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The most recent comprehensive synthesis is a July 2025 systematic review in the HSS Journal , the musculoskeletal journal of the Hospital for Special Surgery in New York, led by Nikhil Vasireddi at Case Western Reserve University School of Medicine

Epidemiological studies have repeatedly linked elevated circulating IGF-1 to risk of certain cancers (LeRoith & Roberts 2003

StatPearls [Internet] StatPearls Publishing

Javadi S, Kazemi NM, Halabian R

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Additional E11 codes may be appropriate depending on the patient clinical picture: E11.21 - Type 2 diabetes mellitus with diabetic nephropathy E11.36 - Type 2 diabetes mellitus with diabetic cataract E11.40 - Type 2 diabetes mellitus with diabetic neuropathy, unspecified E11.51 - Type 2 diabetes mellitus with diabetic peripheral angiopathy without gangrene Listing all applicable diabetes complication codes strengthens the medical necessity case and helps justify tirzepatide over less expensive alternatives