Urgent medical attention is required if any of the following occur: Severe or persistent vomiting or diarrhoea , which can lead to dehydration and electrolyte imbalances Signs of hypoglycaemia (if taking other glucose-lowering medications): confusion, sweating, tremor, rapid heartbeat, or loss of consciousness Symptoms of worsening hyperthyroidism : significant weight loss, severe palpitations, chest pain, shortness of breath, or new-onset atrial fibrillation Symptoms of hypothyroidism : extreme fatigue, cold intolerance, significant weight gain, or depression Severe abdominal pain , particularly if radiating to the back, which could indicate pancreatitis (a rare but serious side effect of GLP-1 receptor agonists) Right upper quadrant pain, fever, or jaundice , which could indicate gallbladder problems Symptoms of diabetic ketoacidosis : abdominal pain, vomiting, rapid breathing, drowsiness, or fruity-smelling breath (particularly if insulin doses have been reduced) Changes in vision or eye symptoms : pain, redness, double vision, or worsening bulging of the eyes Allergic reactions : rash, itching, swelling of the face or throat, or difficulty breathing Routine follow-up with your GP or endocrinologist should occur at least every 36 months, or more frequently if your condition is not yet stable

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doi:10.1126/science.117.3049.628
doi: 10.1111/eos.12177