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Contact your GP or diabetes specialist nurse urgently if you experience: Severe or persistent fatigue that significantly impairs daily functioning or does not improve after 4-6 weeks of stable dosing Signs of hypoglycaemia – particularly if recurrent, including trembling, confusion, sweating, or extreme tiredness (blood glucose consistently below 4mmol/L) Symptoms of dehydration – reduced urination, dark urine, dizziness upon standing, dry mouth, or persistent thirst Rapid or unintentional weight loss persisting over weeks, which may indicate excessive caloric restriction Persistent nausea or vomiting preventing adequate food or fluid intake for more than 24-48 hours New or worsening visual symptoms – including sudden vision changes, floaters, or blurred vision, especially if you have pre-existing diabetic retinopathy Right upper abdominal pain, fever or yellowing of the skin/eyes – which may indicate gallbladder problems If you're unsure whether your symptoms require urgent attention, NHS 111 can provide guidance