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If you have tried semaglutide at meaningful doses for 12+ weeks with minimal response, switching to tirzepatide is still worth attempting

On the other hand, only a few studies clearly reported DPN rather than combining it with autonomic neuropathy

doi: 10.1016/j.numecd.2018.07.009 30

Nicht zugelassenes Arzneimittel (AMG-Versto) 5

Generic Semaglutide manufactured by licensed compound pharmacies is supplied in a vial and dispensed with insulin syringes for once weekly dosing which requires the patient to draw the appropriate amount into the syringe, but allows for easier titration to minimize side effects