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Phase 3 ACHIEVE-1 trial results for orforglipron, as discussed by Rosenstock and colleagues, demonstrated that this once-daily oral small molecule GLP-1 achieved statistically significant reductions in HbA1c (1.3% to 1.6% from a baseline of 8.0%) compared to placebo in adults with type 2 diabetes

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Synthesis of additional metabolites, including TMA and branched amino acids, can also cause dysbiosis, disrupt glucose homeostasis, and trigger the development of T2D (241)

Because tirzepatide remains in the body for days, dosing mistakes cause serious, long-lasting side effects

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