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570 There is also emerging evidence that lifestyle modifications either as exercise alone (supervised aerobic with or without resistance training), combined dietary modification and exercise, or other behavioral interventions may have beneficial effects on preventing DPN in some persons with T2D or prediabetes

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We specify the target trial emulation design in Supplementary Table 2

Peer Review Received June 17, 2020

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Mechanism #2: Metabolic Adaptation & Adaptive Thermogenesis (The Survival Response) Whats happening: Your body interprets caloric restriction as a threat and actively slows your metabolism to conserve energy