doi:10.1007/s00394-020-02247-8
Patients should seek medical evaluation if they experience: Severe or persistent fatigue interfering with daily activities Inability to maintain adequate food or fluid intake Signs of dehydration (dark urine, dizziness, decreased urination) Symptoms of hypoglycemia (shakiness, confusion, sweating) Unexplained weakness or muscle pain Severe abdominal pain (possible pancreatitis) Right upper quadrant pain, fever, or yellowing of skin/eyes (gallbladder disease) Persistent vomiting or severe nausea Seek emergency care for: Severe dehydration with confusion or dizziness Severe, persistent abdominal pain Fainting or severe lightheadedness Clinicians should monitor for nutritional adequacy, assess protein intake, and consider dose adjustment if side effects significantly impair quality of life

The leaf extract and quinic acid derivatives are utilized in experiments, administering 10 mg/mL of extract components and 10 mM to diabetic mice GLUTag cells, resulting in reduced glycemia and increased GLP-1 production [19]
Vogel J, Cinatl J, Dauletbaev N, et al