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[DOI] [PMC free article] [PubMed] [Google Scholar] 8.Ramadani F.G., Perdana N.R., Ringoringo D.R.L

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Diabetes Care 35:12251231 Russell-Jones D, Cuddihy RM, Hanefeld M et al (2012) Efficacy and safety of exenatide once weekly versus metformin, pioglitazone, and sitagliptin used as monotherapy in drug-naive patients with type 2 diabetes (DURATION-4): a 26-week double-blind study

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Conclusion Dietary modification personalized to individual preferences and treatment goals (e.g., caloric deficits of 500 kcal/day), combined with structured physical activity (e.g., 150 minutes of moderate-to-vigorous exercise per week), produces additive benefits beyond GLP-1 therapy alone, enhancing weight loss, improving body composition, and reducing visceral fat and inflammation

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Visceral adiposity contributes to chronic low-grade inflammation through macrophage activation, altered T-cell responses, and adipokine imbalance (1922)

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