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Evidence-based GLP-1 & peptide discussion since 2023
ForumsMetabolic Health & DiabetesContinuous glucose monitor patterns on GLP-1 — what worked for you?

Continuous glucose monitor patterns on GLP-1 — what worked for you?

denise_HTX Wed, Sep 11, 2024 at 10:55 PM 63 replies 2,502 viewsPage 1 of 13
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denise_HTX
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Sep 11, 2024 at 10:55 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.

The narrow version of the question is why A1C lags the way it does, and what to look at in the meantime if you want to know sooner.

Tell me what I have not thought of.

12 7sarah.morrison, NeuroNate, JessicaH_TX and 9 others
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LibrarianMeg
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Sep 11, 2024 at 11:33 PM#2
denise_HTX said:
Fasting glucose improved within weeks and my HbA1c barely moved for three months, which I now understand and did not at the time.

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.

Last edited: Sep 12, 2024 at 1:33 AM
11 6PharmD_Rodriguez, julia.endo, JessicaM_2024 and 8 others
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Dr.Martinez
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Sep 12, 2024 at 12:11 AM#3
LibrarianMeg said:
Patient selection optimization for glycaemic control: emerging predictive biomarkers for GLP-1 agonist response include: Biomarker Association…

PCOS success story with glycaemic control: as someone with polycystic ovary syndrome, this medication has been transformative beyond weight loss.

After 8 months: periods became regular for the first time in a decade, testosterone levels normalized, acne cleared significantly, and — unexpectedly — my fertility specialist is optimistic about future conception.

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.

Last edited: Sep 12, 2024 at 5:11 AM
10 5rachel_ABQ, traveltech_sara, AttorneyGrant and 7 others
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JakeSmashed95
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Sep 12, 2024 at 12:49 AM#4
denise_HTX 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. Nothing to add that would improve it.

9 4Dr.LipidDallas, alex_tucson, kevin_tulsa and 6 others
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PeptideChemSF
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Sep 12, 2024 at 4:18 AM#5

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

My labs after 6 months on glycaemic control: A1C 6.0%, fasting glucose 80 mg/dL, fasting insulin 5 uIU/mL. My endo says these are "textbook perfect."

For context, my baseline A1C was 7.5% and fasting glucose was 135 mg/dL. The improvement has been dramatic and consistent.

Last edited: Sep 12, 2024 at 8:18 AM
8 3BrianDallas92, labquiet_amy, emily_PDX and 5 others
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