence, different timescale.

36 6LindaRN_retired, tommy_boulder, hyun_seoul and 33 others
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