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Acinar cells are the exocrine cells that release pancreatic enzymes to break down food.[ref] The proteases protein-metabolizing digestive enzymes actually break down the proteins that make up your pancreatic tissue

This isnt a complete list of all side effects

Velasque et al

These spikes stimulate IGF-1 production, trigger fat oxidation, and support muscle protein synthesis without chronically elevating GH/IGF-1 (which brings its own concerns with insulin resistance and potential cell growth effects long-term)

These medications may also have different "beyond-use dates" (expiration dates) than brand-name products

In a study comparing tirzepatide and semaglutide, tirzepatide reduced HbA1c by 2.01% to 2.30%, depending on the dose, while semaglutide reduced it by 1.86% in 40 weeks 13