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The inhibitory effect of GLP-1 on glucagon secretion in vivo was observed only when the blood glucose level was equal to or higher than the fasting level, at higher blood glucose levels, the inhibition of glucagon gradually increased (Holst, 2007), and when the blood glucose concentration was less than 3.7 m mol/L, GLP-1 lost its effect on inhibiting glucagon secretion (Nauck et al., 2002)

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First, gastrointestinal distress: tirzepatide's most common side effects are nausea (up to 31% of patients in SURPASS trials), vomiting, diarrhea, and decreased appetite