Read the primary source rather than the write-up and the two do not agree, so here is what is actually in it.
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 little. The improvement on this class comes from two directions — direct glucose-dependent insulin secretion and glucagon suppression, plus the indirect effect of weight loss on insulin sensitivity — and the second continues after the first has plateaued.
Where I think it is weakest: the subgroup findings are the part I trust least — with enough subgroups something is always significant, and these were not all pre-registered.
What I am trying to establish is why A1C lags the way it does, and what to look at in the meantime if you want to know sooner. If the honest answer is that nobody knows, that is a useful answer and I would rather have it.
Figures above are from the primary publication rather than the press summary. If a number here disagrees with one you have, post yours and we will work out which of us is reading a secondary source.
pat_auckland 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…
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: 27 → 13 → 6 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.
pat_auckland 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…
Complete metabolic panel trending on glycaemic control — sharing because comprehensive data helps everyone:
| Test | Baseline | Month 3 | Month 6 | Month 12 |
|---|---|---|---|---|
| Glucose (fasting) | 119 | 105 | 95 | 83 |
| Insulin (fasting) | 25 | 13 | 11 | 6 |
| HOMA-IR | 5.5 | 3.5 | 2.3 | 1.3 |
| Uric Acid | 8.2 | 6.9 | 6.2 | 5.0 |
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.
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Browse GL Biochemkate.chem 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 6 months on glycaemic control: A1C 6.0%, fasting glucose 80 mg/dL, fasting insulin 5 uIU/mL. My endo says these are "textbook perfect."
For context, my baseline A1C was 7.5% and fasting glucose was 135 mg/dL. The improvement has been dramatic and consistent.
LarryQC_SD 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…
Same experience, arrived at from the opposite direction.