I’m 18 weeks in. A1c went from 7.1 to 6.2, weight down 28 lb, but my fasting glucose has sat between 105 and 115 for the last six weeks. CGM overnight line is flat-ish, then a rise around 4-5 a.m.
My clinician says labs matter more than daily numbers, but I’m curious. Did any of you see A1c improve while fasting stayed stuck? What did you track—fasting, post-meal, CGM average? Not looking to change anything without my doctor, just trying to understand the pattern.
I had the same split around week 16. A1c fell, fasting hung out right where yours is. My CGM showed the 4 a.m. rise too. It finally drifted down after a few more weeks.
Dawn phenomenon or less suppressible hepatic glucose? The flat overnight then 4-5 a.m. rise sounds like the latter to me.
Mine was the opposite. Fasting first, A1c lagged.
What’s your post-meal look like? My fasting was noisy until I stopped late snacks. A1c was still the cleaner signal.
I track fasting, 2h post-meal, and monthly A1c. CGM average helped me see trends, but the fingerstick fasting number bounced 15 points day to day.
That bounce is why I stopped weighing every single fasting reading. The CGM overnight curve is more useful for the 4 a.m. question.
I’m at week 72 of a long run, and my A1c went from 7.4 to 5.8 while fasting went from 130s to low 100s, then plateaued for months. What moved it for me was consistency in meal timing and sleep, not any one lab.
I also learned to compare CGM average glucose to lab A1c, because anemia and some other things can skew A1c. If your CGM average and A1c disagree, that’s worth asking your clinician about.
Not saying it’s your case, just a puzzle piece that helped me stop obsessing over one fasting number.
Anemia skewing A1c? That’s a good point. My ferritin was low and my A1c looked better than my CGM average suggested.
Did your ferritin change after starting? Mine dropped, but I also changed diet a lot.
CGM lag acn make that 4 a.m. rise look worse.
Mine did the opposite: fasting improved fast, A1c took almost 6 months. The 72-week data makes me think slow responders exist.
The part people forget about slow responders: week 12 can look like nothing happened at all. Then somewhere around week 24 it actually shifts. Fasting is the last thing to move, basically always the last marker to budge.
Mine did the same—A1c dropped but morning number stayed ugly for weeks. I tracked seep and stress instead.
Week 20 here: A1c 6.0, fasting 108–118, weight down 31 lb. My fasting stayed higher on Saturday and Sunday mornings, and I finally connected it to Friday takeout plus two drinks.
I stopped logging every single morning and just did Mon/Wed/Fri plus waist, and the weekly average told a cleaner story than the daily number.
My fasting finally budged after I stopped eating after 7 and walked 15 min after dinner—down 8 points, not dramatic.
Honestly, I’d trust A1c and waist over one stubborn fasting number; mine lagged 10 weeks then dropped.
Week 16, down 22 lb, resting HR down 8. I quit checking fasting every morning because it made me obsessive; now I log it three times a week and watch the 7-day average. My fasting still hangs around 108-114, but my CGM average dropped about 18 points. The daily number is the noisiest one for me.
My jeans got loose before my fasting number moved at all. Bodies are weird.
Water is my cheat code: if I'm dehydrated, my morning number looks 5-7 points worse.
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