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Chromium (as Chromium Picolinate) 1000 mcg (2,857% DV)

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Euglycemic diabetic ketoacidosis (DKA), a side effect of sodium-glucose cotransporter-2 (SGLT2) inhibitors, is a triad of high metabolic anion gap acidosis, raised serum and urine ketones, and serum glucose <250 mg/dl

Since tirzepatide is a dual GLP1R/GIPR agonist, the interpretation is compelling: GIP receptor activation normally buffers the nausea-inducing effects of GLP-1 agonism, and when that buffer is genetically impaired, the GLP-1 component goes unchecked