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Seek emergency medical care (call 911) if experiencing: Seizure activity Convulsions, loss of consciousness, uncontrolled shaking, or post-event confusion Severe hypoglycemia symptoms Extreme confusion, loss of consciousness, inability to swallow, or seizure in a patient with diabetes Signs of severe dehydration Inability to urinate, extreme dizziness, rapid heartbeat, or altered mental status Severe abdominal pain Particularly if radiating to the back, which may indicate pancreatitis Allergic reactions Difficulty breathing, throat swelling, or widespread rash Contact your healthcare provider within 24 hours for: Persistent vomiting preventing medication or fluid intake for more than 24 hours, signs of dehydration (decreased urination, persistent dizziness), unexplained neurological symptoms (numbness, tingling, vision changes, severe headache), symptoms of hypoglycemia occurring frequently despite medication adjustments, or severe gastrointestinal symptoms not improving with standard management

Finally, as with other neurological subspecialties according to Shirani, there are barriers of cost, access and equity related to racial and socioeconomic differences found in patterns of GLP-1 prescription