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Nature 555 (7694), 121125

Preliminary studies in patients with T1DM and T2DM have shown that diabetes increases the urine ratio of lactobionate, and this may reflect the metabolic process of mitochondrial oxidation to glycolysis, which is reversed by SGLT2 inhibitors (Nespoux and Vallon, 2020)

In a mechanism of action study that aimed to achieve 10% body weight reduction in participants with obesity who were without T2D, tirzepatide was compared to placebo for sleeping and 24-h energy expenditure and respiratory exchange ratio by utilizing metabolic chambers assessed at baseline and after 18 weeks [56]

If you travel frequently, consider using an insulated medication travel case with ice packs to maintain the 3646F range during transport

1 Metformin has historically been the first-line therapy for metabolic management in PCOS