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Lantus Dosage Range

Dose-response Effects Of Insulin Glargine In Type 2 Diabetes

Dose-response Effects Of Insulin Glargine In Type 2 Diabetes

Go to: Abstract To determine the pharmacokinetic and pharmacodynamic dose-response effects of insulin glargine administered subcutaneously in individuals with type 2 diabetes. Twenty obese type 2 diabetic individuals (10 male and 10 female, aged 50 ± 3 years, with BMI 36 ± 2 kg/m2 and A1C 8.3 ± 0.6%) were studied in this single-center, placebo-controlled, randomized, double-blind study. Five subcutaneous doses of insulin glargine (0, 0.5, 1.0, 1.5, and 2.0 units/kg) were investigated on separate occasions using the 24-h euglycemic clamp technique. Glargine duration of action to reduce glucose, nonessential fatty acid (NEFA), and β-hydroxybutyrate levels was close to or >24 h for all four doses. Increases in glucose flux revealed no discernible peak and were modest with maximal glucose infusion rates of 9.4, 6.6, 5.5, and 2.8 μmol/kg/min for the 2.0, 1.5, 1.0, and 0.5 units/kg doses, respectively. Glargine exhibited a relatively hepatospecific action with greater suppression (P < 0.05) of endogenous glucose production (EGP) compared with little or no increases in glucose disposal. A single subcutaneous injection of glargine at a dose of ≥0.5 units/kg can acutely reduce glucose, NEFA, and ketone body levels for 24 h in obese insulin-resistant type 2 diabetic individuals. Glargine lowers blood glucose by mainly inhibiting EGP with limited effects on stimulating glucose disposal. Large doses of glargine have minimal effects on glucose flux and retain a relatively hepatospecific action in type 2 diabetes. Type 2 diabetes is a condition of relative or absolute insulin deficiency. Consequently, insulin replacement becomes a common and essential therapy in these individuals. Insulin therapy in type 2 diabetes can range from a single injection to basal-bolus replacement r Continue reading >>

Levemir Vs. Lantus: Similarities And Differences

Levemir Vs. Lantus: Similarities And Differences

Levemir and Lantus are both long-acting injectable insulins that can be used for long-term management of diabetes. Insulin is a hormone that is naturally produced in the body by the pancreas. It helps convert the glucose (sugar) in your bloodstream into energy. This energy is then distributed to cells throughout your body. With diabetes, your pancreas produces little or no insulin or your body is unable to use the insulin correctly. Without insulin, your body can’t use the sugars in your blood and can become starved for energy. The excess sugar in your blood can also damage different parts of your body, including your blood vessels and kidneys. Everyone with type 1 diabetes and many people with type 2 diabetes must use insulin to maintain healthy blood sugar levels. Levemir is a solution of insulin detemir, and Lantus is a solution of insulin glargine. Both are basal insulin formulas. That means that they work slowly to lower your blood sugar levels. They’re both absorbed into your body over a 24-hour period. They keep blood sugar levels lowered for longer than short-acting insulins do. Although the formulations are slightly different, Levemir and Lantus are very similar drugs. There are only a few differences between them. Children and adults can use both Levemir and Lantus. Specifically, Levemir can be used by people who are 2 years or older. Lantus can be used by people who are 6 years or older. Levemir or Lantus can help with daily management of diabetes. However, you may still need to use short-acting insulin to treat spikes in your blood sugar levels and diabetic ketoacidosis (a dangerous buildup of acids in your blood). Learn more: All about diabetic ketoacidosis » Administration Both Levemir and Lantus are given through injection in the same way. You can gi Continue reading >>

Dose-response Effects Of Insulin Glargine In Type 2 Diabetes

Dose-response Effects Of Insulin Glargine In Type 2 Diabetes

Abstract OBJECTIVE To determine the pharmacokinetic and pharmacodynamic dose-response effects of insulin glargine administered subcutaneously in individuals with type 2 diabetes. RESEARCH DESIGN AND METHODS Twenty obese type 2 diabetic individuals (10 male and 10 female, aged 50 ± 3 years, with BMI 36 ± 2 kg/m2 and A1C 8.3 ± 0.6%) were studied in this single-center, placebo-controlled, randomized, double-blind study. Five subcutaneous doses of insulin glargine (0, 0.5, 1.0, 1.5, and 2.0 units/kg) were investigated on separate occasions using the 24-h euglycemic clamp technique. RESULTS Glargine duration of action to reduce glucose, nonessential fatty acid (NEFA), and β-hydroxybutyrate levels was close to or >24 h for all four doses. Increases in glucose flux revealed no discernible peak and were modest with maximal glucose infusion rates of 9.4, 6.6, 5.5, and 2.8 μmol/kg/min for the 2.0, 1.5, 1.0, and 0.5 units/kg doses, respectively. Glargine exhibited a relatively hepatospecific action with greater suppression (P < 0.05) of endogenous glucose production (EGP) compared with little or no increases in glucose disposal. CONCLUSION A single subcutaneous injection of glargine at a dose of ≥0.5 units/kg can acutely reduce glucose, NEFA, and ketone body levels for 24 h in obese insulin-resistant type 2 diabetic individuals. Glargine lowers blood glucose by mainly inhibiting EGP with limited effects on stimulating glucose disposal. Large doses of glargine have minimal effects on glucose flux and retain a relatively hepatospecific action in type 2 diabetes. Type 2 diabetes is a condition of relative or absolute insulin deficiency. Consequently, insulin replacement becomes a common and essential therapy in these individuals. Insulin therapy in type 2 diabetes can range fr Continue reading >>

Lantus (insulin Glargine) Dose, Indications, Adverse Effects, Interactions... From Pdr.net

Lantus (insulin Glargine) Dose, Indications, Adverse Effects, Interactions... From Pdr.net

Hormone secreted by pancreatic beta-cells of the islets of Langerhans and essential for the metabolism and homeostasis of carbohydrate, fat, and protein. Insulin glargine is a once-daily basal insulin analog without pronounced peaks. BASAGLAR, Lantus, Lantus SoloStar, Toujeo SoloStar BASAGLAR/Lantus/Lantus SoloStar/Toujeo SoloStar Subcutaneous Inj Sol: 1mL, 100U, 300U For the treatment of type 1 diabetes mellitus and type 2 diabetes mellitus. For the treatment of type 1 diabetes mellitus. Subcutaneous dosage (100 units/mL, i.e., Lantus, Basaglar) Initially, administer one-third of the total daily insulin requirements/dose subcutaneously once daily. Titrate dosage to achieve blood glucose control and A1C goals in conjunction with a short-acting insulin. Give the dose at the same time every day, at any time. Administration in the morning may avoid nocturnal hypoglycemia. When transferring from once daily NPH insulin, the dose is usually not changed. However, when transferring from twice-daily NPH insulin to insulin glargine, the total daily dose of NPH insulin (or other twice daily basal insulin) should be reduced by 20% and administered as single dose once daily. When transferring from once-daily Toujeo to once-daily Lantus or Basaglar, the recommended initial Lantus or Basaglar dose is 80% of the Toujeo dose that is being discontinued. Thereafter, the dosage of insulin glargine should be adjusted to response. Children and Adolescents 6 years and older Insulin requirements are highly variable and must be individualized based on patient-specific factors and type of insulin regimen. During partial remission phase, total combined daily insulin requirement is often less than 0.5 units/kg/day. Prepubertal children (outside the partial remission phase) usually require 0.7 to Continue reading >>

Lantus Dosage

Lantus Dosage

Important Administration Instructions Administer LANTUS subcutaneously once daily at any time of day but at the same time every day. Prior to initiation of LANTUS, train patients on proper use and injection technique. Patient should follow the Instructions for Use to correctly administer LANTUS. Administer LANTUS subcutaneously into the abdominal area, thigh, or deltoid, and rotate injection sites within the same region from one injection to the next to reduce the risk of lipodystrophy [see Adverse Reactions (6.1)]. Visually inspect LANTUS vials and SoloStar prefilled pens for particulate matter and discoloration prior to administration. Only use if the solution is clear and colorless with no visible particles. Do not administer intravenously or via an insulin pump. Do not dilute or mix LANTUS with any other insulin or solution. General Dosing Instructions Individualize and adjust the dosage of LANTUS based on the individual's metabolic needs, blood glucose monitoring results and glycemic control goal. Dosage adjustments may be needed with changes in physical activity, changes in meal patterns (i.e., macronutrient content or timing of food intake), during acute illness, or changes in renal or hepatic function. Dosage adjustments should only be made under medical supervision with appropriate glucose monitoring [see Warnings and Precautions (5.2)]. Initiation of LANTUS Therapy In patients with type 1 diabetes, LANTUS must be used concomitantly with short-acting insulin.The recommended starting dose of LANTUS in patients with type 1 diabetes should be approximately one-third of the total daily insulin requirements. Short-acting, premeal insulin should be used to satisfy the remainder of the daily insulin requirements. Changing to LANTUS from Other Insulin Therapies If chan Continue reading >>

Interactive Dosing Calculator

Interactive Dosing Calculator

Lantus® is a long-acting insulin analog indicated to improve glycemic control in adults and pediatric patients with type 1 diabetes mellitus and in adults with type 2 diabetes mellitus. Lantus® should be administered once a day at the same time every day. Limitations of Use: Lantus® is not recommended for the treatment of diabetic ketoacidosis. Contraindications Lantus® is contraindicated during episodes of hypoglycemia and in patients hypersensitive to insulin glargine or one of its excipients. Warnings and Precautions Insulin pens, needles, or syringes must never be shared between patients. Do NOT reuse needles. Monitor blood glucose in all patients treated with insulin. Modify insulin regimen cautiously and only under medical supervision. Changes in insulin strength, manufacturer, type, or method of administration may result in the need for a change in insulin dose or an adjustment in concomitant oral antidiabetic treatment. Do not dilute or mix Lantus® with any other insulin or solution. If mixed or diluted, the solution may become cloudy, and the onset of action/time to peak effect may be altered in an unpredictable manner. Do not administer Lantus® via an insulin pump or intravenously because severe hypoglycemia can occur. Hypoglycemia is the most common adverse reaction of insulin therapy, including Lantus®, and may be life-threatening. Medication errors, such as accidental mix-ups between basal insulin products and other insulins, particularly rapid-acting insulins, have been reported. Patients should be instructed to always verify the insulin label before each injection. Severe life-threatening, generalized allergy, including anaphylaxis, can occur. Discontinue Lantus®, treat and monitor until symptoms resolve. A reduction in the Lantus® dose may be re Continue reading >>

Calculating Insulin Dose

Calculating Insulin Dose

You'll need to calculate some of your insulin doses. You'll also need to know some basic things about insulin. For example, 40-50% of the total daily insulin dose is to replace insulin overnight. Your provider will prescribe an insulin dose regimen for you; however, you still need to calculate some of your insulin doses. Your insulin dose regimen provides formulas that allow you to calculate how much bolus insulin to take at meals and snacks, or to correct high blood sugars. In this section, you will find: First, some basic things to know about insulin: Approximately 40-50% of the total daily insulin dose is to replace insulin overnight, when you are fasting and between meals. This is called background or basal insulin replacement. The basal or background insulin dose usually is constant from day to day. The other 50-60% of the total daily insulin dose is for carbohydrate coverage (food) and high blood sugar correction. This is called the bolus insulin replacement. Bolus – Carbohydrate coverage The bolus dose for food coverage is prescribed as an insulin to carbohydrate ratio. The insulin to carbohydrate ratio represents how many grams of carbohydrate are covered or disposed of by 1 unit of insulin. Generally, one unit of rapid-acting insulin will dispose of 12-15 grams of carbohydrate. This range can vary from 6-30 grams or more of carbohydrate depending on an individual’s sensitivity to insulin. Insulin sensitivity can vary according to the time of day, from person to person, and is affected by physical activity and stress. Bolus – High blood sugar correction (also known as insulin sensitivity factor) The bolus dose for high blood sugar correction is defined as how much one unit of rapid-acting insulin will drop the blood sugar. Generally, to correct a high bloo Continue reading >>

(insulin Glargine Injection) 300 Units/ml

(insulin Glargine Injection) 300 Units/ml

Toujeo® is a long-acting human insulin analog indicated to improve glycemic control in adults with diabetes mellitus. Limitations of Use: Toujeo® is not recommended for treating diabetic ketoacidosis. Contraindications Toujeo® is contraindicated during episodes of hypoglycemia and in patients hypersensitive to insulin glargine or any of its excipients. Warnings and Precautions Toujeo® contains the same active ingredient, insulin glargine, as Lantus®. The concentration of insulin glargine in Toujeo® is 300 Units per mL. Insulin pens and needles must never be shared between patients. Do NOT reuse needles. Monitor blood glucose in all patients treated with insulin. Modify insulin regimens cautiously and only under medical supervision. Changes in insulin strength, manufacturer, type, or method of administration may result in the need for a change in insulin dose or an adjustment in concomitant oral antidiabetic treatment. Changes in insulin regimen may result in hyperglycemia or hypoglycemia. Unit for unit, patients started on, or changed to, Toujeo® required a higher dose than patients controlled with Lantus®. When changing from another basal insulin to Toujeo®, patients experienced higher average fasting plasma glucose levels in the first few weeks of therapy until titrated to their individualized fasting plasma glucose targets. Higher doses were required in titrate-to-target studies to achieve glucose control similar to Lantus®. Hypoglycemia is the most common adverse reaction of insulin therapy, including Toujeo®, and may be life-threatening. Medication errors such as accidental mix-ups between basal insulin products and other insulins, particularly rapid-acting insulins, have been reported. Patients should be instructed to always verify the insulin label bef Continue reading >>

Lantus (insulin Glargine) Side Effects

Lantus (insulin Glargine) Side Effects

What Is Lantus (Insulin Glargine)? Lantus is the brand name of insulin glargine, a long-acting insulin used to treat adults and children with type 1 diabetes mellitus and adults with type 2 diabetes mellitus to control high blood sugar. Lantus replaces the insulin that your body no longer produces. Insulin is a natural substance that allows your body to convert dietary sugar into energy and helps store energy for later use. In type 2 diabetes mellitus, your body does not produce enough insulin, or the insulin produced is not used properly, causing a rise in blood sugar. Like other types of insulin, Lantus is used to normalize blood sugar levels. Controlling high blood sugar helps prevent kidney damage, blindness, nerve problems, loss of limbs, and sexual dysfunction. Proper control of diabetes has also been shown to reduce your risk of a heart attack or stroke. Lantus is meant to be used alongside a proper diet and exercise program recommended by your doctor. Lantus is manufactured by Sanofi-Aventis. It was approved for use by the Food and Drug Administration (FDA) in 2000 as the first long-acting human insulin administered once a day with a 24-hour sugar-lowering effect. Lantus Warnings You will be taught how to properly inject this medication since that is the only way to use it. Do not inject cold insulin because this can be painful. Always wash your hands before measuring and injecting insulin. Lantus is always clear and colorless; look for cloudy solution or clumps in the container before injecting it. Do not use Lantus to treat diabetic ketoacidosis. A short-acting insulin is used to treat this condition. It is recommended that you take a diabetes education program to learn more about diabetes and how to manage it. Other medical problems may affect the use of this Continue reading >>

Lantus, Toujeo (insulin Glargine) Dosing, Indications, Interactions, Adverse Effects, And More

Lantus, Toujeo (insulin Glargine) Dosing, Indications, Interactions, Adverse Effects, And More

100 units/mL (Lantus SoloSTAR; Basaglar KwikPen; 3 mL disposable prefilled pens) 300 units/mL (Toujeo; 1.5 mL SoloStar disposable prefilled pen) 300 units/mL (Toujeo Max; 3 mL SoloStar disposable prefilled pen) Note: Recent studies have suggested that glargine-300 extends blood glucose control well beyond 24 hr Long-acting basal insulin indicated to improve glycemic control in adults with type 1 diabetes mellitus Start ~1/3 of total daily insulin dose; use remaining 2/3 of daily insulin dose on short-acting, premeal insulin Usual initial dose range: 0.2-0.4 units/kg; optimal glucose lowering effect may take 5 days to fully manifest and the first insulin glargine dose may be insufficient to cover metabolic needs in the first 24 hr of use Titrate insulin glargine per instructions, and adjust coadministered glucose-lowering therapies per standard of care See Dosing Considerations and Administration Long-acting basal insulin indicated to improve glycemic control in adults with type 2 diabetes mellitus Start 0.2 units/kg qDay; if necessary, adjust dosage of other antidiabetic drugs when starting insulin glargine to minimize the risk of hypoglycemia See Dosing Considerations and Administration Dose must be individualized based on clinical response; blood glucose monitoring is essential in all patients receiving insulin therapy Patients adjusting the amount or timing of dosage should do so only under medical supervision with appropriate glucose monitoring Titrate Toujeo dose no more frequently than every 3-4 days Use with caution in patients with visual impairment who may rely on audible clicks to dial their dose If changing from a treatment regimen with an intermediate- or long-acting insulin to a regimen with insulin glargine, the amount and timing of shorter-acting insulin Continue reading >>

Is There A Maximum Insulin Glargine (lantus) Dose?

Is There A Maximum Insulin Glargine (lantus) Dose?

Is there a maximum insulin glargine (Lantus) single-injection dose? Anecdotally, I have heard that patients receiving more than 50 units should split the dose from daily dosing to twice-daily. What’s the evidence? The question of a maximum insulin glargine dose is not straightforward because it encompasses several issues: How long does insulin glargine last? Does it ever need to be given twice-daily? Is there a difference in efficacy between daily and twice-daily insulin glargine dosing? Can you administer more than 50 units of insulin glargine as one single injection? Pharmacodynamics and Duration of Insulin Glargine In theory, insulin glargine should last a full 24 hours without a significant peak effect. Glargine forms a depot effect because it is only soluble at an acidic pH.1 In the vial (pH 4), the drug is completely soluble. Once injected, the solution is neutralized to biologic pH (7.4), which causes the insulin molecules to precipitate. These microprecipitates slowly dissolve over a 24-hour period. This slow dissolution results in a slower onset and a lack of a peak effect compared to other insulins, as shown below: Efficacy of Daily versus Twice-Daily Lantus Administration Although insulin glargine should last a full 24 hours, there is some evidence that its duration of action may be reduced to 20-23 hours, particularly following injection due to its delayed onset of activity of about 3-5 hours.2 Currently, the best estimate is that 15-30% of type-I diabetics will have pre-injection hyperglycemia and may benefit from twice-daily dosing. The idea of twice-daily dosing was explored in an 8-week, open-label crossover trial of 20 patients with type-I diabetes.2 Patients received either 100% of a pre-determined dose daily (dinner) or 50% twice-daily (breakfast an Continue reading >>

What Are The Possible Side Effects Of Insulin Glargine (lantus, Lantus Opticlik Cartridge, Lantus Solostar Pen)?

What Are The Possible Side Effects Of Insulin Glargine (lantus, Lantus Opticlik Cartridge, Lantus Solostar Pen)?

LANTUS® (insulin glargine) Injection DESCRIPTION LANTUS (insulin glargine injection) is a sterile solution of insulin glargine for subcutaneous use. Insulin glargine is a recombinant human insulin analog that is a long-acting, parenteral blood-glucose-lowering agent [see CLINICAL PHARMACOLOGY]. Insulin glargine has low aqueous solubility at neutral pH. At pH 4 insulin glargine is completely soluble. After injection into the subcutaneous tissue, the acidic solution is neutralized, leading to formation of microprecipitates from which small amounts of insulin glargine are slowly released, resulting in a relatively constant concentration/time profile over 24 hours with no pronounced peak. This profile allows oncedaily dosing as a basal insulin. LANTUS is produced by recombinant DNA technology utilizing a non-pathogenic laboratory strain of Escherichia coli (K12) as the production organism. Insulin glargine differs from human insulin in that the amino acid asparagine at position A21 is replaced by glycine and two arginines are added to the C-terminus of the B-chain. Chemically, insulin glargine is 21A-Gly-30Ba-L-Arg-3030b-L-Arg-human insulin and has the empirical formula C267H404N72O78S6 and a molecular weight of 6063. Insulin glargine has the following structural formula: LANTUS consists of insulin glargine dissolved in a clear aqueous fluid. Each milliliter of LANTUS (insulin glargine injection) contains 100 Units (3.6378 mg) insulin glargine. The 10 mL vial presentation contains the following inactive ingredients per mL: 30 mcg zinc, 2.7 mg m-cresol, 20 mg glycerol 85%, 20 mcg polysorbate 20, and water for injection. The 3 mL prefilled pen presentation contains the following inactive ingredients per mL: 30 mcg zinc, 2.7 mg m-cresol, 20 mg glycerol 85%, and water for inje Continue reading >>

Getting The Right Dosage

Getting The Right Dosage

Even for those on Lantus® for a while, it may take a little time to get to the right dose of insulin. Your doctor may change your Lantus® dose several times in the first few weeks. This is to be expected. For best results, keep taking your Lantus® as prescribed, and keep talking to your doctor. What if You Miss a Dose? Your doctor will guide you on when to take Lantus®. Ask him or her what to do if you forget to take your insulin, so you can be prepared in advance in case it ever happens. Here are a few ways to remember to take your Lantus® once-a-day: 3 Helpful Tips Make yourself a reminder If you take your Lantus® at night, it might also be a good idea to leave yourself a note on your nightstand as a way to remember. If you take it in the morning, put your supplies where you can't miss them—next to your toothbrush, for example. Keep out of reach of children. Add it to your other daily "to dos" Many people take Lantus® right after brushing their teeth in the evening or while making breakfast in the morning. Set an Alarm Some people set alarms on their wristwatches or mobile devices to remind them when to take their Lantus®. “We changed doses a couple of times when I started on Lantus®, until we found the right amount for me.” Continue reading >>

Getting High Blood Sugar Levels Under Control

Getting High Blood Sugar Levels Under Control

Getting high blood sugar levels under control Getting high blood sugar levels under control A 70-year-old man with a history of type 2 diabetes takes insulin glargine (Lantus) 100 units every morning (he is afraid of developing hypoglycemia at night) and insulin aspart (Novolog) 20 units with each meal. However his blood sugar is still around 250 mg/dL. Can the Lantus dose be increased, and if so, to what? Or should the patient be switched to insulin detemir (Levemir) twice daily? Can the dose of Levemir be greater than 100 units? What else would you suggest for this patient? If your patient's blood sugars are in the 250 range all day, he likely needs more insulin. Patients with type 2 diabetes will routinely need 1-2+ units/kg body weight per day. If he is requiring more than this, one should look for factors that might increase insulin resistance (infection, Cushing syndrome, etc.), noncompliance, or incorrect administration. (I have discovered that some patients who were supposed to be taking multiple shots of insulin per day were injecting air and not insulin!). There is no maximum dose of glargine per se, although at doses >100 units, I usually prescribe this agent b.i.d. In addition, we are finding that in some patients, Lantus seems to last only 12-18 hours, so that splitting the dose to 80 units in the morning and 30 units at bedtime would likely improve his morning/fasting blood sugars. Using insulin detemir b.i.d. at this dose would also suffice. Most patients on stable insulin regimens are taking approximately 50% as basal (glargine in this case) and 50% as bolus (mealtime aspart), so this patient likely needs an increase in his prandial doses. If, despite dosing adjustments that put him at 250-300+ units/day of insulin U-100, he is still not at goal, many d Continue reading >>

How To Adjust Your Lantus Dose

How To Adjust Your Lantus Dose

Three Parts: Recognizing When Your Dosage Should be Adjusted Testing Your Dosage Adjusting Your Dosage Community Q&A Lantus is a common type of insulin prescribed to control diabetes. How large of a dose you need depends on a lot of factors, including your body's own ability to produce insulin, your weight, your diet, your stress levels, and your level of physical activity. [1] If you suspect your dosage needs to be adjusted, you'll need to test your glucose overnight. [2] If your glucose levels are outside the recommended range, you'll need to see your doctor for an adjustment. Recognizing When Your Dosage Should be Adjusted Track any weight loss. The amount of insulin you get in each dosage of Lantus is based on a lot of factors, including how much you weigh. If you've lost or gained weight, more than 1lb (0.45kg) or 1lb (0.45kg), it might be time to adjust your dose. [3] Keep an eye on changes in your physical activity. The amount of physical activity you participate in can affect how much insulin your body produces on its own. If you begin or change a workout regimen, you might need an insulin adjustment. [4] You should also adjust your dose if you cease working out altogether. Check with your doctor to see if your diabetes has progressed. Your doctor can let you know at your initial diagnosis if they believe your diabetes might progress. If it does, and your body produces less insulin on its own, you'll need to increase your dose. Ask your doctor how frequently you should be tested to see if insulin levels have changed. [5] If you lose weight with no explanation, find that you have to urinate more frequently, have blurry vision, or feel tired all the time, your diabetes may have gotten worse. There are a few factors that can cause your diabetes to progress, includ Continue reading >>

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