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Cardiovascular outcomes, long-term efficacy and safety In people with T2D and established cardiovascular disease, the international guidelines for T2D recommend the use of GLP-1 RA or sodium glucose co-transporters 2 inhibitors (SGLT-2i) as first-line treatment (independent of HbA1c), based on multiple trials demonstrating their cardio-renal benefits [109]
The oral semaglutide guide covers this option in detail, and some compounding pharmacies now offer semaglutide with methylcobalamin or semaglutide with B12 as combination formulations
For example, alcohol affects the digestive system, which is a common concern for people who take GLP-1s
One example mentioned: the drug Tirzepatide (brand name Mounjaro for diabetes, Zepbound for weight loss) activates both GLP1 and GIP pathways
The study included a total of 502 subjects and reported an 8% absolute reduction of liver fat in the pooled tirzepatide 10mg and 15mg groups, which was superior by almost 5% to the insulin group at 12 months
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