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More serious adverse effects include pancreatitis, gallbladder disease (cholelithiasis, cholecystitis), and acute kidney injury (particularly with severe dehydration from gastrointestinal symptoms)

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Important safety considerations include risk of acute pancreatitis (seek urgent medical attention for severe, persistent abdominal pain), gallbladder disease, dehydration leading to acute kidney injury with severe gastrointestinal effects, and potential worsening of diabetic retinopathy, particularly with rapid improvement in blood glucose control

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