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ForumsProgress & Lab ResultsA1C from 9.2 to 5.4 in 8 months — what worked for you? Page 2

A1C from 9.2 to 5.4 in 8 months — what worked for you?

pete_RVA Wed, Jan 21, 2026 at 9:53 PM 15 replies 918 viewsPage 2 of 3
PharmacoVig_BOS
Senior Member
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Feb 2024
Boston, MA
Jan 22, 2026 at 10:53 AM#6
pete_manc_UK said:
My labs after 3 months on glycaemic control: A1C 6.2%, fasting glucose 87 mg/dL, fasting insulin 4 uIU/mL.

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

TestBaselineMonth 3Month 6Month 12
Glucose (fasting)1191059183
Insulin (fasting)2513116
HOMA-IR5.53.51.91.3
Uric Acid8.26.95.85.0

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.

21 16amsterdam_pete, LondonLisa, mike_nyc and 18 others
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stefan_berlin
Member
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Oct 2024
Berlin, DE
Jan 22, 2026 at 4:02 PM#7
pete_RVA 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 = 1.1 (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.

20 15JessicaH_TX, KevinCompounds, TirzTom and 17 others
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julia.endo
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Feb 2024
Cincinnati, OH
Jan 22, 2026 at 9:11 PM#8
PharmacoVig_BOS said:
Complete metabolic panel trending on glycaemic control — sharing because comprehensive data helps everyone: Test Baseline Month 3 Month 6 Month 12…

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.

19 14hans_munich, jason_sac26, chris_chi24 and 16 others
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emily_PDX
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Nov 2024
Portland, OR
Jan 23, 2026 at 2:20 AM#9

A narrower follow-up, since the general answer is now clear:

What would you measure differently if you were starting again?

18 13Dr.KarenChen, Dr.NateNeph, PharmD_Rodriguez and 15 others
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pete_RVA
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Dec 2024
Richmond, VA
Jan 24, 2026 at 3:04 AM#10
julia.endo 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: Jan 24, 2026 at 8:04 AM
18 16Dr.LeslieOBGYN, MikeNYC_runner and 15 others
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