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Hypoglycemia can occur, particularly when tirzepatide is used in combination with insulin or sulfonylureas, though it is uncommon when used as monotherapy due to the glucose-dependent mechanism of insulin secretion

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While research specifically isolating tirzepatide's NAION risk is still limited, a study in JAMA Network Open found that patients taking tirzepatide, semaglutide, or both were nearly twice as likely to develop NAION compared to those on other diabetes medications