Contact your healthcare provider within 24-48 hours if: Blurry vision persists beyond 8 weeks of stable metformin therapy Vision changes worsen progressively rather than improving You experience vision disturbances along with symptoms of hypoglycemia (shakiness, sweating, confusion) or hyperglycemia (excessive thirst, frequent urination, fatigue) You have difficulty performing daily activities due to vision changes Your healthcare provider can assess whether vision changes are related to glucose fluctuations, medication effects, or underlying diabetic eye disease
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call NHS 111 or attend A&E Any new neck lump, difficulty swallowing, or persistent hoarseness seek prompt assessment to exclude thyroid pathology Changes in vision in people with diabetes seek prompt ophthalmic review For non-emergency concerns, NHS 111 can provide guidance on whether and how quickly to seek further care

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8 Concurrent therapies, such as antipsychotics or antiepileptic drugs used to treat comorbidities and/or diabetic peripheral neuropathy, add to the risk of weight gain