Hypoglycemia risk with concomitant sulfonylurea use — 6 month update

Curious where everyone stands on this. I have seen strong opinions both ways in other threads and want to get a proper read on the community consensus.

For context: hypoglycemia risk with concomitant sulfonylurea use is something I've been going back and forth on. Some members seem to swear by one approach, others recommend the opposite.

Drop your experience below — even if it is just a quick "this worked" or "this did not work" that helps. Detailed responses obviously welcome too.

Let's get some data points going 📊

PharmacoVig_BOS's experience with Hypoglycemia risk with resonates deeply with mine. I went through almost the identical process — starting dose, titration timeline, side effects, everything.

The main difference: I titrated faster. But the overall trajectory has been remarkably similar. Down 48 lbs in 13 months.

One thing I would add that PharmacoVig_BOS did not mention: the relationship with food fundamentally changed.

Thanks for sharing this, PharmacoVig_BOS. A few questions about your Hypoglycemia risk experience:

1. What dose worked best for you?
2. How long before you noticed appetite suppression kicking in?
3. Did your endo have any specific recommendations about Hypoglycemia?

I am in a similar boat and trying to learn from others' experiences before my next appointment.

OP here — wow, did not expect this much response! Thank you all for the thoughtful replies on Hypoglycemia risk with.

To answer steve_okc: yes, I am on compounded sema from a 503B pharmacy.

Quick update: things are still going well. Thanks again for the evidence-based discussion — this is exactly why I posted in a science-based community. 🙏

Relevant to Hypoglycemia risk with — here is my latest bloodwork comparison:

Key improvements: A1C 8.4% → 5.5%, triglycerides 221 → 91 mg/dL, hsCRP 8.0 → 0.9 mg/L. All on tirzepatide for 13 months.

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