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Biol Chem (2012) 393(6):50511

Your healthcare provider will check how your body responds to treatment

My guess still remains that there's been an error in the process somewhere and it's 'crept out'

PMID 2546112

Peptide degradation pathways Tirzepatide is a 39-amino-acid peptide with specific structural modifications that make it effective, including alpha-aminoisobutyric acid (Aib) substitutions at positions 2 and 13 (which protect against DPP-4 enzyme degradation in the body) and a C20 fatty diacid chain at position 20 (which enables albumin binding for a longer half-life)