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For those who don't improve, the options exist but accessing them on the NHS requires persistence, advocacy, and often a specialist referral

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Rather, the so-called second-meal effect has been described for fermentable fibers to modulate glycemic responses at later meals on the same or even subsequent days due to colonic fermentation and increased production of SCFAs [10, 11]

those who needed more support after 12 weeks received continued or combined care

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