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ForumsMetabolic Health & DiabetesGot off metformin for the first time in 8 years - crying happy tears — looking for input Page 2

Got off metformin for the first time in 8 years - crying happy tears — looking for input

ricardo_MIA Fri, Jan 31, 2025 at 9:41 PM 39 replies 1,834 viewsPage 2 of 8
Dr.MetabolicMD
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Feb 1, 2025 at 5:43 AM#6
Dr.AddMedPHL said:
My labs after 12 months on glycaemic control: A1C 6.4%, fasting glucose 94 mg/dL, fasting insulin 9 uIU/mL.

PCOS success story with glycaemic control: as someone with polycystic ovary syndrome, this medication has been transformative beyond weight loss.

After 10 months: periods became regular for the first time in years, testosterone levels normalized, acne cleared significantly, and — unexpectedly — I got pregnant naturally after 4 years of trying.

GLP-1 agonists address the insulin resistance at the root of PCOS. For PCOS patients, this isn't "just" a weight loss drug — it's treating our underlying metabolic dysfunction.

9 4SleepDoc_PDX, RegAffairsDC, BiostatsBrad and 6 others
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LabKate
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Jan 2024
Oregon
Feb 1, 2025 at 8:54 AM#7
ricardo_MIA 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.

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.

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PeptideChemSF
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Jan 2024
San Francisco, CA
Feb 1, 2025 at 12:05 PM#8
Dr.MetabolicMD said:
PCOS success story with glycaemic control: as someone with polycystic ovary syndrome, this medication has been transformative beyond weight loss.

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

TestBaselineMonth 3Month 6Month 12
Glucose (fasting)1251079385
Insulin (fasting)211595
HOMA-IR5.53.12.11.4
Uric Acid7.86.56.05.1

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.

Last edited: Feb 1, 2025 at 4:05 PM
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tommy_boulder
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Nov 2024
Boulder, CO
Feb 1, 2025 at 3:16 PM#9

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

How would you tell the difference between that and the alternative explanation?

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ricardo_MIA
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Sep 2024
Miami, FL
Feb 2, 2025 at 6:31 AM#10
PeptideChemSF said:
Complete metabolic panel trending on glycaemic control — sharing because comprehensive data helps everyone: Test Baseline Month 3 Month 6 Month 12…

Glycemic variability as the key metric for glycaemic control success: my coefficient of variation (CV) on CGM dropped from 41% to 19%. 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: Feb 2, 2025 at 11:31 AM
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