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Additionally, new or worsening constipation accompanied by unexplained weight loss (beyond expected therapeutic weight reduction), persistent changes in stool caliber, or alternating constipation and diarrhea warrants evaluation to exclude structural or neoplastic causes, particularly in patients age 45 or older or those with family history of colorectal cancer

The European Medicines Agency (EMA) conducted a thorough review in 20232024 and found no causal link between GLP1 receptor agonists and suicidality

On the basis of these findings, the overall efficacy and safety of tirzepatide has been investigated in the SURPASS clinical trial programme in comparison with placebo and other glucose-lowering medications including GLP-1 RAs and basal insulin [11]

It is important to monitor patients for any digestive symptoms and provide appropriate guidance and support

In the PIONEER 1 trial, oral semaglutide 14 mg reduced HbA1c by approximately 1.2-1.4% from baseline, with significant proportions of patients achieving HbA1c targets below 7%

Doctors usually start with a standard protocol and then adjust based on individual response, tolerance, and clinical progress over time