Dr.EM_Chicago said:

Steady state is faster than people expect: half-life about five days, so you are at plateau in roughly three to four weeks rather than five.

Bookmarking. The distinction being drawn above is the one nobody else makes. I will report back once I have actually tried it.

Adding the clinical framing, because it changes how the question reads.

Dose-response modeling for tirzepatide: Emax model fitting to the STEP/SURMOUNT dose-finding data shows:

Semaglutide: ED50 ≈ 0.6mg, Emax ≈ -18%, Hill coefficient ≈ 1.3
Tirzepatide: ED50 ≈ 6mg, Emax ≈ -25%, Hill coefficient ≈ 1.5

Clinical implication: most patients achieve >80% of maximal response by the mid-range dose (1.7mg sema, 10mg tirz). Going to the maximum dose provides diminishing returns — possibly not worth the additional side effect burden for some patients. Individualize dosing based on response vs tolerability.

Dr.RheumBOS said:

HbA1c reflects roughly three months of average glycaemia weighted toward the most recent weeks, which is why repeating it at six weeks tells you very…

I read this differently. The confidence in this thread is running ahead of the evidence, and I would rather the uncertainty were stated than smoothed over because it is unsatisfying.

Adding the numbers, since they settle part of this. Practical: whatever you change, write down the date and the reason. In three months the reason is what you will have forgotten, and the reason is what makes the record worth having.

Worth separating that from glycaemic control, which this thread keeps folding into the same question. They behave differently and the advice does not transfer.

Moderator note: leaving this open. It is being argued well and the disagreement is the useful part.