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Immediate medical attention is required if thirst is accompanied by any of the following: Severe or persistent vomiting or diarrhoea leading to inability to maintain hydration Signs of dehydration such as dizziness, reduced urine output, dark-coloured urine, or dry mucous membranes Symptoms suggestive of hypoglycaemia (blood glucose below 4 mmol/L) that do not resolve with standard treatment Severe abdominal pain, which may indicate pancreatitisa rare but serious adverse effect of GLP-1 receptor agonists Symptoms of DKA, including rapid breathing, fruity breath odour, confusion, or loss of consciousness If pancreatitis is suspected (severe, persistent abdominal pain, possibly radiating to the back), stop taking semaglutide and seek urgent medical assessment

The prescriber should include pharmacy records showing the metformin fill and discontinuation date, plus a clinical note explaining the reason for intolerance

Your pregnancy care provider will test you for gestational diabetes after your baby is born to confirm its gone (usually around six to 12 weeks postpartum)

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