Patients should check their blood glucose during symptomatic episodes, especially if taking insulin or sulfonylureas alongside tirzepatide, as hypoglycemia can cause similar symptoms
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This effect is associated with increased insulin signal transduction via phosphatidylinositol-3-OH kinase in the liver (but not in the skeletal muscle) and with reduced hepatic expression of the gluconeogenic genes, glucose-6-phosphatase and phosphoenolpyruvate kinase (German et al., Leptin, insulin, and nutrient-related signals in the CNS improve hepatic insulin sensitivity however, the mechanism by which CNS leptin signaling normalizes diabetic hyperglycemia and whether this process involves leptin-dependent effects on hepatic glucose production or tissue glucose uptake are unknown (German et al., 2011)
Results published in the New England Journal of Medicine in May 2025 confirmed what many expected: Tirzepatide significantly outperformed Semaglutide on every measured endpoint
May is not prone to hypoglycemia as some insulin therapies are
McCallum, R
