Just wanted to say — for anyone reading this SUSTAIN-6 to SELECT thread who is feeling discouraged: it gets better. The first few weeks are the hardest. Hang in there. 💪

Want to share my personal experience related to SUSTAIN-6 to SELECT what since I think it might help others in a similar situation.

I started my GLP-1 journey in October 2024 at 256 lbs with prediabetes and hypertension. My endocrinologist prescribed semaglutide 0.25mg to start.

Now, 12 months later: I am down 81 lbs, my labs have normalized, and I am off 2 of my 3 medications. The SUSTAIN-6 to SELECT aspect specifically was something that made a big difference in my journey.

This community helped me every step of the way.

Clinical perspective on SUSTAIN-6 to SELECT what worked for:

I have managed ~150 patients on GLP-1 therapy and this topic comes up frequently. What the data shows — and what I see in practice — is that proper titration prevents most adverse events.

For this specific question, I would recommend: reviewing the relevant clinical guidelines.

Thank you mike_nyc! This is incredibly helpful. Taking this to my next appointment. 🙏

Relevant to SUSTAIN-6 to SELECT what — here is my latest bloodwork comparison:

Key improvements: A1C 7.2% → 5.3%, triglycerides 219 → 119 mg/dL, hsCRP 6.0 → 1.3 mg/L. All on tirzepatide for 11 months.

The inflammatory marker drop is what impresses me most. Consistent with the SELECT trial's cardiovascular findings.