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[23] [13] Nausea is most common during the first week of GLP-1 therapy and typically improves significantly within 24 weeks as your body adjusts to the medication

However, conflicting evidence highlights context-dependent risks, such as early DR worsening in poorly controlled glycemic states

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Its success in controlling blood glucose has prompted the American Diabetes Association to recommend it and other GLP-1-based drugs as the new first line injectable treatments for diabetes, ahead of insulin

During GLP-1 treatment , contact your GP if you experience: Severe or persistent abdominal pain , particularly if different in character from your usual IBS symptoms or if radiating to your back (which may indicate pancreatitisstop the medication and seek urgent medical attention) Significant worsening of diarrhoea or constipation that doesn't improve with standard measures Persistent nausea or vomiting affecting your ability to maintain adequate nutrition and hydration New symptoms such as rectal bleeding, unintentional weight loss (beyond expected therapeutic effect), or nocturnal symptoms waking you from sleep Difficulty distinguishing between IBS symptoms and medication side effects Sudden pain in the upper right abdomen, fever, or yellowing of the skin/eyes (possible gallbladder diseaseseek urgent medical attention) Red flag symptoms requiring urgent medical attention include: Severe, unremitting abdominal pain Rectal bleeding or black, tarry stools Unexplained weight loss Persistent vomiting with inability to keep fluids down Signs of dehydration Your GP may arrange appropriate investigations such as blood tests (full blood count, inflammatory markers, coeliac serology) or faecal calprotectin testing to distinguish IBS from inflammatory bowel disease where appropriate