HealthRX.com · Printable lab tracker
Fasting insulin, glucose and low-sugar record for Zepbound
Write down each fasting insulin and glucose result with the lab's units, how long you had fasted and your dose at the time, plus any low-sugar episodes if you also use insulin or a sulfonylurea. The facts box shows what SURMOUNT-4 and the Zepbound label actually report.
Starting values, before the first injection
Copy the units exactly as the lab prints them. Insulin may be reported in μIU/mL or pmol/L.
Date and time of the blood draw
Hours since you last ate or drank anything but water
Fasting insulinnumber and units
Fasting glucose (mg/dL)
HbA1c (%)
Weight
Glucose-lowering medicines and dosessay if any is insulin or a sulfonylurea
Repeat results
| Date | Weeks on Zepbound | Dose (mg) | Hours fasted | Fasting insulin and units | Fasting glucose | Weight | Same lab as before? |
|---|---|---|---|---|---|---|---|
What the sources report
- SURMOUNT-4 post hoc analysis: in 308 people who lost at least 10% of their weight over 36 weeks of tirzepatide, average fasting insulin went from 13.5 to 7.5 μIU/mL.[1]
- After 52 weeks on placebo, fasting insulin rose by an estimated 23.3% overall from week 36: by 15.4% to 46.2% in the groups that regained a quarter or more of the lost weight, with no significant change in those who regained less.[1]
- Units differ between labs: to convert insulin from μIU/mL to pmol/L, multiply by 6.945.[1]
- Zepbound lowers blood glucose and can cause low blood sugar.[2]
- When Zepbound is started, the label says to consider lowering the dose of insulin or of a medicine such as a sulfonylurea.[2]
Warning signs from the Zepbound Medication Guide
- Signs of low blood sugar, which is more likely if you also use insulin or a sulfonylurea: dizziness or light-headedness, sweating, confusion or drowsiness, headache, blurred vision, slurred speech, shakiness, fast heartbeat, anxiety, irritability or mood changes, hunger, weakness, feeling jittery.[2]
- Severe stomach pain that will not go away, with or without nausea or vomiting: stop Zepbound and call your healthcare provider right away.[2]
Low-sugar episodes (if you use insulin or a sulfonylurea)
Date, time and reading
What you had eaten, and when
What you did about it
Who you told, and any dose change agreed
Questions for the clinician ordering the tests
- Is a fasting insulin result needed for my care, or will glucose and HbA1c answer the question?
- Will every test use the same lab and units, so results can be compared?
- How long should I fast before each blood draw?
- Should my insulin or sulfonylurea dose change when I start Zepbound?
- If I stop Zepbound, which of these results should be rechecked, and when?
Sources for the facts on this sheet
- Horn DB, Linetzky B, Davies MJ, et al. Cardiometabolic Parameter Change by Weight Regain on Tirzepatide Withdrawal in Adults With Obesity: A Post Hoc Analysis of the SURMOUNT-4 Trial. JAMA Intern Med 2026. PMID 41284285. https://pubmed.ncbi.nlm.nih.gov/41284285/
- Eli Lilly and Company, via DailyMed. Zepbound (tirzepatide) injection, for subcutaneous use: prescribing information and Medication Guide. Effective 2026-08-28. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=487cd7e7-434c-4925-99fa-aa80b1cc776b
This sheet records information for a conversation with your prescriber or pharmacist. It does not replace their instructions or the medication's prescribing information.