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The hypothesis driving its design was straightforward but unverified at the time: that engaging GIP and GLP-1 receptors simultaneously, pathways which are normally co-secreted from the gut following a meal, would produce additive or synergistic effects on insulin secretion, gastric motility, and downstream metabolic markers beyond what either pathway could deliver alone

3 Introduction/background: a novel dual incretin analog Despite historical research stating GIP did not assist in lowering blood glucose even with supratherapeutic levels, the success of GLP-1 RAs has led to the approval of a novel GLP-1/GIP RA, tirzepatide [42]

doi: 10.1146/annurev-physiol-021113-170315 11 Bjerre KnudsenLMadsenLWAndersenSAlmholtKde BoerASDruckerDJet al

It is better understood as a lower-intensity strategy that may support appetite control, cravings, and consistency while preserving the option to adjust later if clinically appropriate

Pick a day and time that works 90% of the time and adjust occasionally for the other 10%

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