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Animal and human studies published in English language were included

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Contact your GP or bariatric team if you experience: Recurrent episodes of suspected hypoglycaemia Confirmed blood glucose readings below 3.0 mmol/L on home monitoring Symptoms that significantly impact daily activities or quality of life Hypoglycaemic episodes occurring during fasting or overnight (suggesting alternative diagnoses) Difficulty managing symptoms with dietary modification alone Concerns about hypoglycaemia unawareness (lack of warning symptoms) Seek urgent medical attention (call 999 or attend A&E) if: Loss of consciousness or inability to swallow safely Seizure activity Severe confusion or altered mental state Persistent hypoglycaemia despite appropriate carbohydrate intake Injury sustained during a hypoglycaemic episode Patients should inform their GP and bariatric team about hypoglycaemic episodes, as this may warrant specialist endocrinology referral