u/Azratoh

Part 3: Another year of the metabolism experiment — HbA1c keeps falling, but HOMA-IR went up

This is a continuation of my previous posts:

**Part 1:** https://www.reddit.com/r/prediabetes/s/43HE5Ntzhq

**Part 2:** https://www.reddit.com/r/prediabetes/s/frnTzn6uV1

It's been another year, so here's the next update.

**What I did**

For the last year, I've kept essentially the same lifestyle:

- 3x/week weight training
- Daily biking
- Same body weight, more or less
- Continued reducing animal fat
- Continued increasing carbohydrates, primarily from whole-food/whole-grain sources
- Increased unsaturated fat, particularly olive oil

My weight has remained basically unchanged.

**Bloodwork**

Here is the progression:

HbA1c: **5.58 -> 5.40 -> 5.19**

Fasting insulin: **6.6 -> 3.8 -> 11.8**

HOMA-IR: **1.4 -> 0.9 -> 2.97**

Fasting glucose: **85-95 -> 80-95 -> 102 mg/dL**

So something interesting happened this year.

My **HbA1c continued to decrease**, and is now the lowest it's ever been.

This is despite the fact that I'm eating considerably more carbohydrates (200-250g) than when I started this experiment.

However, my **fasting insulin and HOMA-IR went up quite substantially**, and my fasting glucose is back to 102 (highest 108 in 2024)

So now I'm a little confused about what direction I should actually be trying to optimize for.

**What should I prioritize?**

Is it better to have:

**A)** Lower HbA1c but higher fasting insulin/HOMA-IR

or

**B)** Lower fasting insulin/HOMA-IR but somewhat higher HbA1c?

I honestly don't know.

I'm not sure whether I should change my diet based on these results, or simply continue doing what I've been doing and see what happens over another year.

For context, I'm still normal weight (BMI ~22), my weight hasn't meaningfully changed, and I have a family history of type 2 diabetes. So I realize my situation may be quite different from the typical person with prediabetes.

I'm posting this mainly because I find the evolution interesting, and I'd be interested in hearing how others would interpret the discordance between **HbA1c and fasting insulin/HOMA-IR**.

For now, I'm probably going to continue monitoring rather than making a major change based on a single set of results.

I'll keep you updated.

reddit.com
u/Azratoh — 1 day ago