What can I do to decrease fasting blood sugar, or to overcome “Dawn Phenomenon?”

Dawn Phenomenon is when your morning fasting blood glucose is spiky high despite having not eaten all night while sleeping.


Time on Mounjaro can help this out, plus titrating up as needed for overall optimum results. The fasting blood sugar number is the last to resolve, so perhaps take a load off by putting that priority on the back burner.


I started with an A1C of 11.7 before MJ. I was fasting in the mid-240s before MJ. Then I started MJ and was in the 125 range. Then I got 100, 97 on the 7.5 & 10mg but only in the days just after my shot, and it crept back up toward the next shot day. I took the 12.5mg yesterday and I’m at 97 at 6am.


What goes on is the cortisol rush trying to wake you up in the morning hollers at your liver to dump glucose into your bloodstream. MJ well slowly work across time to tell your liver to calm that down. 


But you can also do other things to mitigate how much cortisol and adrenaline you routinely have coursing through your system. This is why I’m trying to focus on relaxing and mental wellness. It’s truly impactful. If you have a CGM, you can see for paid if you have a highly tense interaction, or a panicky episode: the things that make your heart pound with anxiety might show up on your CGM as a giant, steep spike in blood sugar. 


While we can’t control how we emotionally respond to panicky events all the time, we can practice learned coping mechanisms, whatever those may be, that work best for us. So I’m making that an endeavor: to develop coping mechanisms that protect my body from staying in these states by trying things out & practicing them. Breathing exercises, mediating, whatever. Please come back and let us know if you find things that work.

Plus, getting deep quality sleep helps. I’ve noticed even if I take a Tylenol PM or a Benadryl before bed, which knocks me out, my sleep is great & longer and my overnight HRV (heart rate variability) is greater on my sleep apps too.


Finally, exercise. Vigorous exercise spikes cortisol & blood sugar in the moments when it is happening. But the after effects are positive for the next 24 hours, and there may be a sweet spot at the “just going for a walk” level that’s easier to accomplish than vigorous exercise, pushes glucose into the muscle cells, improves cardiovascular wellness and doesn’t spike the cortisol. Some exercise daily or weekly helps us to sleep better and is a general stress reducer.


I’m finding there’s not “one weird trick” for resolving this problem, but rather coming at it in a multi-directional manner, given experimentation, consistency & time. Good news is, most of these practices help multiple things at once.


Finally, don’t look to your fasting blood sugar right away as evidence you’re progressing on Mounjaro. It is the last marker to change. Try to focus on things that are within your locus of control first, on a daily basis, and have patience. 


“In the early hours of the morning, hormones, including cortisol and growth hormone, signal the liver to boost the production of glucose, which provides energy that helps you wake up. This triggers beta cells in the pancreas to release insulin in order to keep blood glucose levels in check. But if you have diabetes, you may not make enough insulin or may be too insulin resistant to counter the increase in blood sugar. As a result, your levels may be elevated when you wake up.”