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Users on Reddit report a variety of experiences regarding insulin resistance (IR) changes and increased insulin sensitivity while on GLP-1 medications. Many have seen significant improvements in their metabolic health, including better blood sugar control and reduced need for other diabetes medications. However, concerns about the return of insulin resistance after stopping the medication are also prevalent.

Experiences with Insulin Resistance Changes / Increased Insulin Sensitivity:

Improved Glycemic Control and Reduced Medication Needs: Many users report significant improvements in their A1C levels and overall blood sugar management. One user with Type 2 diabetes stated, "My A1C went from 6. 3 to 5. 4 in 6 months or less, all of my metabolic panels are clean, my LDL/HDL are dead center of where they should be and I feel awesome. "[2] Another user on Mounjaro shared, "A1C down to 5. 5. Doc has cut some of my other prescriptions in half. "[7] A Type 1 diabetic on Ozempic noted, "my insulin requirements are down (at least 50%) my A1c is down from over 8 to 6. 0, my kidneys have stabilised, and so on. "[30] Similarly, a user on Ozempic for a year mentioned, "No longer on insulin. A1C was 6. 2 on my most recent test. "[14]

Direct Impact on Insulin Resistance: GLP-1 medications are recognized for their role in addressing insulin resistance. One user explained, "GLP-1s have stabilized my blood sugar very quickly and, after only a couple of months, had me off insulin completely... I woke up this morning with BG of 98. "[20] Another user with PCOS and lupus on Mounjaro found it helped with more than just weight loss before insurance issues arose. [24] A user with Type 1 diabetes on tirzepatide (Mounjaro) experienced a dramatic reduction in insulin needs: "On my second day, I had to reduce my basal insulin by 30% and my rapid by 70%. "[22] This was echoed by another T1D user who went from "300U + of insulin per day down to 60-80U per day. "[26]

Weight Loss Leading to Improved Sensitivity: For some, weight loss achieved on GLP-1s is a key factor in improving insulin sensitivity. A user mentioned, "For some people, losing weight increases insulin sensitivity... So it’s possible that losing weight will actually help you to maintain a lower weight. "[4] Another user on Zepbound who was becoming insulin resistant stated, "Eliminated cravings, let me see what normal portion sizes look like again... and retrained my eating habits and preferences to focus mostly on protein and whole foods. "[16]

Discovery of Insulin Resistance: Some users only realized they likely had insulin resistance after experiencing success with GLP-1s when other weight loss methods failed. One user on Zepbound suspected IR because, "I ate in a deficit and no changes. Fast forward to 5mg of Zepbound and I’m eating in the same deficit and finally seeing loss. "[32] Another shared, "I couldn’t lose weight before — not without starving myself — and now I can. I also had extreme blood sugar changes before which likely meant … something? "[33]

Concerns About IR Returning After Discontinuation: A primary concern is whether insulin resistance will return once the medication is stopped. The original poster of one thread asked, "once I lose the weight and stop taking the medication - my insulin resistance will return IMMEDIATELY. "[1] One user who stopped compounded Semaglutide regained weight and found it "much harder to stick to my caloric requirements as I'm constantly thinking about what I can eat for the day and almost never feel full. "[15] Another user whose insurance stopped covering their GLP-1 noted, "My insulin numbers have zoomed up- but I have not gained back the weight, so that’s good. "[6]

Lifelong Medication Perspective: Many users and some doctors view GLP-1s as a long-term or lifelong treatment for chronic conditions like insulin resistance. One user stated, "The truth is that we don't really know yet but the existing studies indicate it's a lifetime medication. "[2] Another commented, "Because they’re a lifelong medication. Everyone I know who has achieved any sustainable weight loss goes on a maintenance dose. "[5]

Remedies and Preventions Recommended for Maintaining Insulin Sensitivity:

Lifestyle Changes (Diet and Exercise):

Diet is frequently emphasized. One user suggested, "If you stay low carb, no sweets no processed foods it shouldn't [return]. "[3] Another whose doctor recommended Zepbound for IR said, "I have always been active and ate well... With a history of diabetes of both sides of my family, my doctor ran tests and we found out I was insulin resistant. "[34]

Focusing on protein and exercise is also key. A user seeing a nutritionist learned "the importance of protein and exercise and I truly hope that it will help me keep the weight off when I stop the GLP1!!! "[8] The nutritionist advised focusing on "muscle building and less intensive forms of exercise. So walking and weight resistance. If you lose too much weight too fast you can also start losing muscle. Thats why it’s super important to eat protein. "[9]

One user highlighted the importance of learning new habits: "Use it, learn proper eating habits and work yourself off of it. "[18]

Continued Medication/Maintenance Dosing: Many believe ongoing medication is necessary. "I’m still on Zepbound at the moment but once I hit the weight I want, I’m going to start titrating down very slowly, probably over a couple of years... If I can’t maintain then back up I go. "[2] Another user mentioned their doctor's plan: "My doctor said once I hit my goal weight I’ll drop to a maintenance dose, if I continue to lose weight she’ll take me off altogether. "[19]

Combining with Other Medications: Some users take GLP-1s in conjunction with metformin. "I am on the lowest dose of mounjaro for my insulin resistance. I also take 500 mg of metformin which I was on before but wasn’t doing enough. "[8] Another user successfully combined Metformin and Wegovy: "About two months into taking metformin, I started on compounded glp1. Now, I’m taking wegovey, and it’s changed my life. I finally process food like a person without pcos. "[21]

Addressing Root Causes: Some users emphasize that GLP-1s help manage symptoms but underlying issues need addressing. "The medicine is helping address root cause and metabolic issues for many of us. "[31]

Slow Tapering: When considering stopping, a slow taper is often advised. "I did low dose daily Victoza... haven’t gained weight after stoping though i did taper off it by every other day use. "[10]

It's important to note that individual experiences vary, and what works for one person may not work for another. Consulting with healthcare professionals is crucial for managing insulin resistance and GLP-1 medication.