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ForumsMetabolic Health & DiabetesGLP-1 and insulin resistance — what worked for you? Page 2

GLP-1 and insulin resistance — what worked for you?

Dr.ReproEndo Tue, Dec 17, 2024 at 1:52 PM 49 replies 2,383 viewsPage 2 of 10
JennaRN
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Dec 17, 2024 at 3:21 PM#6
DebRD_ATL said:
Complete metabolic panel trending on glycaemic control — sharing because comprehensive data helps everyone: Test Baseline Month 3 Month 6 Month 12…

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: 22 → 14 → 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.

21 16Dr.KarenChen, Dr.NateNeph, PharmD_Rodriguez and 18 others
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Dr.GutHealth
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Dec 17, 2024 at 3:55 PM#7
Dr.ReproEndo said:
Fasting glucose improved within weeks and my HbA1c barely moved for three months, which I now understand and did not at the time.

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.

20 15tyler_CSCS, VanRx_Mike, steve_okc and 17 others
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Dr.SurgeonPGH
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Dec 17, 2024 at 4:29 PM#8
JennaRN 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…

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.

19 14PharmHunterJen, TomTeleRx, DoseLogDan and 16 others
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tane_welly
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Dec 17, 2024 at 5:03 PM#9

One thing that is still open after julia.endo’s answer:

Did your prescriber agree with that reading, and if not what was their objection?

18 13marco_milano, pam_columbus, nick_SD_fit and 15 others
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Dr.ReproEndo
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Dec 17, 2024 at 7:46 PM#10
Dr.SurgeonPGH said:
Patient selection optimization for glycaemic control: emerging predictive biomarkers for GLP-1 agonist response include: Biomarker Association…

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.

16 14carl_compliance, DanielChem_CHI, marco_milano and 13 others
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