Association of GLP-1 receptor agonists and hepatocellular carcinoma incidence and hepatic decompensation in patients with type 2 diabetes

Contact your GP if you experience: Persistent heartburn or reflux symptoms occurring more than twice weekly despite lifestyle measures and over-the-counter treatments Difficulty or pain when swallowing (dysphagia or odynophagia), which may indicate oesophageal inflammation, stricture, or other complications Unintentional weight loss beyond your planned calorie deficit, particularly if accompanied by reduced appetite or early satiety Persistent nausea or vomiting, especially if vomit contains blood or resembles coffee grounds Symptoms that significantly impact your quality of life, sleep, or daily activities Seek urgent medical attention (call 999 or attend A&E) if you develop: Severe chest pain, particularly if radiating to the arm, neck, or jawwhilst this may be reflux, cardiac causes must be excluded urgently Difficulty breathing or sensation of food stuck in the chest Vomiting large amounts of blood or passing black, tarry stools (melaena), indicating possible gastrointestinal bleeding Your GP will assess your symptoms and may arrange initial investigations

These referral triggers align with guidance applicable to the broader GLP-1 drug class and represent prudent patient safety practice
For plots c, d, and e, point estimates are represented as circles, and horizontal bars indicate 95% confidence intervals
Suspected adverse reactions to medicines including those received in clinical trials can also be reported via the MHRA Yellow Card Scheme at yellowcard.mhra.gov.uk
We lack comprehensive tracking methods for cell fate after implantation