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Ketoacidosis is more common in people with type 1 diabetes, but it can also happen with type 2 diabetes that requires insulin

For most people, it is mild to moderate and improves within a few weeks as the body adjusts

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Some compounders add B12, glycine, or other excipients to alter pH, taste, or stability

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Other notable side effects include injection site reactions (redness, itching, or swelling at the injection site), fatigue, and hypoglycemia, particularly when tirzepatide is used in combination with insulin or sulfonylureas