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Metformin ameliorates testicular damage in male mice with streptozotocin-induced type 1 diabetes through the PK2/PKR pathway

Semaglutide is often chosen first if cost is a major barrier, if insurance covers it more reliably, or if someone is nervous about potentially stronger gastrointestinal side effects, and it has a long track record in both diabetes and chronic weight management, so clinicians may start there for a conservative yet effective approach, especially for modest weight loss goals, then consider switching to tirzepatide later if results plateau, side effects remain manageable, and coverage improves, and some practices even map out this stepwise plan during the very first visit