Tirze for T2D specifically — metformin + tirze stack experiences

The metformin + tirze combo is one of the cleanest modern T2D stacks. Metformin for long-term all-cause mortality signal, tirze for glucose + weight + cardiovascular endpoints. Synergistic on glucose, non-overlapping on the ancillary benefits. Don't de-prescribe either unless you have a specific reason.

Met 1500 + tirze 7.5 for 14 months. A1c 7.8 -> 5.9, fasting 158 -> 104, weight down 28lb. Endo left metformin alone for the reasons yours cited — cardioprotective / kidney-protective signal is independent of glucose control. Don't drop it just because glucose is fixed.

Running both + empagliflozin (SGLT2i). A1c 8.1 -> 5.4 in 9 months. My cardiologist is happy, my endo is happy, I'm happy. The triple combo is the modern T2D protocol in my view and I wish I'd been on it 5 years ago.

Tirze as monotherapy for T2D is supported by SURPASS-1 data but most real-world use is as add-on to metformin. Combination has the best evidence base for long-term outcomes. The 'should I drop metformin' question almost always has the answer 'no' unless you're having GI issues from it.

Thanks all. Keeping metformin. Planning to retest at 6 months and post an update. The A1c trajectory in 3 months already beat anything I saw in 11 years of metformin alone.

Worth tracking fasting insulin and HOMA-IR too, not just A1c. A1c is average glucose but insulin dynamics tell you about the underlying driver. Seeing those two numbers normalize is the real win.

Yeah the met + tirze combo is solid. Been there, and honestly the real difference I notice is that my glucose readings stopped being all over the place. Used to swing like crazy on met alone, now it's just... flat. Boring in the best way. Don't bother dropping the metformin, your endo's right about that.

The A1c numbers in here are solid but nobody's talking about what actually changed in terms of diet, exercise, or stress during these 3-9 month windows. Like, did you all tighten up food intake when you started the meds or was it genuinely just the pharmacology? Asking because I see people conflate "got on tirze" with "also stopped eating like garbage" and then credit all the glucose improvement to the drug. Not saying that's what happened here but it matters for real expectations.