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.
The narrow version of the question is why A1C lags the way it does, and what to look at in the meantime if you want to know sooner.
I would rather have one careful answer than five confident ones.
BenResearch_OR 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 = 5.6 (insulin resistant) → Current = 1.0 (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.
Dr.RenalNash said:Insulin sensitivity test (HOMA-IR) on glycaemic control — arguably the most important metabolic marker most people aren't tracking: HOMA-IR = (fasting…
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 → 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.
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Shop Reference StandardsBenResearch_OR 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 is my experience too, for whatever a second data point is worth.
Adding the clinical framing, because it changes how the question reads.
My labs after 3 months on glycaemic control: A1C 5.1%, fasting glucose 91 mg/dL, fasting insulin 8 uIU/mL. My endo says these are "textbook perfect."
For context, my baseline A1C was 7.7% and fasting glucose was 126 mg/dL. The improvement has been dramatic and consistent.