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Between weeks 5 and 40, patients in all treatment groups were instructed to self-adjust the dose of insulin glargine using their self-measured blood glucose values to a target fasting blood glucose of less than 100 mg/dL as per the treat-to-target algorithm (eTable 1 in Supplement 2)

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PMID: 31497255

This individualization is why many patients achieve better outcomes on compounded tirzepatide than on fixed-dose regimens

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An increased concentration of cAMP leads to the activation of protein kinase A (PKA), which activates tissue-specific downstream signaling pathways (37)