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.
What I actually want to know is why A1C lags the way it does, and what to look at in the meantime if you want to know sooner.
Tell me what I have not thought of.
zoe_NC 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.
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: 31 → 15 → 5 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.
BariatricNurseD 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…
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 = 5.1 (insulin resistant) → Current = 1.5 (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.
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Browse GL Biochemzoe_NC 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.
This matches mine closely enough to be worth saying so out loud.
Clinical perspective, offered as context rather than as advice.
My labs after 3 months on glycaemic control: A1C 6.2%, fasting glucose 87 mg/dL, fasting insulin 4 uIU/mL. My endo says these are "textbook perfect."
For context, my baseline A1C was 6.9% and fasting glucose was 122 mg/dL. The improvement has been dramatic and consistent.