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Patients should avoid prolonged fasting periods and maintain a balanced diet rich in complex carbohydrates, lean proteins, and healthy fats

Given that elevations in AAs are associated with obesity and insulin resistance (30) and predict risk of T2D (31), the further reduction in AAs in patients with PBH as compared with unaffected post-surgical patients may reflect the impact of weight loss, altered nutrition, and improved insulin sensitivity to yield an exaggerated anti-diabetes metabolic state contributing to reductions in gluconeogenesis