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Numerous clinical studies have shown that regular physical exercise can significantly improve insulin sensitivity by promoting the translocation of glucose transporter proteins to the cell membrane in skeletal muscle cells, thus enhancing glucose uptake and utilization in peripheral tissues (Liu et al., 2023)

Drug treatment varied by age in the present study and in the NASPGHAN recommendations due to expert opinion regarding low tolerability (tachycardia and increased frustration) of amitriptyline in younger children and low efficacy of cyproheptadine in older children [1]

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