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The GCGR arm adds pathways tirzepatide lacks: hepatic fatty-acid oxidation (~85–90% liver fat reduction in Phase 2a MASLD), adipose lipolysis, and thermogenic energy expenditure

There is also the issue of treatment fatigue

So what else might they be doing wrong

Attorney Andrew Grossman, representing the compounders, told the court the FDAs move was a prospective legal prohibition on compounding for an entire industry. That, he said, makes it a rule under the Administrative Procedure Act, and rules require public notice and comment

These features make GLP-1 RAs an advantageous alternative to rapid-acting insulin for patients inadequately controlled on a long-acting basal insulin

When the anemia is severe and the red blood cell count is extremely low, blood transfusions may be necessary for the first couple of days until the vitamin B 12 injections begin working