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Evidence-based GLP-1 & peptide discussion since 2023
ForumsPharmacology & MechanismsIncretin effect in healthy vs T2DM — looking for input Page 2

Incretin effect in healthy vs T2DM — looking for input

PedsEndoPhilly Tue, Jun 25, 2024 at 10:31 PM 13 replies 2,056 viewsPage 2 of 3
PeptideSynthNJ
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Jun 26, 2024 at 1:39 AM#6
PedsEndoPhilly said:
HbA1c reflects roughly three months of average glycaemia weighted toward the most recent weeks, which is why repeating it at six weeks tells you very…

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

After 7 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.

7 2wanda_boise, NurseAsh_DET, BenResearch_OR and 4 others
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paul_denver
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Jun 26, 2024 at 2:52 AM#7

Following on from Dr.GastroMayo — and this may be the naive question:

Was that from a primary source or from a summary of one?

Last edited: Jun 26, 2024 at 8:52 AM
6 1jason_paloalto, Dr.LeslieOBGYN, MikeNYC_runner and 3 others
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Dr.LipidDallas
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Jun 26, 2024 at 4:05 AM#8
PeptideSynthNJ 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)1261049482
Insulin (fasting)2212105
HOMA-IR4.53.72.21.5
Uric Acid8.46.66.15.2

The insulin resistance improvement (HOMA-IR) is what my endo focuses on most. Going from 4.5 to near 1.0 is a metabolic transformation.

5 0cory_ATX, lori_vegas, Dr.PulmRoch and 2 others
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PedsEndoPhilly
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Jun 26, 2024 at 5:18 AM#9
PeptideSynthNJ said:
PCOS success story with glycaemic control: as someone with polycystic ovary syndrome, this medication has been transformative beyond weight loss.

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.

Last edited: Jun 26, 2024 at 10:18 AM
4 24Dr.LeslieOBGYN, MikeNYC_runner and 1 other
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mona_PHX
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Jun 26, 2024 at 11:10 AM#10
Dr.LipidDallas said:
Complete metabolic panel trending on glycaemic control — sharing because comprehensive data helps everyone: Test Baseline Month 3 Month 6 Month 12…

My labs after 12 months on glycaemic control: A1C 5.1%, fasting glucose 86 mg/dL, fasting insulin 5 uIU/mL. My endo says these are "textbook perfect."

For context, my baseline A1C was 6.7% and fasting glucose was 111 mg/dL. The improvement has been dramatic and consistent.

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