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However, Inpefas label does list DKA as a potential risk in those with type 1 and states that ketone monitoring should be considered for this population

Therefore, B12 from food or oral supplements will be poorly absorbed if: There is low stomach acid due to use of a Proton Pump Inhibitor (PPI) There is low intrinsic factor

Preserved Inhibitory Potency of GLP-1 on Glucagon Secretion in Type 2 Diabetes Mellitus. The Journal of Clinical Endocrinology & Metabolism 94.12 (2009): 4679-4687

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I get the sense that its not the first time hes made this point

Starting Tirzepatide for weight loss begins with a comprehensive medical evaluation to ensure the medication is appropriate and safe for you