Fasting glucose improved within weeks and my HbA1c barely moved for three months, which I now understand and did not at the time.
The question I want answered is why A1C lags the way it does, and what to look at in the meantime if you want to know sooner.
Not looking for reassurance. Looking for the part I have got wrong.
carlos_SATX said:Fasting glucose improved within weeks and my HbA1c barely moved for three months, which I now understand and did not at the time.
Glycemic variability as the key metric for glycaemic control success: my coefficient of variation (CV) on CGM dropped from 40% to 22%. Target is <36%, with <30% being ideal.
Why this matters more than average glucose: large glucose swings cause oxidative stress, endothelial damage, and promote advanced glycation end-products (AGEs). A flat glucose line at 95 mg/dL is metabolically healthier than oscillating between 60 and 160, even if the average is the same.
BethLabQueen said:Glycemic variability as the key metric for glycaemic control success: my coefficient of variation (CV) on CGM dropped from 40% to 22%.
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: 23 → 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.
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Shop Reference Standardscarlos_SATX said:Fasting glucose improved within weeks and my HbA1c barely moved for three months, which I now understand and did not at the time.
Adding a me-too, because a thread of one person's experience is not much use. Nothing to add that would improve it.
Clinical perspective, offered as context rather than as advice.
Complete metabolic panel trending on glycaemic control — sharing because comprehensive data helps everyone:
| Test | Baseline | Month 3 | Month 6 | Month 12 |
|---|---|---|---|---|
| Glucose (fasting) | 125 | 107 | 89 | 85 |
| Insulin (fasting) | 21 | 15 | 9 | 5 |
| HOMA-IR | 5.5 | 3.1 | 1.7 | 1.4 |
| Uric Acid | 7.8 | 6.5 | 5.6 | 5.1 |
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.