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Pica behavior is a validated endpoint to assess the ability of a compound to induce nausea/malaise in non-vomiting species, as mouse, based on the monitoring of non-nutritive (kaolin) food intake, as an index of gastrointestinal discomfort 43,44

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Therefore, if GLP-1 RA treatment specifically increases the risk of pancreatitis in this vulnerable population, such an effect would likely remain undetected in randomized trials

In poorly managed T2DM treated with basal insulin, tirzepatide can improve glucose control without hypoglycemia risk, alone or in combination with other oral hypoglycemic medications [79]