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Evidence-based GLP-1 & peptide discussion since 2023
ForumsMetabolic Health & DiabetesContinuous glucose monitor patterns on GLP-1 — time in range improvements Page 2

Continuous glucose monitor patterns on GLP-1 — time in range improvements

NicoleRaleigh Wed, Jun 3, 2026 at 8:34 AM 19 replies 321 viewsPage 2 of 4
mike.trainer_LA
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Jun 3, 2026 at 9:24 PM#6
Dr.SportsMedIN said:
Insulin sensitivity test (HOMA-IR) on glycaemic control — arguably the most important metabolic marker most people aren't tracking: HOMA-IR = (fasting…

My labs after 12 months on glycaemic control: A1C 6.1%, fasting glucose 86 mg/dL, fasting insulin 9 uIU/mL. My endo says these are "textbook perfect."

For context, my baseline A1C was 6.7% and fasting glucose was 121 mg/dL. The improvement has been dramatic and consistent.

Last edited: Jun 4, 2026 at 1:24 AM
24 19Dr.AddMedPHL, newstart_MO, mia_MS2 and 21 others
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Dr.PeteFamMed
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Jun 4, 2026 at 2:32 AM#7
NicoleRaleigh 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.

23 18tommy_boulder, hyun_seoul, jim_asheville and 20 others
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anders_CPH
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Jun 4, 2026 at 7:39 AM#8
mike.trainer_LA said:
My labs after 12 months on glycaemic control: A1C 6.1%, fasting glucose 86 mg/dL, fasting insulin 9 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: 28 → 12 → 6 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.

22 17AussieAnna, BethLabQueen, ChrisMacros and 19 others
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oliver_london
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Jun 4, 2026 at 12:45 PM#9

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

Was that from a primary source or from a summary of one?

Last edited: Jun 4, 2026 at 1:45 PM
21 16jason_paloalto, Dr.LeslieOBGYN, MikeNYC_runner and 18 others
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NicoleRaleigh
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Jun 5, 2026 at 1:18 PM#10
anders_CPH said:
Fasting insulin is the lab my functional medicine doctor cares about most for glycaemic control: it's a much earlier marker of metabolic dysfunction…

Glycemic variability as the key metric for glycaemic control success: my coefficient of variation (CV) on CGM dropped from 39% 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.

Last edited: Jun 5, 2026 at 2:18 PM
49 24mike_nyc, VendorMark, COA_Karl and 46 others
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