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Evidence based reporting suggests AT is very versatile in terms of their metabolic flexibility due to the energy demands and being able to cope with large and rapidly evolving balance between fasting and feeding through the day and also fine tune to long term changes in energy balance with tissue expansion and reduction (176)

There are patients who are still very reluctant to do the weekly injection

Once-weekly tirzepatide versus once-daily insulin degludec as add-on to metformin. The Lancet , 2021

By mouth (Rybelsus): Initially 3 mg once daily for 1 month, then increased to 7 mg once daily for at least 1 month, then increased if necessary to 14 mg once daily, dose to be taken on an empty stomach, one 14 mg tablet should be used to achieve a 14 mg dose