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The lack of clear guidance on optimal positioning and sequencing of SGLT2is and GLP-1 RAs is, in part, due to limited direct comparative data on the two agents

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Seek immediate medical attention (call 999 or attend A&E) if you experience: Chest pain or tightness , particularly if radiating to the arm, jaw, or back (possible myocardial infarction) Sudden breathlessness or difficulty breathing , especially with chest pain or coughing up blood (possible pulmonary embolism) Sudden weakness, numbness, or paralysis affecting one side of the body, face drooping, or speech difficulties (possible stroke) Severe leg pain, swelling, warmth, or redness , particularly in one calf (possible deep vein thrombosis) Sudden severe headache unlike any previously experienced Visual disturbances , including sudden loss of vision or double vision Contact your GP or diabetes specialist nurse if you notice: Persistent or worsening leg swelling Unexplained shortness of breath on exertion New or worsening chest discomfort Concerns about your cardiovascular risk factors Patients should also be aware of common side effects of GLP-1 agonists , which are unrelated to blood clots but may cause concern

Argentina, Colombia, Chile, and Peru contribute smaller but steady increments