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Seek immediate medical attention (call 999 or attend A&E) if you develop: Severe, unrelenting abdominal pain Signs of severe dehydration with confusion or altered consciousness Persistent vomiting with inability to retain any fluids for more than 24 hours Chest pain or difficulty breathing alongside gastrointestinal symptoms For patients with diabetes taking GLP-1 medications, persistent vomiting poses additional risks

Alternatively, DPP-4 inhibitors could not restore sufficient GLP-1 levels (Fig

Long term administration of agonists could potentially lead to unanticipated consequences in these organs

Can I go back on GLP-1s later

Appetite meaningfully reduced

Your insurer wants a formulary check, ICD-10 diagnosis (E66.9 or E11.9), documented step-therapy failures, and a letter of medical necessity