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Signos de alarma que requieren atencin mdica inmediata incluyen: Dolor abdominal severo y persistente (posible pancreatitis) Dolor en la parte superior derecha del abdomen, fiebre o ictericia (posible enfermedad de la vescula biliar) Vmitos incoercibles que impiden la hidratacin Cambios visuales (monitorear especialmente en pacientes con retinopata diabtica) Sntomas de reaccin alrgica grave Bulto o hinchazn en el cuello, ronquera, dificultad para tragar o respirar (posibles signos de tumor tiroideo) Sntomas de hipoglucemia (en pacientes que tambin toman insulina o sulfonilureas) Estos sntomas no deben manejarse simplemente ajustando el horario de inyeccin, sino que requieren evaluacin mdica urgente

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Conclusions/interpretation Approximately half of type 2 diabetes patients who had started using GLP-1 receptor agonists or SGLT2 inhibitors had discontinued treatment within 5 years of follow-up