Jump to: Understanding the combination | Research evidence | Why intensive monitoring matters | Second Nature’s approach | Getting the right support | Take home message
You can take Mounjaro (tirzepatide) with insulin, but only under specialist medical supervision.
Human clinical trials show that combining Mounjaro with insulin can significantly improve blood sugar control and support weight loss in people with type 2 diabetes.
However, this combination requires extra monitoring due to the risk of low blood sugar levels (hypoglycemia).
At Second Nature, we don’t currently accept people taking insulin onto our Mounjaro programme because the level of medical supervision required exceeds what we can safely provide through our current structure.
Many people taking insulin worry that adding Mounjaro might complicate their diabetes management.
While the combination can be highly effective, it requires specialist oversight to adjust insulin doses appropriately and prevent hypoglycemia.
The key is working with an endocrinologist or specialist diabetes team who can provide the frequent monitoring and dose adjustments this combination demands.
Understanding the combination
Mounjaro and insulin work differently to control blood sugar, which is why they can be used together effectively.
Insulin directly replaces or supplements the hormone your pancreas struggles to produce. It moves glucose from your bloodstream into your cells for energy or storage.
Mounjaro works through multiple mechanisms. It mimics hormones called GLP-1 and GIP that help your pancreas release insulin more effectively when blood sugar rises. It also slows digestion and reduces appetite.
When used together, these medications can provide better blood sugar control than either alone.
Studies show people often achieve target HbA1c levels that weren’t possible with insulin alone.
The challenge comes from their combined effect on blood sugar. Adding Mounjaro to insulin therapy often means your insulin doses need to be reduced to prevent blood sugar from dropping too low.
This is why the combination requires specialist management. Your diabetes team needs to carefully balance both medications as your weight changes and your insulin sensitivity improves.
Research evidence
Clinical research strongly supports the use of Mounjaro in combination with insulin when properly managed.
The SURPASS-5 trial studied 475 people with type 2 diabetes who were taking insulin and added Mounjaro to their treatment.
Research showed significant improvements in blood sugar control and substantial weight loss.
Participants taking Mounjaro alongside insulin lost an average of 7-11kg over 40 weeks, compared to minimal weight loss in those continuing insulin alone. Their HbA1c levels also improved significantly.
Studies consistently show that people using this combination often require a 20-50% reduction in their insulin doses to maintain safe blood sugar levels. This reduction in insulin typically occurs gradually over the first few months.
The weight loss benefits remain substantial even when combined with insulin. Unlike some diabetes medications that can cause weight gain, Mounjaro continues to support weight loss in insulin users.
However, research also confirms the hypoglycemia risk. Studies report that without proper dose adjustments, severe low blood sugar episodes can increase significantly.
Why intensive monitoring matters
Combining Mounjaro with insulin creates specific challenges that require specialist oversight.
The primary concern is hypoglycemia, or dangerously low blood sugar levels. As Mounjaro improves your body’s insulin sensitivity and reduces appetite, your insulin requirements often decrease substantially.
Without proper monitoring and dose adjustments, continuing your previous insulin doses alongside Mounjaro can cause severe hypoglycemia. This can lead to confusion, seizures, or loss of consciousness.
Your diabetes team typically needs to monitor several factors closely:
- Blood sugar patterns change as Mounjaro takes effect. What worked for your insulin dosing before may cause problems within weeks of starting the new medication.
- Appetite changes affect your carbohydrate intake, which directly impacts insulin requirements. Many people eat significantly less on Mounjaro, requiring insulin dose reductions.
- Weight loss improves insulin sensitivity, meaning your body responds more effectively to smaller insulin doses. This effect builds gradually but significantly over months.
- Meal timing often shifts on Mounjaro as appetite decreases. This can affect when and how much rapid-acting insulin you need around meals.
Your healthcare team needs to coordinate these changes carefully, often requiring weekly or fortnightly contact during the first few months.
Second Nature’s approach
We don’t currently accept people taking insulin into our Mounjaro programme, but this decision reflects our commitment to patient safety rather than any limitation of the medication combination.
People taking insulin need more intensive medical monitoring than our current programme structure can provide. This includes frequent blood sugar checks, regular adjustments to insulin doses, and immediate access to specialised diabetes care.
Our health coaches are qualified nutritionists and dietitians with expertise in weight management and general health support.
However, managing the complex interaction between Mounjaro and insulin requires specialist diabetes training that extends beyond our current scope.
The combination also requires coordination between multiple healthcare providers. Your endocrinologist needs to adjust insulin doses, your GP may need to monitor other medications, and you need access to specialist diabetes services for urgent concerns.
Rather than attempting to provide inadequate support for such complex medical needs, we prefer to ensure that people receive the specialist care this combination demands.
This may change as our medical capabilities expand, but currently, we prioritise patient safety by directing insulin users to services specifically designed for complex diabetes management.
Getting the right support
If you’re taking insulin and want to explore Mounjaro, the right starting point is your current diabetes team.
Your endocrinologist or specialist diabetes nurse can assess whether the combination is appropriate for your specific situation. They have the expertise to manage the complex dose adjustments required.
Many NHS diabetes centres now offer Mounjaro alongside insulin for eligible patients. Speak to your diabetes team about whether you meet the criteria for NHS prescribing.
If NHS access isn’t available, some private diabetes specialists offer Mounjaro prescribing with the intensive monitoring required for insulin users.
However, ensure any private provider has specific experience with this combination.
You’ll need access to frequent blood sugar monitoring, which may include continuous glucose monitoring systems. Your diabetes team can arrange this and interpret the data to guide dose adjustments.
Don’t attempt to manage this combination without specialist support. The interaction between these medications requires professional expertise to navigate safely and effectively.
Take home message
You can take Mounjaro with insulin, and research shows this combination can significantly improve blood sugar control and support substantial weight loss.
However, this combination requires specialist medical supervision with intensive monitoring and careful dose adjustments to prevent dangerous hypoglycemia.
While we can’t currently support insulin users in our programme, this reflects our commitment to ensuring people get the level of medical care this complex combination demands.
If you’re taking insulin and are interested in Mounjaro, work with your diabetes team to explore whether this combination is right for you and ensure you receive the specialist monitoring required for safe and effective treatment.
Second Nature's Mounjaro programme
Second Nature provides Mounjaro as part of our Mounjaro weight-loss programme
Why choose Second Nature over other medication providers, assuming you’re eligible?
Because peace of mind matters.
We’ve had the privilege of working with the NHS for over eight years, helping people across the UK take meaningful steps toward a healthier, happier life.
Our programmes are designed to meet people where they are, whether that means support with weight loss through compassionate one-to-one health coaching, or access to the latest weight-loss medications (like Mounjaro) delivered alongside expert care from a multidisciplinary team of doctors, psychologists, dietitians, and personal trainers.
At the heart of everything we do is a simple belief: real, lasting change comes from building better habits, not relying on quick fixes. We’re here to support that change every step of the way.
With over a decade of experience, thousands of lives changed, and a long-standing record of delivering programmes used by the NHS, we believe we're the UK’s most trusted weight-loss programme.
We hope to offer you something invaluable: peace of mind, and the support you need to take that first step.
