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Less common but more serious risks include: Pancreatitis, which can cause severe abdominal pain and may require stopping the medication Gallbladder problems, such as gallstones or inflammation, especially with higher doses or longer use Allergic reactions, including swelling or difficulty breathing, which need immediate medical attention Injection site reactions, such as redness or itching, with injectable forms Rare vision changes or worsening diabetic eye disease, especially when blood sugar improves rapidly Anyone with intense abdominal pain, signs of dehydration (such as dizziness or reduced urination), or unexpected vision changes should seek medical advice promptly