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[83] [85] A 2014 case report also showed improvement in primary hypersomnia symptoms after treatment with a continuous subcutaneous flumazenil infusion

This altered ratio is associated with increased energy harvest from food, potentially exacerbating obesity (71)

If these symptoms worsen or become troublesome, contact your GP Body weight : Regular weight monitoring helps assess the effectiveness of your diabetes treatment and can identify unexpected changes Retinal screening : If you have pre-existing diabetic retinopathy, arrange appropriate monitoring as rapid improvements in blood glucose can sometimes temporarily worsen retinopathy When to seek urgent medical help: Severe, persistent abdominal pain (with or without vomiting) contact NHS 111 or seek emergency care (999) as this could indicate pancreatitis or gallbladder disease Signs of dehydration or ketosis due to persistent vomiting or diarrhoea Sudden changes in vision Symptoms of hypoglycaemia (if you are also taking insulin or sulfonylureas) Maintain open communication with your healthcare team about all aspects of your treatment, including any supplements you are taking

Microbiota-derived metabolites, including short-chain fatty acids and oxalate-degrading agents, are key mediators in these processes