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ForumsPharmacology & MechanismsIncretin effect in healthy vs T2DM — need advice

Incretin effect in healthy vs T2DM — need advice

alex_tucson Wed, Mar 26, 2025 at 10:30 AM 13 replies 1,530 viewsPage 1 of 3
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alex_tucson
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Tucson, AZ
Mar 26, 2025 at 10:30 AM#1

Fasting glucose improved within weeks and my HbA1c barely moved for three months, which I now understand and did not at the time.

So the question, as narrowly as I can put it: 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.

2 22emily_PDX, Dr.SleepRoch
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Dr.GastroMayo
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Mar 26, 2025 at 10:39 AM#2
alex_tucson said:
Fasting glucose improved within weeks and my HbA1c barely moved for three months, which I now understand and did not at the time.

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

TestBaselineMonth 3Month 6Month 12
Glucose (fasting)1151059583
Insulin (fasting)2113116
HOMA-IR5.54.12.31.4
Uric Acid8.86.56.25.1

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: Mar 26, 2025 at 3:39 PM
1 21VendorMark
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paul_denver
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Mar 26, 2025 at 10:48 AM#3
Dr.GastroMayo said:
Complete metabolic panel trending on glycaemic control — sharing because comprehensive data helps everyone: Test Baseline Month 3 Month 6 Month 12…

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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.

50 20wendy_avl, jason_paloalto, Dr.LeslieOBGYN and 47 others
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quinn_sf
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Mar 26, 2025 at 10:57 AM#4
alex_tucson said:
Fasting glucose improved within weeks and my HbA1c barely moved for three months, which I now understand and did not at the time.

Second this.

49 19andrew_nyc, Dr.EndoEP, GraceAZ_72 and 46 others
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Dr.PulmRoch
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Mar 26, 2025 at 11:42 AM#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 39% to 20%. 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.

48 18KristenIndy, MarkLI_maint, Dr.PeteFamMed and 45 others
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