12 weeks in: A1c down but fasting glucose stuck

Mine did that too. A1c fell first, fasting lagged like 6 weeks. Are you waking at 4am or just CGM says so? Sleep apnea messes mine up.

Not the same for me. My afsting dropped before post-meals, opposite of the lag you saw. Could be dinner timing. What time do you eat?

Dawn rise here too. 4am spike every night.

The 4am rise plus high fasting insulin makes me think dawn phenomenon and maybe early morning cortisol, not necessarily the GLP-1 failing. My CGM looked like that until I shifted dinner earlier and started walking after it. But careful—I'm not saying that fixes you. What does your overnight graph look like between 1-3am? If it's flat then climbs, that's classic dawn. If it's rising all night, maybe dinner/snack or overnight stuff. Also alcohol? That used to wreck my 3am. When I finally posted mine, someone pointed out the difference between the 1am flat line and the 4am climb. That question changed how I looked at it. Not medical advice, just pattern spotting.

My ALT was in that range too. Fasting insulin 18 is the number I'd ask your endo about. Mine was similar and they checked c-peptide.

C-peptide check is a good call. I had mine done and it explained why my fasting number was stubborn.

I'd separate A1c and fasting. A1c is an average, and mine dropped mostly from post-meal changes. My 12-week labs were A1c 7.0, fasting 128, and afternoons looked great. What changed for me was tracking sick days and poor sleep—both added 10-15 points. The dawn pattern on CGM was real. If you post a 24h screenshot, people here can eyeball the shape. Also, how's your weight trend the last 3 weeks?

Fasting was the last number to move for me, like embarrassingly last — A1c went 7.6 to 6.1 over about five months and my mornings sat in the 120s-130s that whole time while my mid-afternoon was already 100. The thing that actually budged it wasn't dinner composition, it was pulling my last real meal to around 5:30 and doing a 15-20 minute walk after, and then a total accident: I cut out my weeknight glass of wine for a month and my 4am CGM climb went from about 25 points to 8. My sleep tracker also showed I was waking 6-8 times a night and I had zero clue. What flipped the script for me was that fasting was the slowest to respond, not the fastest — it lagged my A1c by roughly three months, which nobody warned me about. Curious what your overnight curve looks like on a 7-hour night vs a 5-hour one, because that side-by-side was the single most useful thing I did at that stage.

Week 14 here and my fasting finally cracked 118 after sitting at 135ish for two solid months while my afternoons lived in the 90s — so I'll push back a little on "just wait it out," because the thing that actually moved mine was boring tracking stuff, not time. I stopped looking at the daily fasting number entirely and started logging the 7-day average plus my waist at the navel every Sunday, and the average was drifting down a full 3 weeks before the morning number ever budged, which made it way less maddening. The surprise was that my 4am rise tracked almost perfectly with nights I slept under 6 hours or woke up 3-4 times, and on good-sleep weeks that rise started closer to 6am and topped out 15-20 points lower. The other thing I noticed from my own log: Friday and Saturday nights, when I ate dinner an hour or two later than usual, my Sunday and Monday fasting numbers were consistently the worst of the week even with identical food. So yeah, I'd look at sleep before I'd touch anything else — what does your CGM say your overnight low is, like the actual 2-3am trough? That number told me more than the 4am rise did.

Same pattern here. A1c moved first; fasting was the stubborn laggard.

road warrior here. The one thing that shifted my stuck morning number wasn’t dinner—it was sleep and time zones. Red-eyes, hotel room temp, and 10pm airport-food dinners made my 4am CGM climb way bigger. At home, same-ish dinner at 6:30 and blackout curtains, it’s much flatter. Does your 4am rise change when you’re traveling vs home? Also, are you catching a 3am dip-then-rebound, or a steady climb? Mine looked totally different.

Three-year regular. We hashed this in the old circadian-rhythm thread: my 4am rise tracked almost 1:1 with sleep quality and room temp. Bad nights—hot room, a couple drinks, or a hard evening workout—gave me 135-145 fastings; good sleep kept it 115-125, same meals. Afternoon stayed 95-105 the whole time. If you're already CGM'ing, tag sleep and room temp for a week. Are you seeing actual wakeups at 4, or just the curve climbing?

Trend-line nerd here. The thing I’d add: log sleep midpoint and number of wakeups right next to the CGM. My stuck 130s morning number tracked way more with fragmented sleep and an early wake-up than with anything food-related. On nights I slept straight through, the 4am rise started later and peaked lower; on rough nights it spiked hard. What does your 4am curve look like on a sleep-in day vs a workday? That comparison was the most useful one for me.