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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 Page 2

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

DerekSJ_a1c Sat, May 9, 2026 at 4:03 AM 28 replies 646 viewsPage 2 of 6
Dr.RenalNash
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May 9, 2026 at 9:44 PM#6
Dr.NutriCornell said:
My labs after 12 months on glycaemic control: A1C 5.7%, fasting glucose 82 mg/dL, fasting insulin 5 uIU/mL.

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

TestBaselineMonth 3Month 6Month 12
Glucose (fasting)1151059583
Insulin (fasting)2113116
HOMA-IR5.54.12.31.4
Uric Acid8.86.56.25.1

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.

8 3wei_SG, cory_ATX, lori_vegas and 5 others
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VendorMark
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May 10, 2026 at 4:46 AM#7
DerekSJ_a1c 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.

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 = 4.2 (insulin resistant) → Current = 1.0 (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: May 10, 2026 at 6:46 AM
7 2KristenIndy, MarkLI_maint, Dr.PeteFamMed and 4 others
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traveltech_sara
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May 10, 2026 at 11:48 AM#8
Dr.RenalNash said:
Complete metabolic panel trending on glycaemic control — sharing because comprehensive data helps everyone: Test Baseline Month 3 Month 6 Month 12…

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 → 13 → 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.

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EndoResFellow
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May 10, 2026 at 6:50 PM#9

Following on from anna.melb_AU — and this may be the naive question:

What did you change at the same time, and can you separate the two now?

5 0NurseKim_ATL, paul_denver, TinaHashiRN and 2 others
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DerekSJ_a1c
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San Jose, CA
May 12, 2026 at 4:36 AM#10
traveltech_sara 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 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.

Last edited: May 12, 2026 at 9:36 AM
49 22AttorneyGrant, DebRD_ATL, KristenIndy and 46 others
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