My Approach When Prescribing Here's my general framework not a rigid protocol, but a starting point for the conversation: I Tend to Start with Semaglutide When The patient has established cardiovascular disease (because of the SELECT trial data) Insurance covers semaglutide but not tirzepatide The patient has MASH/fatty liver disease Cost is the primary concern and semaglutide is more accessible I Tend to Start with Tirzepatide When Maximum weight loss is the primary goal The patient has type 2 diabetes (tirzepatide shows greater A1C reduction roughly 2.02.5% vs 1.02.0% for semaglutide) The patient has tried semaglutide with insufficient results Insurance covers both options equally Regardless of which medication we choose, I always emphasize that GLP-1 therapy is most effective when combined with nutritional counseling, physical activity, and behavioral support
Ex vivo experiments using pancreatic islets indicate that -arrestin1 limits insulin response to GLP-1 but not GIP or tirzepatide, supporting a distinct signaling profile
The second mechanism is direct: GLP-1 receptor activation in skeletal muscle reduces GLUT4 translocation
This is an important question that applies to all GLP-1 therapy, not just Ivim Health
Declaration of Helsinki ethical principles for medical research involving human subjects
Last Published 01.01.2026 Effective Date: 01.01.2026 This policy addresses the use of Vyjuvek (beramagene geperpavec-svdt) for the treatment of wounds in patients with dystrophic epidermolysis bullosa (DEB)
