HbA1c / fasting insulin / HOMA-IR
Diagnostics · Glycemic / insulin status
Tier S
What this is
HbA1c alone misses early metabolic dysfunction by years. Fasting insulin elevation precedes glucose abnormalities by ~10 years. Kraft insulin pattern (based on post-glucose insulin response) proposed 4 stages of insulin resistance. Most providers won't order fasting insulin without patient advocacy.
Mechanism
HbA1c = glycated hemoglobin, 3-month average glucose; fasting insulin + fasting glucose → HOMA-IR = insulin resistance estimate; OGTT is gold standard for hidden dysglycemia; CGM reveals postprandial patterns invisible to fasting tests
Dose & route
HbA1c and fasting insulin annually; biohackers target HbA1c <5.4%, fasting insulin <5-7 μIU/mL
Citations
- https://pubmed.ncbi.nlm.nih.gov/23991239/
- https://pubmed.ncbi.nlm.nih.gov/31257302/
- https://pmc.ncbi.nlm.nih.gov/articles/PMC6394487/
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This is an independent synthesis of published research by a non-clinician. Scores are opinions supported by citations, not prescriptions. See the full disclaimer and methodology for how this score was produced and what it does and doesn't mean.