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At baseline and at weeks 8 and 12, a clinician should assess fasting insulin and HOMA-IR (the homeostasis model assessment of insulin resistance, a calculated index derived from fasting glucose and insulin), HbA1c, high-sensitivity C-reactive protein as an inflammatory marker, and body composition by DEXA scan or bioelectrical impedance

165 A meta-analysis of 13 randomized controlled trials with a total of 1,345 participants found standard medical treatment plus tinnitus retraining therapy led to higher response rates after one, three, and six months, and reduced tinnitus-related disability more than medical treatment alone

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