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ForumsMetabolic Health & DiabetesPrediabetes reversal on GLP-1 — my results so far

Prediabetes reversal on GLP-1 — my results so far

KarenAZ_mom Wed, Mar 5, 2025 at 2:11 PM 16 replies 1,721 viewsPage 1 of 4
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KarenAZ_mom
Member
567
2,567
Aug 2024
Scottsdale, AZ
Mar 5, 2025 at 2:11 PM#1

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

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 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.

Practical detail welcome, however dull — the duller the better.

26 21anna.melb_AU, mark_tokyo, hans_munich and 23 others
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LarryQC_SD
Senior Member
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9,876
Jan 2024
San Diego, CA
Mar 5, 2025 at 2:44 PM#2
KarenAZ_mom said:
Fasting glucose improved within weeks and my HbA1c barely moved for three months, which I now understand and did not at the time.

Glycemic variability as the key metric for glycaemic control success: my coefficient of variation (CV) on CGM dropped from 42% to 22%. 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.

25 20paul_denver, TinaHashiRN, robert_kc and 22 others
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ZaraB_AL
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1,678
Jan 2025
Alabama
Mar 5, 2025 at 3:17 PM#3
LarryQC_SD said:
Glycemic variability as the key metric for glycaemic control success: my coefficient of variation (CV) on CGM dropped from 42% to 22%.

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.

24 19TirzTom, TrialTracker_MD, JennaRN and 21 others
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tyler_CSCS
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Jun 2024
Phoenix, AZ
Mar 5, 2025 at 3:50 PM#4
KarenAZ_mom said:
Fasting glucose improved within weeks and my HbA1c barely moved for three months, which I now understand and did not at the time.

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

23 18amy_econ_NJ, bbq_ray_KC, oliver_london and 20 others
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PharmHunterJen
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Jul 2024
Illinois
Mar 5, 2025 at 6:54 PM#5

From the other side of the consultation, briefly.

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: Mar 6, 2025 at 12:54 AM
22 17mike_mealprep, NicoleRaleigh, james_edin and 19 others
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