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Both semaglutide and tirzepatide are designed for steady, sustained results rather than rapid drops, which is part of why ongoing monitoring matters
The pathophysiological link between diabetes and acromegaly is given by the association between elevated GH levels and insulin resistance, which especially in patients with a long history of the disease can result over time in impaired glucose tolerance to the point of insulin deficiency and diabetes (138)
Forms of B12 supplements available include: Cyanocobalamin : The most common and cost-effective form in over-the-counter supplements Methylcobalamin : A naturally occurring form, often marketed as superior though evidence for clinical advantage is limited Hydroxocobalamin : The preferred form for intramuscular injection in the UK, used therapeutically for pernicious anaemia and confirmed deficiency [4] Dosing considerations depend on the indication
J Cereb Blood Flow Metab (2011) 31(8):1696705
