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Evidence-based GLP-1 & peptide discussion since 2023
ForumsMetabolic Health & DiabetesBlood sugar used to spike to 200 after meals, now barely hits 120 — need advice Page 2

Blood sugar used to spike to 200 after meals, now barely hits 120 — need advice

HealthEcon_DC Thu, Mar 21, 2024 at 11:00 PM 24 replies 2,236 viewsPage 2 of 5
lucas_SP_BR
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Mar 22, 2024 at 12:16 AM#6
HealthEcon_DC said:
HbA1c reflects roughly three months of average glycaemia weighted toward the most recent weeks, which is why repeating it at six weeks tells you very…

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: Mar 22, 2024 at 2:16 AM
2 22NurseKim_ATL, paul_denver
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laura_annarbor
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Mar 22, 2024 at 12:45 AM#7

Following on from Dr.NateNeph — and this may be the naive question:

How would you tell the difference between that and the alternative explanation?

1 21emily_PDX
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JenPlateau
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Mar 22, 2024 at 1:14 AM#8
lucas_SP_BR said:
Patient selection optimization for glycaemic control: emerging predictive biomarkers for GLP-1 agonist response include: Biomarker Association…

My labs after 3 months on glycaemic control: A1C 5.3%, fasting glucose 83 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.

50 20RunnerRach, TrialNerd_Beth, HPLC_Greg and 47 others
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HealthEcon_DC
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Mar 22, 2024 at 1:43 AM#9
lucas_SP_BR said:
Patient selection optimization for glycaemic control: emerging predictive biomarkers for GLP-1 agonist response include: Biomarker Association…

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 = 4.7 (insulin resistant) → Current = 1.3 (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.

Last edited: Mar 22, 2024 at 3:43 AM
49 19TirzTom, TrialTracker_MD, JennaRN and 46 others
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Admin
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Mar 22, 2024 at 4:04 AM#10
JenPlateau said:
My labs after 3 months on glycaemic control: A1C 5.3%, fasting glucose 83 mg/dL, fasting insulin 4 uIU/mL.

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

After 11 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.

43 18PeptideSynthNJ, Dr.KarenChen, Dr.NateNeph and 40 others
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