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While tirzepatide itself does not cause nightmares, nocturnal hypoglycemia (low blood sugar at night) can cause nightmares and sleep disturbances, particularly when tirzepatide is combined with insulin or sulfonylureas

SUSTAIN 6 Trial In this trial, new or worsening nephropathy, defined as persistent macroalbuminuria, persistent doubling of the serum creatinine, or a creatinine clearance 339 mg/mmol), a sustained decline in eGFR of 30% or more from baseline, or chronic renal replacement therapy (322)

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This not only improved efficacy but also significantly reduced off-target toxicity." Dr