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.