pete_RVA 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 3 months on glycaemic control: A1C 6.2%, fasting glucose 87 mg/dL, fasting insulin 4 uIU/mL. My endo says these are "textbook perfect."

For context, my baseline A1C was 6.9% and fasting glucose was 122 mg/dL. The improvement has been dramatic and consistent.

pete_manc_UK said:

My labs after 3 months on glycaemic control: A1C 6.2%, fasting glucose 87 mg/dL, fasting insulin 4 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: 22 → 14 → 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.

pete_RVA 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 is my experience too, for whatever a second data point is worth.

From the other side of the consultation, briefly.

Glycemic variability as the key metric for glycaemic control success: my coefficient of variation (CV) on CGM dropped from 41% to 21%. 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.