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It could be the medication

Vertical sleeve gastrectomy triggers fast -cell recovery upon overt diabetes

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Dual GLP-1/GIP Agonists Dual GLP-1/GIP agonists, such as tirzepatide, represent a significant advancement in incretin-based therapies, offering enhanced efficacy over GLP-1 mono-agonists due to synergistic effects on glucose metabolism, weight loss, and cardiovascular risk factors [14,52]

Of note, receptor activator of NF-B ligand (RANKL) is an essential cytokine that binds to the RANK receptor and is required for the formation, maturation and differentiation of osteoclasts [69]

If appropriate, youll begin with a low-dose GLP-1 plan under supervision