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Key domains requiring structured oversight include: Pancreatitis and gallbladder disease Progression of diabetic retinopathy Severe gastrointestinal intolerance Visual loss and rare opticnerve complications Nutritional/metabolic issues with rapid weight reduction In India, where continuity of care is variable and prescribing often occurs outside endocrinology, these risks can be underrecognised or misattributed

Although the pathophysiology is incompletely understood, there are common mechanisms between sarcopenia and the phenomenon of accelerated ageing seen in diabetes mellitus

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