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 would genuinely help is knowing 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.
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.
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.
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.
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: 22 → 14 → 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.
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Shop Reference Standardspete_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.
This is my experience too, for whatever a second data point is worth.
From the other side of the consultation, briefly.
Glycemic variability as the key metric for glycaemic control success: my coefficient of variation (CV) on CGM dropped from 41% to 21%. 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.