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This is risky for several reasons: Wrong patient selection, such as people with pancreatitis, gallstones, or severe kidney disease using them without screening Rapid, unsupervised dose escalation No monitoring of kidney, liver, pancreatic, or eye status Complications seen with unsupervised use include pancreatitis, dehydration-induced acute kidney injury (especially in hot Indian summers with vomiting or diarrhoea), and even diabetic ketoacidosis in susceptible individuals

6.45) and it has therefore been proposed as screening test for colorectal cancer in asymptomatic individuals