clinical trial tirzepatide Tirzepatide: A Systematic Update endocrinology #clinicaltrials | NEJM Group

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Supplementation with Astragalus polysaccharides alters Aeromonas-induced tissue-specific cellular immune response

Contact your GP or diabetes specialist nurse if: Sleep disturbances persist beyond 46 weeks despite implementing sleep hygiene measures You experience persistent gastrointestinal symptoms that significantly impair your quality of life You suspect nocturnal hypoglycaemia (symptoms include night sweats, nightmares, morning headaches, or waking feeling confused) Sleep problems are accompanied by mood changes, significant fatigue, or difficulty functioning during the day You develop persistent vomiting or diarrhoea that could lead to dehydration Seek urgent medical attention (call 111 or attend A&E) if you experience: Severe, persistent abdominal pain which may radiate to your back (possible sign of pancreatitis) Severe abdominal pain with nausea and vomiting (possible gallbladder problems) Signs of severe dehydration (extreme thirst, dry mouth, little or no urination, weakness) Call 999 immediately if you experience: Severe chest pain Difficulty breathing Symptoms of severe hypoglycaemia that you cannot manage yourself Your healthcare provider may: Review your current dose and consider adjusting the titration schedule Assess for other potential causes of sleep disturbance, including obstructive sleep apnoea (more common in people with type 2 diabetes and obesity) [20] [21] Evaluate your overall diabetes management plan and consider whether other medications need adjustment Screen for depression or anxiety, which are more prevalent in people with diabetes and can significantly affect sleep [23] Refer you for specialist sleep assessment if appropriate Do not stop taking Ozempic abruptly without medical advice, as this may lead to deterioration in your glycaemic control

In cases of overdose or unclear presentations, consultation with your local poison center or a medical toxicologist can help guide nuanced care