pete_manc_UK said:

Fasting glucose improved within weeks and my HbA1c barely moved for three months, which I now understand and did not at the time.

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: 25 → 13 → 7 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.

TrialNerd_Beth 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 37% to 21%. 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.

pete_manc_UK said:

Fasting glucose improved within weeks and my HbA1c barely moved for three months, which I now understand and did not at the time.

Same pattern here, and in the same order. Posting only so the count is not one.

Clinical perspective, offered as context rather than as advice.

Patient selection optimization for glycaemic control: emerging predictive biomarkers for GLP-1 agonist response include:

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.