sarah_nash92 said:

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

My labs after 6 months on glycaemic control: A1C 5.4%, fasting glucose 84 mg/dL, fasting insulin 5 uIU/mL. My endo says these are "textbook perfect."

For context, my baseline A1C was 8.3% and fasting glucose was 129 mg/dL. The improvement has been dramatic and consistent.

julia.endo said:

My labs after 6 months on glycaemic control: A1C 5.4%, fasting glucose 84 mg/dL, fasting insulin 5 uIU/mL.

Patient selection optimization for glycaemic control: emerging predictive biomarkers for GLP-1 agonist response include:

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.

sarah_nash92 said:

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

Adding a me-too, because a thread of one person's experience is not much use. Nothing to add that would improve it.

From the other side of the consultation, briefly.

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 = 4.8 (insulin resistant) → Current = 1.4 (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.