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[11] [3] Individuals with a history of pancreatitis, severe gastrointestinal disease, or significant renal impairment should seek specialist advice before considering any GLP-1based therapy

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Contact your GP or diabetes specialist nurse if : Symptoms persist beyond four weeks despite dietary modifications Symptoms worsen rather than improve over time You experience severe or persistent nausea and vomiting , which may indicate severe delayed gastric emptying There is unintentional weight loss beyond expected therapeutic effects You develop persistent abdominal pain , particularly in the upper abdomen Burps are accompanied by diarrhoea lasting more than 48 hours or signs of dehydration You notice blood in vomit or stools, or black, tarry stools (seek urgent medical attention) You develop right upper abdominal pain with or without fever/jaundice , which could indicate gallbladder problems If you cannot contact your GP and need urgent advice, call NHS 111

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Proc Nutr Soc 2012

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