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When to seek medical advice: Persistent vomiting preventing adequate fluid intake Severe abdominal pain Signs of pancreatitis (severe upper abdominal pain radiating to the back) Symptoms of thyroid problems (lump in neck, hoarseness, difficulty swallowing) Any side effect that significantly impacts quality of life According to NICE guidance, treatment should be reviewed if HbA1c targets are not achieved or if side effects prove intolerable despite management strategies

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