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Besides medication effects, stress, diet, and underlying health issues can also play significant roles

Laursen JC, Sondergaard-Heinrich N, Lopes de Melo JM et al (2021) Acute effects of dapagliflozin on renal oxygenation and perfusion in type 1 diabetes with albuminuria: a randomised, double-blind, placebo-controlled crossover trial

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This is higher than the general recommendation for tirzepatide users (1.0 to 1.2 g/kg) because of the additive muscle loss risk from autoimmune disease
