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Other notable adverse effects include: Fatigue (common), which may relate to dietary changes, improved metabolic control, or medication effects Gallbladder disorders including cholelithiasis and cholecystitis (uncommon but important) Pancreatitis (rare but serious)patients should seek immediate medical attention for severe, persistent abdominal pain Diabetic retinopathy complications patients with pre-existing retinopathy and rapid improvement in blood glucose control may be at increased risk

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645 Protoplasmic (but not fibrous) astrocytes protect against -synuclein toxicity by removing this latter through endocytosis, 646,647 and hence astrocytic atrophy reduces neuroprotection

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