matt_MKE 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 = 4.3 (insulin resistant) → Current = 1.5 (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.

Dr.SleepRoch said:

Insulin sensitivity test (HOMA-IR) on glycaemic control — arguably the most important metabolic marker most people aren't tracking: HOMA-IR = (fasting…

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

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.

matt_MKE 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.

Can confirm. Same sequence, different timescale. The detail I would add is minor and it is already implied above.

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 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.