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“The paradigm for treating people with obesity has often been to recommend lifestyle changes, and then if they develop diabetes or another metabolic condition, to treat them with metformin, insulin, or GLP-1 drugs,” says study senior and corresponding author Andrew Stokes, associate professor of global health

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Practical implementation considerations include: Post-meal activity : Even light walking (10-15 minutes) after meals may improve postprandial glucose levels Reducing sedentary time : Breaking up prolonged sitting with brief activity every 30 minutes Consistency over intensity : Regular moderate activity provides greater metabolic benefit than sporadic vigorous exercise Individualization : Exercise prescriptions should account for baseline fitness, comorbidities, and personal preferences to optimize adherence Special precautions are needed for those with diabetes complications, including proper footwear with neuropathy, avoiding high-impact or head-down exercises with retinopathy, and appropriate cardiovascular assessment before beginning vigorous exercise