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While metformin and lifestyle modification are the preferred first-line treatments in patients with T2DM and an elevated HbA1c, GLP-1 RAs are now a preferred second-line therapy and are even recommended first-line agents in patients with known atherosclerotic cardiovascular disease, high cardiovascular risk, or chronic kidney disease

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Understanding how these medications work is essential context for evaluating their potential effects on bone health, as both their metabolic actions and the weight loss they induce may theoretically influence bone density and skeletal integrity