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ForumsProgress & Lab ResultsA1C from 9.2 to 5.4 in 8 months — need advice Page 2

A1C from 9.2 to 5.4 in 8 months — need advice

ZaraB_AL Sun, Dec 29, 2024 at 9:04 AM 12 replies 1,701 viewsPage 2 of 3
LabKate
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Dec 30, 2024 at 1:08 PM#6
TrialTracker_MD said:
Patient selection optimization for glycaemic control: emerging predictive biomarkers for GLP-1 agonist response include: Biomarker Association…

Glycemic variability as the key metric for glycaemic control success: my coefficient of variation (CV) on CGM dropped from 42% to 20%. 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.

48 18JenMemphis, pat_auckland, Dr.GastroMayo and 45 others
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PharmacoVig_BOS
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Feb 2024
Boston, MA
Dec 31, 2024 at 12:18 AM#7
ZaraB_AL 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.

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: Dec 31, 2024 at 3:18 AM
47 17Dr.GutHealth, amsterdam_pete, LondonLisa and 44 others
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Dr.EndoIndy
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Oct 2024
Indianapolis, IN
Dec 31, 2024 at 11:28 AM#8
LabKate said:
Glycemic variability as the key metric for glycaemic control success: my coefficient of variation (CV) on CGM dropped from 42% to 20%.

Complete metabolic panel trending on glycaemic control — sharing because comprehensive data helps everyone:

TestBaselineMonth 3Month 6Month 12
Glucose (fasting)121998983
Insulin (fasting)271396
HOMA-IR5.53.21.71.5
Uric Acid7.97.15.65.2

The insulin resistance improvement (HOMA-IR) is what my endo focuses on most. Going from 5.5 to near 1.0 is a metabolic transformation.

46 16marcus_mpls, DeniseRN_TPA, SandraNC_45 and 43 others
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tyler_CSCS
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Phoenix, AZ
Dec 31, 2024 at 10:38 PM#9

Following on from AmyNC_wife — and this may be the naive question:

Did your prescriber agree with that reading, and if not what was their objection?

45 15amy_econ_NJ, bbq_ray_KC, oliver_london and 42 others
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ZaraB_AL
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Jan 2025
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Jan 3, 2025 at 4:12 AM#10
Dr.EndoIndy said:
Complete metabolic panel trending on glycaemic control — sharing because comprehensive data helps everyone: Test Baseline Month 3 Month 6 Month 12…

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 = 6.0 (insulin resistant) → Current = 1.2 (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.

17 17JennaRN, LabKate, kate.chem and 14 others
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