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Tirzepatide peptide therapy | Uses, dosage, and safety

Sponsored: Tirzepatide is a novel dual-incretin agonist that was recently approved as a medication for type 2 diabetes (T2D).

Tirzepatide is a novel dual-incretin agonist that was recently approved as a medication for type 2 diabetes (T2D).

Currently, the peptide shows superior glucose-lowering potency compared to other incretin mimetics, and it is under active investigation as a potential weight loss and cardioprotective agent.

For researchers looking to incorporate tirzepatide, this guide will provide the latest information on tirzepatide’s mechanism of action, uses, and side effects.

We also include details on how to dose and administer tirzepatide in research settings, as well as where to source 99% purity tirzepatide online.

P.S: Click here to get Tirzepatide ASAP!

What is Tirzepatide?

Tirzepatide (LY3298176) is a first-in-class medication developed by Eli Lilly and patented in 2016 as a potential treatment of T2D [1].

It is composed of 39 amino acids and simultaneously mimics two key incretin hormones: glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) [2].

The peptide’s structure is based on a modified part of the GIP sequence at the N-terminus, while the C-terminus of the peptide is an amidated sequence borrowed from the GLP-1 agonist exenatide.

Additionally, tirzepatide is conjugated with a C20 fatty di-acid moiety, which allows the peptide to bind to serum albumin, endowing it with a half-life of around five days. This makes the peptide suitable for dosing as a once-weekly subcutaneous injection [3].

Following its success in several phase-3 trials, tirzepatide was approved by the United States Food and Drug Administration (FDA) in May 2022 as a weekly subcutaneous injection for the treatment of T2D under the brand name Mounjaro. It became the first dual GLP-1 and GIP receptor agonist indicated for the condition [4].

Apart from its approved use for T2D, tirzepatide is currently in clinical trials to evaluate its safety and efficacy as a weight loss treatment in adults with a body mass index (BMI) of 27 or greater [5].

In addition to being an approved prescription medication under brand name Mounjaro, tirzepatide is also available as a reference material for qualified researchers and laboratory professionals.

(peptides.org, sponsored) Tirzepatide peptide therapy: uses, dosage, and safety.

What Does Tirzepatide Do?

Tirzepatide works by activating the GLP-1 and GIP receptors in various organs, notably the pancreas [6, 7].

By activating GLP-1 and GIP receptors in the pancreas, tirzepatide produces a synergistic effect. It works to increase insulin secretion, decrease glucagon release, and lower blood sugar levels more effectively compared to administering GIP or GLP-1 alone [8, 9].

The peptide appears to have similar affinity at the GIP receptor as native GIP. On the other hand, tirzepatide has about 5 times lower affinity for the GLP-1 receptor than native GLP-1. Notably, studies have shown that tirzepatide exhibits a preference for cAMP signaling over beta-arrestin recruitment at the GLP-1 receptor [10].

By primarily activating the cAMP pathway, tirzepatide leads to robust insulin secretion and glucose control while minimizing the beta-arrestin pathway’s effects, such as receptor desensitization [10].

This suggests that tirzepatide may have advantages over GLP-1 agonists in T2D management and glycemic control.

Additionally, tirzepatide slows gastric emptying after a meal, reducing postprandial glucose spikes. These effects may also improve glycemic control in patients with T2D [11].

The peptide also activates the GLP-1 and GIP receptors in the brain and in white adipose tissue, which helps to reduce appetite, improve insulin sensitivity, and induce weight loss.

For example, activation of GIP receptors in the central nervous system, particularly the hypothalamus, is known to result in decreased food intake [12].

The peptide appears to also upregulate adiponectin synthesis in adipose tissue, which helps to further reduce insulin resistance [13].

By activating the GLP-1 receptors in the brain and the gut, tirzepatide may also increase the expression of appetite-suppressing peptides, such as peptide YY (PYY), while downregulating the appetite-stimulating neuropeptide Y (NPY) and agouti-related peptide (AgRP) [14, 15, 16].

All of these tirzepatide-related mechanisms lead to improved glycemic control, lower insulin resistance, reduced hunger levels, decreased food intake, and weight loss.

Tirzepatide Benefits | Clinical Trials

As mentioned, tirzepatide is already FDA-approved as a T2D therapy due to its potent effects on insulin secretion and glycemic control.

The peptide is also actively researched as a weight loss medication and anti-obesity treatment. Below, researchers will discover the latest research regarding these notable tirzepatide uses.

Tirzepatide for Weight Loss

Based on research into its anti-diabetic effect, tirzepatide has shown significant weight loss benefits in T2D patients.

A 2022 meta-analysis summarized all available randomized control trials on T2D patients that also showcase tirzepatide’s weight loss effects. The authors pooled data from nine trials that lasted 2-12 months and included over 7000 participants [17].

The researchers found that tirzepatide demonstrated significant weight loss effects at all tested doses (5mg, 10mg, 15mg/weekly) compared to placebo.

Specifically, the 5mg dose led to an average weight reduction of 11.66lb (5.29kg), the 10mg dose resulted in a mean reduction of 16.15lb (7.33kg), and the highest dose of 15mg yielded the most substantial weight loss, with an average reduction of 18.43lb (8.36 kg).

Tirzepatide also led to greater weight loss compared to established T2D treatments including GLP-1 agonists and insulin [17].

In another meta-analysis conducted in 2023, researchers included data from trials involving nondiabetics who were struggling with chronic weight management.

By pooling data from almost 10,000 participants, the scientists found that both the 10mg and 15mg/weekly doses lead to significant weight loss. Specifically, the weight loss observed was -23lb (10.5kg) at the 10mg dose and -24lb (10.9kg) at the 15mg dose [18].

Tirzepatide for Fat Loss

Research suggests that the weight loss caused by tirzepatide is primarily due to fat loss. The peptide is believed to reduce both visceral and subcutaneous fat while preserving lean body mass [19].

Yabe et al. (2023) conducted a substudy of the SURPASS J-mono trial, which aimed to assess the efficacy and safety of tirzepatide monotherapy compared to the FDA-approved GLP-1 agonist dulaglutide in Japanese patients with T2D.

The substudy involved 48 participants out of the 636 in the original study. The authors investigated the effects of tirzepatide 10mg/weekly and 15mg/weekly on body weight, lean body mass, and body fat mass.

The findings revealed significant reductions in all of the aforementioned parameters, especially body fat mass. There was also a slight decline in total lean body mass, which was attributed to decreased body water.

When evaluating body composition percentages, both the 10mg/weekly and 15mg/weekly groups exhibited a decrease in body fat by approximately 5%. Additionally, bioelectric impedance analysis indicated increases in body water (3.7%), protein (2%), and minerals (0.4%) [19].

Tirzepatide for Obesity

Tirzepatide is currently investigated for its potential to treat obesity in the SURMOUNT development program sponsored by Eli Lilly [5].

This program consists of four global phase 3 trials in which volunteers with a BMI of 27kg/m² or higher are randomly assigned to receive either tirzepatide or placebo in a double-blinded manner.

The program’s primary aim is to evaluate the percentage change in body weight during each treatment period. The results of SURMOUNT-1 have already been published in the New England Journal of Medicine and include data from 2539 overweight or obese subjects without T2D.

The authors report that tirzepatide at weekly doses of 5mg, 10mg, and 15mg are all effective at achieving weight loss. The 5mg group participants lost an average of 15% of body weight, while the 10mg and 15mg group participants each lost about 20% (19.5% and 20.9%, respectively).

Notably, the 10mg/weekly group demonstrated similar weight loss to the higher dose, and even a higher discontinuation rate due to side effects compared to the 15mg/weekly group [20].

Eli Lilly has also shared information on the primary endpoints of SURMOUNT-2, although the official results have not been published as of mid-2023. This trial investigated the effect of tirzepatide on weight loss in 938 individuals with chronic weight issues and T2D.

The results indicated that 10mg tirzepatide led to an average weight loss of 13.4% (29.8lb), while 15mg led to a 15.7% loss (34.4lb), and the placebo resulted in a 3.3% (7.0lb) weight reduction.

Additionally, a significantly higher percentage of participants taking tirzepatide (81.6% for 10mg and 86.4% for 15mg) achieved at least a 5% body weight reduction compared to those on placebo (30.5%) [21].

Tirzepatide for Diabetes

Tirzepatide received FDA approval as an adjunct T2D intervention after successfully completing five of the phase-3 trials in the SURPASS global clinical development program [22].

These trials compared the efficacy of 5mg, 10mg, and 15mg/weekly of tirzepatide to a placebo, a GLP-1 receptor agonist (1mg semaglutide), and two forms of basal (long-acting) insulin.

All three doses of tirzepatide (5mg, 10mg, and 15mg/weekly) had a superior effect on glycemic control and glycated hemoglobin (HbA1c) levels when compared to either placebo or semaglutide.

Further, the mean HbA1c reduction at different tirzepatide doses was greater by -0.29% to -0.92% when compared to semaglutide, and by -0.70% to -1.09% when compared to basal insulin regimens [23, 24, 25, 26, 27].

The largest trial, encompassing over 3000 participants and spanning 12 months, reported mean HbA1c changes from baseline of -2.43% at the 10mg dose of tirzepatide and -2.58% at the 15mg dose, whereas insulin glargine showed a change of -1.44% [25].

For more information, check out our review of tirzepatide vs. liraglutide.

(peptides.org, sponsored) Tirzepatide peptide therapy: uses, dosage, and safety.

Tirzepatide Side Effects

As of writing, tirzepatide has demonstrated a positive safety record in all phase 3 clinical trials.

Nevertheless, researchers should be aware that its use is associated with certain side effects, namely gastrointestinal (GI) complaints.

In a meta-analysis of ten trials involving 6836 participants, the authors found the incidence of GI reaction to increase in a dose-dependent manner. Overall, the rates of gastrointestinal adverse events were 39%, 46%, and 49% for the 5mg, 10mg, and 15mg doses, respectively [28].

The most frequently reported GI side effects were nausea and diarrhea, which affected anywhere between 10-25% of the participants, depending on tirzepatide dose.

Other frequently reported side effects include:

  • indigestion

  • headache

  • constipation

  • abdominal pain

  • dyspepsia

  • vomiting

  • Injection site reactions.

Serious side effects such as cholelithiasis, cholecystitis, and pancreatitis occurred in less than 1% of subjects, and the incidence tended to decrease with higher doses. Hypersensitivity reactions were also infrequent and affected 2-4% of participants.

The discontinuation rate due to adverse events was 10% at the highest dose of 15mg/weekly [28].

Is Tirzepatide Safe?

To ensure safety in experimentation, handlers should remain mindful of the available safety data on tirzepatide.

Based on the results of the SURPASS program trials, tirzepatide is deemed safe for use in adults with T2D [22].

Researchers are investigating its safety in other conditions, such as obesity. Preliminary results of tirzepatide for weight loss trials continue to demonstrate its favorable safety profile [5, 20].

There are safety concerns in certain populations which has led to contraindications against tirzepatide therapy. For example, the peptide should not be taken by pregnant and breastfeeding women as its safety in these groups is not fully known.

Further, T2D patients who take tirzepatide in combination with other glucose-lowering medications should be monitored for hypoglycemia.

Researchers should also note that the peptide is contraindicated in subjects with a medical history of thyroid cancer or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). These concerns stem from the fact that tirzepatide was shown to cause thyroid C-cell tumors in animal studies. It has not been established whether this effect may also occur in humans [4].

Tirzepatide Dosage Calculator and Protocol

Researchers looking to set up a tirzepatide study and unsure of which dosing protocol to follow, this section is required.

The available research on tirzepatide therapy for T2D and obesity can be used as a reference for dosing in future trials.

The data suggests that tirzepatide should be initiated at doses of 2.5mg/weekly. This dosage should be applied for four consecutive weeks and then increased by 2.5mg/weekly every four weeks until achieving a full dose of 10mg-15mg. The once-weekly dosage should not exceed 15mg.

As stated above, trials report similar weight loss at 10mg/weekly and 15mg/weekly tirzepatide protocols. Therefore, we recommend titrating the dose up to 10mg per test subject and then increasing only after a careful evaluation of individual response [5, 18, 26].

Here is a sample tirzepatide dosage for weight loss protocol based on the latest evidence:

  • Tirzepatide Dose: 2.5mg/weekly for the first four weeks of the study period, followed by an increase to 5mg/weekly in weeks 5-8, 7.5mg/weekly in weeks 9-12, and 10mg/weekly in weeks 13-16. Depending on the subject’s tolerance and results, consider increasing to 12.5mg/weekly in weeks 17-20 and 15mg in weeks 21 and beyond.

  • Frequency: Once weekly at the same time every week.

  • Study Duration: 24-72 weeks.

  • Notes: Do not exceed the maximum dose of 15mg/weekly, per the Mounjaro dosing guidelines and clinical trial data.

(peptides.org, sponsored) Tirzepatide peptide therapy: uses, dosage, and safety.

Where to Buy Tirzepatide Online?

For researchers looking for high-quality tirzepatide as a reference material, it’s important to assess different vendors before making a final decision on where to buy.

Factors like cost-efficiency, shipping options, payment methods, and customer reviews should all be part of the analysis.

At Peptides.org, we highly recommend this vendor as our go-to source for tirzepatide:

Limitless Life

Limitless Life is an innovative and customer-oriented peptide vendor. Click the link above to sign up for the Limitless Life VIP club for special access to tirzepatide and more.

Researchers will also find these benefits with this vendor:

  • Reasonable Prices: Limitless Life’s growing catalog lists high-quality tirzepatide at reasonable prices. It offers an array of other peptides that are suitable for weight loss research.

  • Secure shopping: The peptide vendor uses SSL technology for secure and confidential online transactions. Personal information and payment details are always protected.

  • Convenient payment options: Researchers can pay with select cryptocurrencies, cash on delivery (COD), and a range of other secure payment methods, including Revolut, Cash App, and Zelle.

How to Reconstitute Tirzepatide

Tirzepatide for research purposes is supplied as a lyophilized powder that needs to be reconstituted with an appropriate solvent like sterile water or bacteriostatic water.

The solvent should be chosen carefully as this will determine the peptide’s shelf-life once reconstituted. Overall, bacteriostatic water is the better option, as sterile water does not suppress microbial proliferation, making the peptide unsuitable for use within 24 hours.

Bacteriostatic water contains 0.9% benzyl alcohol, which has no toxicity at this concentration and acts as a suppressant of microorganism growth.

This enables the reconstituted peptide to remain viable for up to four weeks post-reconstitution when stored properly at a temperature range of 2 to 8 degrees Celsius (36 to 46 degrees Fahrenheit).

To ensure safety during reconstitution, it’s important to also follow standard precautions such as:

  • cleaning the tops of both the peptide and sterile water vials with alcohol wipes prior to reconstitution

  • using sterile needles and syringes to draw the solvent and inject it into the powder

  • slowly injecting the reconstituting liquid down the side of the vial to prevent foaming

After reconstitution, researchers can allow the solution to dissolve naturally or use sonication. Avoid shaking or tapping the vial, and do not freeze, heat, or expose it to direct sunlight.

Tirzepatide Injections | A-Z Guide

Researchers should be aware of the standard methods for administering reconstituted peptides such as tirzepatide for research purposes.

Here is a short guide on how to administer tirzepatide:

  1. Always use sterile needles before injection. In order to minimize pain, it is possible to apply pain-numbing cream or ice to the skin of a subject before an injection.

  2. Disinfect the injection site and pinch the subject’s skin with the fingertips of the non-dominant hand. Take into account that the amount of subcutaneous fat varies between subjects.

  3. Use the dominant hand to quickly stick the whole insulin needle into the pinched fold of the subject’s skin.

  4. Stick the needle at a 45° angle with the bevel of the needle facing up to prevent skin tearing.

  5. Push the plunger of the syringe slowly to inject the peptide, and give it a few seconds before pulling the needle out. Afterward, instruct each subject to put only light pressure on the injection spot and that they should not massage it.

  6. Discard any used needles in the sharps container, and always use a new sterile needle and syringe for the next injection/subject.

As a reference, researchers should also consider the recommendations in the Mounjaro package insert. According to those, the peptide can be injected subcutaneously in the abdomen, thigh, or upper arm. It is also important to rotate the injection sites with each use [29].

FAQ

How to take tirzepatide

Tirzepatide for research must be reconstituted and then administered to test subjects via subcutaneous injection.

How is tirzepatide delivered?

Tirzepatide for research purposes typically comes in the form of lyophilized powder and must be reconstituted into a liquid using an appropriate solvent like bacteriostatic water.

Is tirzepatide a steroid?

Tirzepatide is not a steroid. It does not have any structural similarities to steroid hormones and does not activate the androgen receptor. Instead, it is made of amino acids and works by mimicking the action of the naturally-occurring hormones called glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP).

Does tirzepatide increase testosterone?

No, tirzepatide does not affect testosterone production in any way. However, weight loss associated with tirzepatide use may have hypothetical benefits for testosterone levels in overweight and obese men.

Does tirzepatide build muscle?

No, tirzepatide has not been reported to stimulate muscle-building or exert any anabolic effects on muscle protein synthesis.

Does tirzepatide cause weight gain?

No, tirzepatide has not been reported to cause weight gain. On the contrary, the peptide has been shown to cause weight loss amongst T2D patients, and it is currently under investigation as a potential therapy for chronic weight management.

Tirzepatide. Just. Works.

Tirzepatide is a first-in-class GLP-1/GIP receptor agonist that is FDA-approved for the treatment of T2D. It is under active study as a weight loss agent in overweight and obese individuals.

Studies in both diabetics and nondiabetics have shown that the peptide is beneficial for reducing body weight via its unique mechanism of action.

Tirzepatide can be legally purchased for research purposes by qualified professionals here.

The peptide has a favorable safety profile and is administered once weekly via subcutaneous injection.

References

  1. Chavda, V. P., Ajabiya, J., Teli, D., Bojarska, J., & Apostolopoulos, V. (2022). Tirzepatide, a New Era of Dual-Targeted Treatment for Diabetes and Obesity: A Mini-Review. Molecules (Basel, Switzerland), 27(13), 4315. https://doi.org/10.3390/molecules27134315

  2. Zhao, F., Zhou, Q., Cong, Z., Hang, K., Zou, X., Zhang, C., Chen, Y., Dai, A., Liang, A., Ming, Q., Wang, M., Chen, L. N., Xu, P., Chang, R., Feng, W., Xia, T., Zhang, Y., Wu, B., Yang, D., Zhao, L., … Wang, M. W. (2022). Structural insights into multiplexed pharmacological actions of tirzepatide and peptide 20 at the GIP, GLP-1 or glucagon receptors. Nature communications, 13(1), 1057. https://doi.org/10.1038/s41467-022-28683-0

  3. Sun, B., Willard, F. S., Feng, D., Alsina-Fernandez, J., Chen, Q., Vieth, M., Ho, J. D., Showalter, A. D., Stutsman, C., Ding, L., Suter, T. M., Dunbar, J. D., Carpenter, J. W., Mohammed, F. A., Aihara, E., Brown, R. A., Bueno, A. B., Emmerson, P. J., Moyers, J. S., Kobilka, T. S., … Sloop, K. W. (2022). Structural determinants of dual incretin receptor agonism by tirzepatide. Proceedings of the National Academy of Sciences of the United States of America, 119(13), e2116506119. https://doi.org/10.1073/pnas.2116506119

  4. Farzam K, Patel P. Tirzepatide. [Updated 2022 Dec 27]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK585056/

  5. le Roux, C. W., Zhang, S., Aronne, L. J., Kushner, R. F., Chao, A. M., Machineni, S., Dunn, J., Chigutsa, F. B., Ahmad, N. N., & Bunck, M. C. (2023). Tirzepatide for the treatment of obesity: Rationale and design of the SURMOUNT clinical development program. Obesity (Silver Spring, Md.), 31(1), 96–110. https://doi.org/10.1002/oby.23612

  6. Usdin, T. B., Mezey, E., Button, D. C., Brownstein, M. J., & Bonner, T. I. (1993). Gastric inhibitory polypeptide receptor, a member of the secretin-vasoactive intestinal peptide receptor family, is widely distributed in peripheral organs and the brain. Endocrinology, 133(6), 2861–2870. https://doi.org/10.1210/endo.133.6.8243312

  7. Abu-Hamdah, R., Rabiee, A., Meneilly, G. S., Shannon, R. P., Andersen, D. K., & Elahi, D. (2009). Clinical review: The extrapancreatic effects of glucagon-like peptide-1 and related peptides. The Journal of clinical endocrinology and metabolism, 94(6), 1843–1852. https://doi.org/10.1210/jc.2008-1296

  8. Coskun, T., Sloop, K. W., Loghin, C., Alsina-Fernandez, J., Urva, S., Bokvist, K. B., Cui, X., Briere, D. A., Cabrera, O., Roell, W. C., Kuchibhotla, U., Moyers, J. S., Benson, C. T., Gimeno, R. E., D’Alessio, D. A., & Haupt, A. (2018). LY3298176, a novel dual GIP and GLP-1 receptor agonist for the treatment of type 2 diabetes mellitus: From discovery to clinical proof of concept. Molecular metabolism, 18, 3–14. https://doi.org/10.1016/j.molmet.2018.09.009

  9. Min, T., & Bain, S. C. (2021). The Role of Tirzepatide, Dual GIP and GLP-1 Receptor Agonist, in the Management of Type 2 Diabetes: The SURPASS Clinical Trials. Diabetes therapy : research, treatment and education of diabetes and related disorders, 12(1), 143–157. https://doi.org/10.1007/s13300-020-00981-0

  10. Willard, F. S., Douros, J. D., Gabe, M. B., Showalter, A. D., Wainscott, D. B., Suter, T. M., Capozzi, M. E., van der Velden, W. J., Stutsman, C., Cardona, G. R., Urva, S., Emmerson, P. J., Holst, J. J., D’Alessio, D. A., Coghlan, M. P., Rosenkilde, M. M., Campbell, J. E., & Sloop, K. W. (2020). Tirzepatide is an imbalanced and biased dual GIP and GLP-1 receptor agonist. JCI insight, 5(17), e140532. https://doi.org/10.1172/jci.insight.140532

  11. Urva, S., Coskun, T., Loghin, C., Cui, X., Beebe, E., O’Farrell, L., Briere, D. A., Benson, C., Nauck, M. A., & Haupt, A. (2020). The novel dual glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 (GLP-1) receptor agonist tirzepatide transiently delays gastric emptying similarly to selective long-acting GLP-1 receptor agonists. Diabetes, obesity & metabolism, 22(10), 1886–1891. https://doi.org/10.1111/dom.14110

  12. Kim, S. J., Nian, C., Karunakaran, S., Clee, S. M., Isales, C. M., & McIntosh, C. H. (2012). GIP-overexpressing mice demonstrate reduced diet-induced obesity and steatosis, and improved glucose homeostasis. PloS one, 7(7), e40156. https://doi.org/10.1371/journal.pone.0040156

  13. Thomas, M. K., Nikooienejad, A., Bray, R., Cui, X., Wilson, J., Duffin, K., Milicevic, Z., Haupt, A., & Robins, D. A. (2021). Dual GIP and GLP-1 Receptor Agonist Tirzepatide Improves Beta-cell Function and Insulin Sensitivity in Type 2 Diabetes. The Journal of clinical endocrinology and metabolism, 106(2), 388–396. https://doi.org/10.1210/clinem/dgaa863

  14. Ard, J., Fitch, A., Fruh, S., & Herman, L. (2021). Weight Loss and Maintenance Related to the Mechanism of Action of Glucagon-Like Peptide 1 Receptor Agonists. Advances in therapy, 38(6), 2821–2839. https://doi.org/10.1007/s12325-021-01710-0

  15. Secher, A., Jelsing, J., Baquero, A. F., Hecksher-Sørensen, J., Cowley, M. A., Dalbøge, L. S., Hansen, G., Grove, K. L., Pyke, C., Raun, K., Schäffer, L., Tang-Christensen, M., Verma, S., Witgen, B. M., Vrang, N., & Bjerre Knudsen, L. (2014). The arcuate nucleus mediates GLP-1 receptor agonist liraglutide-dependent weight loss. The Journal of clinical investigation, 124(10), 4473–4488. https://doi.org/10.1172/JCI75276

  16. Iepsen, E. W., Lundgren, J., Dirksen, C., Jensen, J. E., Pedersen, O., Hansen, T., Madsbad, S., Holst, J. J., & Torekov, S. S. (2015). Treatment with a GLP-1 receptor agonist diminishes the decrease in free plasma leptin during maintenance of weight loss. International journal of obesity (2005), 39(5), 834–841. https://doi.org/10.1038/ijo.2014.177

  17. Permana, H., Yanto, T. A., & Hariyanto, T. I. (2022). Efficacy and safety of tirzepatide as novel treatment for type 2 diabetes: A systematic review and meta-analysis of randomized clinical trials. Diabetes & metabolic syndrome, 16(11), 102640. https://doi.org/10.1016/j.dsx.2022.102640

  18. Lin, F., Yu, B., Ling, B., Lv, G., Shang, H., Zhao, X., Jie, X., Chen, J., & Li, Y. (2023). Weight loss efficiency and safety of tirzepatide: A Systematic review. PloS one, 18(5), e0285197. https://doi.org/10.1371/journal.pone.0285197

  19. Yabe, D., Kawamori, D., Seino, Y., Oura, T., & Takeuchi, M. (2023). Change in pharmacodynamic variables following once-weekly tirzepatide treatment versus dulaglutide in Japanese patients with type 2 diabetes (SURPASS J-mono substudy). Diabetes, obesity & metabolism, 25(2), 398–406. https://doi.org/10.1111/dom.14882

  20. Jastreboff, A. M., Aronne, L. J., Ahmad, N. N., Wharton, S., Connery, L., Alves, B., Kiyosue, A., Zhang, S., Liu, B., Bunck, M. C., Stefanski, A., & SURMOUNT-1 Investigators (2022). Tirzepatide Once Weekly for the Treatment of Obesity. The New England journal of medicine, 387(3), 205–216. https://doi.org/10.1056/NEJMoa2206038

  21. Lilly’s tirzepatide achieved up to 15.7% weight loss in adults with obesity or overweight and type 2 diabetes in SURMOUNT-2 | Eli Lilly and Company. (n.d.). Retrieved May 24, 2023, from https://investor.lilly.com/news-releases/news-release-details/lillys-tirzepatide-achieved-157-weight-loss-adults-obesity-or

  22. FDA Approves Novel, Dual-Targeted Treatment for Type 2 Diabetes (2022, May 13). Retrieved May 24, 2023, from https://www.fda.gov/news-events/press-announcements/fda-approves-novel-dual-targeted-treatment-type-2-diabetes

  23. Frías, J. P., Davies, M. J., Rosenstock, J., Pérez Manghi, F. C., Fernández Landó, L., Bergman, B. K., Liu, B., Cui, X., Brown, K., & SURPASS-2 Investigators (2021). Tirzepatide versus Semaglutide Once Weekly in Patients with Type 2 Diabetes. The New England journal of medicine, 385(6), 503–515. https://doi.org/10.1056/NEJMoa2107519

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  25. Del Prato, S., Kahn, S. E., Pavo, I., Weerakkody, G. J., Yang, Z., Doupis, J., Aizenberg, D., Wynne, A. G., Riesmeyer, J. S., Heine, R. J., Wiese, R. J., & SURPASS-4 Investigators (2021). Tirzepatide versus insulin glargine in type 2 diabetes and increased cardiovascular risk (SURPASS-4): a randomised, open-label, parallel-group, multicentre, phase 3 trial. Lancet (London, England), 398(10313), 1811–1824. https://doi.org/10.1016/S0140-6736(21)02188-7

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