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Wark et al

People with diabetes, kidney disease, liver disease, eating-disorder history, or who are pregnant or breastfeeding should consult a registered dietitian or physician before changing macro ratios substantially

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They work through several mechanisms that are relevant even when your pancreas no longer makes insulin: they slow gastric emptying (meaning food hits your bloodstream more gradually), suppress glucagon release (the hormone that raises blood sugar), and reduce appetite

Even moderate activity like daily walking can have meaningful impact

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