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It cites a 2015 meta-analysis of 14 randomised controlled trials finding consistent but modest HbA1c reductions, while noting many trials lacked rigorous controls and that publication bias toward positive findings is likely

Maintenance sessions may be suggested

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Depletion of liver Kupffer cells prevents the development of diet-induced hepatic steatosis and insulin resistance

10 While these effects have been associated with indirect mechanisms such as glucose control and weight loss, scientists have also observed that some of the anti-inflammatory effects begin before a significant reduction in adiposity is achieved