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When to seek medical advice: Persistent vomiting preventing adequate fluid or nutrition intake Severe abdominal pain or signs of pancreatitis (rare but serious) Right upper abdominal pain, fever or yellowing of the skin (possible gallbladder issues) Signs of dehydration (dark urine, dizziness, extreme thirst) Low blood glucose symptoms if also taking insulin or sulfonylureas Unintentional muscle weakness or significant functional decline Inability to maintain adequate protein intake despite supplementation Patients experiencing severe or persistent side effects should contact their GP or diabetes care team promptly