INS and Insulin resistance: While participants’ average baseline fasting insulin and HOMA-IR levels indicated insulin resistance, we found a significant decrease in serum insulin levels (median 3.2, IQR 0.0-5.4 μU/ml; P=.003), HOMA-IR levels (median 0.4, IQR –0.2 to 2.1 mmol/L; P=.02), and HbA1c levels (median 0.5, IQR –0.7 to 3.8 mmol/mol; P=.03) (Table 4), suggesting improved glycemic control.