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ForumsMetabolic Health & DiabetesType 1.5 diabetes (LADA) and GLP-1 — anyone have experience? Page 2

Type 1.5 diabetes (LADA) and GLP-1 — anyone have experience?

marcus_mpls Thu, Mar 5, 2026 at 12:04 PM 12 replies 878 viewsPage 2 of 3
BethLabQueen
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Mar 6, 2026 at 5:34 AM#6
sarah.morrison 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…

My labs after 3 months on glycaemic control: A1C 5.7%, fasting glucose 87 mg/dL, fasting insulin 8 uIU/mL. My endo says these are "textbook perfect."

For context, my baseline A1C was 6.9% and fasting glucose was 132 mg/dL. The improvement has been dramatic and consistent.

15 10maya_sedona, stefan_berlin, Dr.EM_Chicago and 12 others
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Dr.GutHealth
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Mar 6, 2026 at 12:31 PM#7
marcus_mpls said:
Fasting glucose improved within weeks and my HbA1c barely moved for three months, which I now understand and did not at the time.

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 = 5.2 (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.

14 9tyler_CSCS, VanRx_Mike, steve_okc and 11 others
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Dr.SurgeonPGH
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Mar 6, 2026 at 7:28 PM#8
BethLabQueen said:
My labs after 3 months on glycaemic control: A1C 5.7%, fasting glucose 87 mg/dL, fasting insulin 8 uIU/mL.

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.

13 8PharmHunterJen, TomTeleRx, DoseLogDan and 10 others
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AussieAnna
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Mar 7, 2026 at 2:24 AM#9

One thing that is still open after JennaRN’s answer:

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

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marcus_mpls
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Mar 8, 2026 at 11:42 AM#10
Dr.SurgeonPGH said:
Patient selection optimization for glycaemic control: emerging predictive biomarkers for GLP-1 agonist response include: Biomarker Association…

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

TestBaselineMonth 3Month 6Month 12
Glucose (fasting)1311019585
Insulin (fasting)2715115
HOMA-IR5.53.72.31.5
Uric Acid8.47.16.25.2

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.

32 5mona_PHX, andrew_nyc, Dr.EndoEP and 29 others
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