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(15) After inducing diabetic osteoporosis through a high fat diet and streptozotocin, light and scanning electron microscopy revealed evidence of bone deterioration via the upregulation of nuclear factor kappa-B ligand (RANKL) and downregulation of pro-osteogenic markers OPG and osteocalcin

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Seek urgent medical attention (contact 999 or attend A&E) if experiencing: Severe, persistent abdominal pain , particularly if it is constant and worsening Signs of pancreatitis : severe upper abdominal pain radiating to the back, often accompanied by nausea and vomiting Symptoms of bowel obstruction : severe abdominal pain with inability to pass stool or wind, progressive abdominal distension, and persistent vomiting Signs of dehydration : dizziness, reduced urine output, extreme thirst, or confusion, particularly if associated with severe vomiting or diarrhoea Blood in vomit or stool , which may indicate gastrointestinal bleeding Signs of gallbladder disease : severe right upper quadrant pain (which may be accompanied by fever), pain after fatty meals, or jaundice (yellowing of the skin or eyes) Contact your GP or diabetes specialist nurse within 24-48 hours if: Stomach pain persists beyond the first few weeks of treatment without improvement Abdominal discomfort is significantly affecting your quality of life or ability to eat adequately You are unable to maintain hydration or nutrition due to gastrointestinal symptoms New symptoms develop, such as jaundice (yellowing of skin or eyes), dark urine, or pale stools You experience unexplained weight loss beyond what is expected with diabetes management Pancreatitis is a rare but serious adverse effect associated with GLP-1 receptor agonists, including Ozempic

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