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While tirzepatide does increase metabolism through its own mechanisms, dramatic or unexpected weight loss should prompt a thyroid function check

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In AWARD-10 [31], a 24-week, randomized, double-blind, placebo-controlled trial evaluating once-weekly dulaglutide (administered at either 1.5 or 0.75 mg) as add-on therapy to SGLT2is in a total of 424 patients with inadequately controlled T2DM, only one episode of severe hypoglycemia was reported throughout the study, in a patient treated with dulaglutide 0.75 mg, confirming the very low incidence of serious hypoglycemia with GLP-1RAs in combination with SGLT2is [31]