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Patients taking both agents should monitor for signs of hypoglycemia (shakiness, sweating, confusion), particularly if they are also on insulin or sulfonylureas, because GLP-1 medications lower blood glucose and NAD-boosting compounds may theoretically potentiate this effect in susceptible individuals

For patients using insulin or sulfonylureas, proactive dose reduction of these medications should be considered before tirzepatide escalation to mitigate hypoglycemia risk, with increased glucose monitoring during the transition

You have hit a dose that suits your goal and you are simply maintaining

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Each study participant received identical meals of 2 MJ in energy content

Vascular Recruitment and Gastrointestinal Tract Healing Current Pharmaceutical Design, 2018;24(18):1990-2001