A mechanism of action phase 1 study showed that the glycemic efficacy of tirzepatide in T2DM results from concurrent improvements in key components of diabetes pathophysiology, including -cell function, insulin sensitivity, and glucagon secretion (135)
Patients may need a more careful discussion if they have a history of: Previous NAION in one eye Significant optic nerve crowding Diabetes with vascular complications Sleep apnea, especially untreated sleep apnea High blood pressure or low nighttime blood pressure Cardiovascular disease Sudden unexplained vision loss in the past This does not automatically mean a GLP-1 medication is unsafe, but it does mean the patient should have a personalized risk-benefit discussion with their medical provider
Read How to eat while taking GLP-1 medications by Damien Zielinski for practical guidance on protein targets, slow carbs, and how to make food choices that reduce common side effects when appetite is lower
Monitoring blood sugar is advised for diabetic patients
Other brands (single-use, once-weekly pens) may be kept at room temperature (4686F / 830C) for up to 28 days after removal from the refrigerator
Change is on the horizon, though
