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Diabetes 50(1):96104
Research shows: Slowed progression of chronic kidney disease (CKD) Reduced proteinuria (albumin in urine) , an early marker of kidney damage Improved kidney filtration rates over time The FLOW trial with semaglutide demonstrated that GLP-1 therapy could significantly reduce the risk of kidney failure in patients with type 2 diabetes and CKD
Injections are favored for severe deficiency, malabsorption (e.g., postGI surgery, chronic diarrhea), very low B12 levels with neurologic signs, poor adherence, or when rapid repletion is needed
While B12 directly addresses absorption issues created by tirzepatide effects on the GI tract, glycine provides theoretical muscle preservation benefits
Vitamin B6 also contributes to normal protein and glycogen metabolism
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