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Only the combination group improved all of the following: Hemoglobin A1c (a measure of long-term blood sugar control) Insulin sensitivity (how well your body responds to insulin) Cardiorespiratory fitness (how efficiently your heart and lungs work) Bone mineral density (the strength of your bones) The medication alone did not improve fitness or bone health, and exercise alone did not improve blood sugar as much

Clinicians can better tailor advice when they know your adherence barriers, food access, and cultural preferences

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If you experience persistent mood changes, discuss these with your healthcare provider