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Contact a healthcare provider if you notice: Persistent or worsening neuropathy symptoms, such as tingling, numbness, burning pain, or weakness New or unusual side effects, including skin rash, itching, or acne-like breakouts Possible medication interactions, especially if you take metformin, acid-reducing medications, or other long-term prescriptions Changes in neurological function, such as balance issues, confusion, memory changes, or worsening coordination Recognizing these warning signs early helps prevent complications and supports better long-term nerve health outcomes

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For the full disclaimer wording see BMJ's terms and conditions: Sheyu Li, endocrinologist, clinical chair12, Per Olav Vandvik, methodologist, internist34, Lyubov Lytvyn, methodologist5, Gordon H Guyatt, methodologist, internist56, Suetonia C Palmer, nephrologist7, Ren Rodriguez-Gutierrez, endocrinologist8910, Farid Foroutan, methodologist11, Thomas Agoritsas, methodologist, internist12, Reed A C Siemieniuk, methodologist, internist56, Michael Walsh, nephrologist, methodologist56, Lawrie Frere, general practitioner13, David J Tunnicliffe, research fellow1415, Evi V Nagler, nephrologist16, Veena Manja, cardiologist17, Bjrn Olav svold, endocrinologist1819, Vivekanand Jha, nephrologist2022, Mieke Vermandere, general practitioner23, Karim Gariani, internist12, Qian Zhao, general practitioner24, Yan Ren, endocrinologist1, Emma Jane Cartwright, UK patient editor25, Patrick Gee, patient partner26, Alan Wickes, patient partner27, Linda Ferns, patient partner27, Robin Wright, patient partner27, Ling Li, methodologist2, Qiukui Hao, geriatrician, methods chair528, Reem A Mustafa, nephrologist, methodologist, clinical chair529 1 Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, China 2 Chinese Evidence-based Medicine Center, Cochrane China Center and MAGIC China Center, West China Hospital, Sichuan University, Chengdu, China 3 University of Oslo, Oslo, Norway 4 MAGIC Evidence Ecosystem Foundation 5 Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada 6 Department of Medicine, McMaster University, Hamilton, ON, Canada 7 Department of Medicine, University of Otago, Christchurch, New Zealand 8 Plataforma INVEST Medicina UANL KER Unit (KER Unit Mxico), Subdireccin de Investigacin, Universidad Autnoma de Nuevo Len, Monterrey, 64460, Mxico 9 Knowledge and Evaluation Research Unit in Endocrinology, Mayo Clinic, Rochester, MN, 55905, USA 10 Endocrinology Division, Department of Internal Medicine, University Hospital Dr

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