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Contact your GP or diabetes care team if you experience any of the following: Persistent or worsening fatigue that continues beyond the first 46 weeks of treatment or does not improve with dietary and lifestyle modifications Severe tiredness that significantly impairs your ability to perform daily activities, work, or care for yourself Symptoms suggestive of hypoglycaemia , particularly if occurring frequently or if you are unable to maintain blood glucose levels within target range Signs of dehydration or electrolyte imbalance , including dizziness, reduced urine output, dark urine, persistent headaches, or muscle cramps Concurrent symptoms such as unexplained weight loss beyond expected targets, persistent nausea or vomiting preventing adequate nutrition, or palpitations Mood changes including low mood, anxiety, or depression, which can both cause and be exacerbated by fatigue Snoring, witnessed pauses in breathing during sleep, or excessive daytime sleepiness , which may indicate obstructive sleep apnoea, a treatable condition common in people with obesity [19] Seek urgent medical attention (call 999 or go to A&E) if you experience severe chest pain, shortness of breath, or severe, persistent abdominal pain (especially if radiating to the back), as these could indicate serious conditions including pancreatitis, which is a rare but recognised complication of GLP-1 treatment

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