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Many patients benefit from maintenance therapy at a stable dose rather than cycling on and off

Seek urgent medical attention (call NHS 111 or 999 for severe symptoms) if you experience: Severe, persistent abdominal pain, especially in the upper right quadrant (potential pancreatitis or gallbladder disease) Yellowing of the skin or eyes (jaundice) Signs of dehydration or significantly reduced urine output Symptoms of hypoglycaemia (particularly if you're taking insulin or sulfonylureas for diabetes) Allergic reactions (rash, swelling, difficulty breathing) Visual changes or severe headaches (especially if you have diabetes with pre-existing retinopathy) You should also discuss with your healthcare provider if cold sensitivity significantly impacts your quality of life, even without other concerning symptoms

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