sophie_paris 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.

Glycemic variability as the key metric for glycaemic control success: my coefficient of variation (CV) on CGM dropped from 38% 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.

Dr.SportsMedIN said:

Glycemic variability as the key metric for glycaemic control success: my coefficient of variation (CV) on CGM dropped from 38% to 18%.

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 → 12 → 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.

sophie_paris 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.

Same experience, arrived at from the opposite direction. The detail I would add is minor and it is already implied above.

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

My labs after 9 months on glycaemic control: A1C 5.3%, fasting glucose 93 mg/dL, fasting insulin 4 uIU/mL. My endo says these are "textbook perfect."

For context, my baseline A1C was 8.1% and fasting glucose was 128 mg/dL. The improvement has been dramatic and consistent.