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Call 999 if you develop chest pain or breathlessness, which could indicate a pulmonary embolism Occur alongside significant changes in skin colour or temperature , or if there is pain when walking that improves with rest (intermittent claudication), suggesting peripheral arterial disease Present with sudden severe pain, cold or pale limb, or skin ulceration, which may indicate acute limb ischaemia requiring urgent medical attention Are accompanied by severe gastrointestinal symptoms (persistent vomiting or diarrhoea), which may lead to dehydration and electrolyte disturbances Develop suddenly after starting a new medication or changing the dose of an existing one Your GP or diabetes specialist nurse can conduct a thorough assessment, which may include: Blood tests to check electrolyte levels (sodium, potassium, magnesium, calcium), renal function, vitamin D, and HbA1c Neurological examination to assess for signs of peripheral neuropathy Vascular assessment if there are concerns about circulation, which may include ankle-brachial pressure index (ABPI) measurement Medication review to identify potential drug interactions or side effects In line with NICE guidance on diabetes management , regular monitoring and patient education are essential

doi: 10.1016/j.trsl.2020.07.008