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Other important safety considerations include: Risk of acute pancreatitis : Seek urgent medical attention for severe, persistent abdominal pain with or without vomiting [1] Gallbladder disease : Increased risk of gallstones and related complications Diabetic retinopathy : Caution in patients with pre-existing retinopathy due to rapid improvement in blood glucose control Hypoglycaemia : Increased risk when used with insulin or sulfonylureas, which may require dose reduction of these medications Oral contraceptive interaction : Reduced effectiveness due to delayed gastric emptying

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The NHS hypokalaemia overview explains why it matters, and clinical references such as StatPearls on B12 deficiency treatment specifically flag monitoring potassium during the early loading phase in people who were severely deficient

Body mass index (BMI) at baseline, metabolic health status, and duration of obesity can all affect response to therapy