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routine ultrasound screening is not standard UK practice Risk-benefit discussion : Shared decision-making addressing potential adverse effects, including pancreatitis risk, balanced against substantial metabolic benefits Ongoing monitoring recommendations: Regular clinical review : Initially at 48 week intervals during dose titration, then 36 monthly once stable Symptom surveillance : Systematic enquiry about abdominal pain, nausea, vomiting, or other concerning symptoms at each consultation Indication-specific monitoring : For diabetes patients, HbA1c every 36 months as per NICE NG28