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symptoms include confusion, sweating, trembling, or loss of consciousness Changes in vision blurred vision or other visual disturbances, which may indicate worsening of pre-existing diabetic retinopathy (particularly relevant for patients with diabetes) Persistent vomiting inability to keep down fluids for more than 24 hours, leading to dehydration Depression or suicidal thoughts patients and carers should be vigilant for mood changes and seek urgent help if such symptoms occur