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Key domains requiring structured oversight include: Pancreatitis and gallbladder disease Progression of diabetic retinopathy Severe gastrointestinal intolerance Visual loss and rare opticnerve complications Nutritional/metabolic issues with rapid weight reduction In India, where continuity of care is variable and prescribing often occurs outside endocrinology, these risks can be underrecognised or misattributed

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Semaglutide was also associated with a lower rate of inpatient, outpatient and emergency room visits compared with a DPP4i