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These include: A new or persistent lump or swelling in the neck, particularly in the thyroid region Progressive difficulty swallowing (dysphagia) or a sensation of pressure in the throat Persistent hoarseness or voice changes lasting more than three weeks Unexplained stridor (high-pitched breathing sound) Rapidly enlarging neck mass Patients experiencing any of these symptoms should contact their GP promptly for clinical assessment, in line with NICE guidance on suspected cancer referral (NG12)
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During this run-in period, metformin treatment was optimized and all other OADs were discontinued
However, it should be administered under professional supervision and its strictly contraindicated during pregnancy
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