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Specific situations requiring prompt medical review include: Persistent hyperglycaemia : blood glucose readings consistently above your target range despite medication adherence Rising HbA1c levels : an increase in HbA1c on repeat testing suggests treatment inadequacy Unexpected weight gain : whilst not all patients lose weight on Ozempic, significant weight gain warrants investigation Severe or persistent side effects : particularly nausea, vomiting, or abdominal pain that prevents proper nutrition or medication continuation Signs of pancreatitis : severe, persistent abdominal pain radiating to the back requires immediate medical attentioncall 999 or go to A&E Symptoms of diabetic ketoacidosis : though rare with type 2 diabetes, seek urgent care (call 999 or go to A&E) for excessive thirst, frequent urination, confusion, or fruity-smelling breath New or worsening vision problems : report any visual changes promptly as GLP-1 medications may worsen diabetic retinopathy in some patients [19] [20] Right upper abdominal pain, fever or yellowing of the skin/eyes : these could indicate gallbladder problems, which can occur with GLP-1 medications [22] [23] Your healthcare provider can assess whether dose adjustment, administration technique review, or additional investigations are needed

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Snchez-Navarro and colleagues have written an outstanding review on the use of a new generation of peptides for overcoming the BBB [205]