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Patients should eat slowly, chew food thoroughly, and avoid talking while eating to minimize air swallowing (aerophagia)

For intention-to-treat analysis, follow-up started at treatment assignment (T0) and ended at the occurrence of outcomes, death or last encounter (to 30 June 2024)

Tirzepatide is a 39amino acid dual incretin receptor agonist that activates both GLP1 and GIP receptors, enhancing glucosedependent insulin secretion, suppressing glucagon, slowing gastric emptying, and reducing appetite [1] [2]

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Shaking creates shearing forces and froth, both of which are catastrophic for peptide integrity