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The recommendations, approved by voice vote, also urge continued and expanded prevention efforts such as nutrition education and physical-activity programming and call for improved coordination among agencies and managed-care organizations

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Despite these promising perspectives, no unequivocal benefits have been established since in a recent large intention-to-treat analyses, acarbose was associated with a higher risk of development of any cardiovascular event, heart failure, and ischemic stroke compared to metformin [22]

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