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Risk factors include acute illness, reduced food intake, alcohol excess, and insulin dose reduction
The trigger is the combination of rapid weight loss and caloric restriction: when appetite suppression is working well, patients are eating significantly less, and if protein and micronutrient intake fall below what the body needs, hair follicles are among the first structures deprioritized
The triple agonist mechanism appears to match or slightly exceed tirzepatide for blood sugar management , likely because the glucagon component, while it can raise blood sugar in isolation, works synergistically with GLP-1 and GIP activation to produce a net positive effect on glucose regulation
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