ricardo_MIA 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.

My labs after 12 months on glycaemic control: A1C 6.4%, fasting glucose 94 mg/dL, fasting insulin 9 uIU/mL. My endo says these are "textbook perfect."

For context, my baseline A1C was 8.3% and fasting glucose was 139 mg/dL. The improvement has been dramatic and consistent.

Dr.AddMedPHL said:

My labs after 12 months on glycaemic control: A1C 6.4%, fasting glucose 94 mg/dL, fasting insulin 9 uIU/mL.

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 = 6.1 (insulin resistant) → Current = 1.1 (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.

ricardo_MIA 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.

This matches mine closely enough to be worth saying so out loud. I had assumed I was the exception until I read this.

Clinical perspective, offered as context rather than as advice.

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: 30 → 12 → 6 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.