A1cHero_PHX 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 9 months on glycaemic control: A1C 6.1%, fasting glucose 81 mg/dL, fasting insulin 6 uIU/mL. My endo says these are "textbook perfect."

For context, my baseline A1C was 7.7% and fasting glucose was 136 mg/dL. The improvement has been dramatic and consistent.

PharmacoVig_BOS said:

My labs after 9 months on glycaemic control: A1C 6.1%, fasting glucose 81 mg/dL, fasting insulin 6 uIU/mL.

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: 31 → 15 → 5 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.

A1cHero_PHX said:

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

Second this. The detail I would add is minor and it is already implied above.

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

Glycemic variability as the key metric for glycaemic control success: my coefficient of variation (CV) on CGM dropped from 35% 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.