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Rare but serious effects can include pancreatitis, gallbladder problems, kidney injury (often linked to dehydration from severe vomiting or diarrhea), severe or persistent abdominal pain, serious allergic reactions, worsening of diabetic retinopathy in people with type 2 diabetes, and low blood sugar especially if semaglutide is combined with insulin or sulfonylureas

However, semaglutide is not a suitable first-line drug for diabetes that has not been controlled by diet and exercise

This step-wise dosing approach is essential for better tolerability and long-term adherence