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Olanzapine Diabetes

Olanzapine Labeling Change Indicates Risk Of Hyperglycemia, Diabetes

Olanzapine Labeling Change Indicates Risk Of Hyperglycemia, Diabetes

Olanzapine Labeling Change Indicates Risk of Hyperglycemia, Diabetes March 22, 2004 Eli Lilly and Co. has notified healthcare professionals of a revision to the labeling for olanzapine (Zyprexa), describing the increased risk of hyperglycemia and diabetes in patients taking the drug. The U.S. Food and Drug Administration (FDA) has asked all manufacturers of atypical antipsychotic medications, including Lilly, to add this warning statement to drug labeling, according to an alert sent today from MedWatch, the FDA's safety information and adverse event reporting program. In addition to olanzapine, the atypical antipsychotic class includes clozapine (Clozaril; Novartis), risperidone (Risperdal; Janssen), quetiapine (Seroquel; AstraZeneca), ziprasidone (Geodon; Pfizer), and aripiprazole (Abilify; Bristol Myers Squibb and Otsuka American Pharmaceutical). According to the revised olanzapine labeling, "Hyperglycemia, in some cases extreme and associated with ketoacidosis or hyperosmolar coma or death, has been reported in patients treated with atypical antipsychotics." The revised labeling recommends that "[p]atients with an established diagnosis of diabetes mellitus who are started on atypical antipsychotics should be monitored regularly for worsening of glucose control. Patients with risk factors for diabetes mellitus (e.g., obesity, family history of diabetes) who are starting treatment with atypical antipsychotics should undergo fasting blood glucose testing at the beginning of treatment and periodically during treatment." In addition, all patients treated with atypical antipsychotics should be monitored for symptoms of hyperglycemia, including polydipsia, polyuria, polyphagia, and weakness, the labeling states. Patients who develop symptoms of hyperglycemia during treatme Continue reading >>

Sound Mind, But Sweet Blood: Olanzapine Induced Hyperglycaemia

Sound Mind, But Sweet Blood: Olanzapine Induced Hyperglycaemia

Sound mind, but sweet blood: olanzapine induced hyperglycaemia Gideon Mlawa, Rakhi Seth, Sandeep Deshmukh & Patrick Sharp Southampton General Hospital, Southampton, UK. Background: Atypical antipsychotic agents are useful in treating patients with schizophrenia and other psychoses, but may cause hyperglycaemia. Hyperglycaemia is not dose dependent and is reversible on stopping the treatment. Occurrence of diabetes after atypical antipsychotic drug administration is of major concern as patients may not recognise their symptoms, and health workers may fail to reach an early diagnosis, with major implications for morbidity and mortality. The effect and ability of various atypical antipsychotic drugs to cause diabetes is debatable. The current available evidence seems to indicate that olanzapine and clonazapine have the highest propensity to induce diabetes compared to other atypical antipsychotics. We present a case of a 37-year-old lady with advanced Huntingtons chorea who was admitted after general deterioration at home over 3 days, with loss of appetite, high temperature, worsening of chorei form movements, urinary frequency and reduced level of consciousness. On admission she was found to be in significant metabolic acidosis (pH 7.22), hyperglycaemic (glucose 73.3 mmol/l), renal failure and hypernatraemic (Na+170). Inflammatory markers were raised (WCC 23.6, CRP 42) and her urine dipstick was positive for blood, protein, glucose, and ketones. She was treated for urinary sepsis with IV antibiotics, IV fluids and insulin sliding scale. There was no family history of diabetes. She was on olanzapine 20 mg once/day started 2 years prior to admission as well as sulpiride 200 mg mornings, and 600 mg evenings. She was discharged home on insulin (Mixtard 30) 34 units morning, Continue reading >>

Zyprexa (olanzapine) Causing Diabetes....

Zyprexa (olanzapine) Causing Diabetes....

Zyprexa (olanzapine) causing diabetes.... Zyprexa (olanzapine) causing diabetes.... I have just been informed that my antipsychotic may be the culprit behind me possibly developing T2 diabetes. After a lot of research on my own, I have discovered that the antipsychotic Zyprexa has a high rate of causing diabetes in persons not prone to it. I have even found where there have been class action suits against the pharmecutical company in past years. I am now aware of the problems it can cause. I am worried that my psychiatrist might take me off of it even though it is helping me tremendously. I will have to have a long talk with her at my next appointment. Has anyone else on the forums taken an antipsychotic that has caused this type of disease? 09/14/2014 - A1c 5.8 Official from PCP, eAG 120 02/16/2015 - A1c 5.9 Official from PCP, eAG 123 02/21/2015 - A1c 6.2 w/ ReliOn A1c Test @ Home 03/24/2015 - Metformin ER 500mg 1/day added to med regimine Recent FBS 178, 150, 140, 154, 140, 140, 138, 218, still ranging 140-160 Officially Pre-Diabetic (if there is such a thing... D.D. Family Getting much harder to control D.D. Family T1 since 1985, MM Pump 2013, CGM 2015 As much as I tire of diabetes, given the choice of being Psychotic or being Diabetic, I'd take Diabetic. Sometimes the side effects are a necessary evil. My best friend's father died of a heart attack when we were in high school. He had had a severe bout with cancer several years before, and one of the life-saving medications he was given was bad news for the heart. He was well aware, as was his wife (but not his kids or anyone else, we found out years later). The drug extended his life for several years, which he lived to the fullest. It was sad that he passed away so early, but without the drug he would have passed Continue reading >>

Diabetes And Antipsychotic Drugs

Diabetes And Antipsychotic Drugs

Aust Prescr 2004;27:118-91 Oct 2004DOI: 10.18773/austprescr.2004.098 There is an increased risk of diabetes in patients with schizophrenia and this risk is elevated by some antipsychotic medications. The risk is greater with the atypical drugs clozapine and olanzapine and the low potency conventional antipsychotics than with risperidone or high potency conventional drugs. While weight gain may be a mechanism for the development of diabetes, a direct effect of these drugs on insulin action in muscle may also be an important contributor. Patients with major psychosis should be managed in the same way as other patients with diabetes, but difficulties in complying with diet, exercise and taking medication should be kept in mind. Treating cardiovascular risk factors is important. An impaired action of insulin (insulin resistance) in patients with schizophrenia was reported over 55 years ago and later confirmed in Australia. 1 The prevalence of diabetes in patients with schizophrenia was found to be higher than in the general population even before the widespread use of antipsychotic medication. The mechanisms underlying the relationship between schizophrenia and diabetes remain unknown. It is now clear that some antipsychotic medications increase the risk of diabetes in patients with schizophrenia. Rarely, this may present as diabetic ketoacidosis. The atypical medications (Table 1) have become widely used because of their lower rate of extra pyramidal adverse effects compared to older classes of medication such as the phenothiazines and the butyrophenones. However, while some of the atypical drugs are better tolerated, they also increase the incidence of diabetes. In patients younger than 40 years of age, the odds ratio for developing diabetes is 1.63 if they are taking an Continue reading >>

Atypical Antipsychotic-induced Type 2 Diabetes

Atypical Antipsychotic-induced Type 2 Diabetes

Atypical Antipsychotic-Induced Type 2 Diabetes Jennifer Berg, PharmD, Gregory Stajich, PharmD, and Martin Zdanowicz, PharmD Patients with schizophrenia and other disorders who take atypical antipsychotics should be monitored for an increased risk for diabetes. Reducing the Risk for Metabolic Disorders Begins with Choosing the Right Treatment Patients taking antipsychotic agents, and particularly those with schizophrenia, are at risk for developing more detrimental conditions that can lead to increased susceptibility to cardiovascular disease and hyperlipidemia. Since 2002, coinciding with the addition of the newer generation of atypical antipsychotic drugs, patients have also been prone to an increase in weight gain and the subsequent metabolic effects leading to a predilection to type 2 diabetes. According to the National Institute of Mental Health, in 2008, 2.4 million people in the United States were living with schizophrenia.1 Schizophrenia is a mental disorder characterized by positive symptoms like delusions, hallucinations, and disorganization of thought, and negative symptoms such as flat affect, avolition, alogia, anhedonia, and social inattention.2,3 In addition to the mental complications of the disorder, studies have shown that patients with schizophrenia are 2 to 3 times more likely to develop type 2 diabetes.4 There is not a clear understanding why schizophrenic patients are at an increased risk for developing type 2 diabetes. Schizophrenic patients have a number of risk factors for type 2 diabetes, including family history, increased body mass index (BMI), sedentary lifestyle associated with the disorder, and the use of atypical antipsychotic medications.5 In 2004, the FDA required that a warning be placed in the package inserts of all atypical antipsych Continue reading >>

Tips From Other Journals - American Family Physician

Tips From Other Journals - American Family Physician

Increased Risk of Diabetes with Olanzapine Therapy New antipsychotic medications such as olanzapine and risperidone often can effectively control schizophrenic symptoms without the extrapyramidal side effects of traditional agents. However, these newer medications are associated with metabolic changes, such as weight gain, dyslipidemia, and even cardiomyopathy, which could cause significant morbidity. Koro and colleagues studied the risk of diabetes in patients taking olanzapine and risperidone. The authors used data from the General Practice Research Database, which involved more than 400 practices in England and Wales with more than 30 million patient-years of observations. Case patients were defined as persons being treated for schizophrenia who developed diabetes within three months of the start of the study period. All new cases were verified by a search of medical records for any diagnosis of diabetes or prescription for insulin or an oral hypoglycemic agent. For each case patient, they matched six control patients by age, sex, and length of observation. All control patients were diagnosed with or being treated for schizophrenia but had no diagnosis of diabetes or record of diabetic therapy. Of 19,637 patients being treated for schizophrenia, 451 patients with new cases of diabetes were matched with 2,696 control patients. The study population consisted of equal numbers of men and women, and the average age of participants was 51 years. Olanzapine was prescribed for 970 patients (4.9 percent) and risperidone for 1,683 patients (8.6 percent). During the follow-up period (mean, 5.2 years), 451 patients developed diabetes. The incidence of diabetes in all patients with schizophrenia who were treated with antipsychotics was 4.4 per 1,000 person-years, but it was sign Continue reading >>

Olanzapine | Diabetes Forum The Global Diabetes Community

Olanzapine | Diabetes Forum The Global Diabetes Community

Diabetes Forum The Global Diabetes Community This site uses cookies. By continuing to use this site, you are agreeing to our use of cookies. Learn More. Get the Diabetes Forum App for your phone - available on iOS and Android . Find support, ask questions and share your experiences. Join the community I was diagnosed as bi-polar more than 7 years ago and put on Olazapine by my consultant. The drug company knows it causes hunger, increase in body weight, increase sugars and diabetes and can make those with a diagnosis of diabetes worse. Why are Doctors still prescribing drugs that know carry the risk of a patient getting diabetes? Why cure one problem with another? I've a friend with mental illness that has taken that same drug olazapine for many years. A few years ago he was diagnozed with diabetes type 2 and subsequently put on metformin for a while. Now he doesn't take metformin for diabetes as he controls it with diet. He needs the olazapine because he has paranoid schizophrenia and became very unwell with it, hearing voices and doing unusual things etc. His medication was changed over a few years ago to another drug(I cannot recall the name of) and he went backwards with the mental illness, hearing voices again and not sleeping at all. He was put in a psychiatric hospital for a while whereby they changed his medication back to olazapine then after a few weeks he was a bit better and after a few months became fully recovered. Point is it seems olazapine is the only drug to help his illness (despite the weight increase and diabetes factors) whereby another drug was inadequate. I'm not to sure if this answers your question but it sure says for better or worse no one is ever alone. Continue reading >>

Diabetes Risk Associated With Use Of Olanzapine, Quetiapine, And Risperidone In Veterans Health Administration Patients With Schizophrenia

Diabetes Risk Associated With Use Of Olanzapine, Quetiapine, And Risperidone In Veterans Health Administration Patients With Schizophrenia

Diabetes Risk Associated with Use of Olanzapine, Quetiapine, and Risperidone in Veterans Health Administration Patients with Schizophrenia Correspondence to Dr. Bruce L. Lambert, Department of Pharmacy Administration, University of Illinois at Chicago, 833 South Wood Street (M/C 871), Chicago, IL 60612-7231 (e-mail: [email protected] ). Search for other works by this author on: American Journal of Epidemiology, Volume 164, Issue 7, 1 October 2006, Pages 672681, Bruce L. Lambert, Francesca E. Cunningham, Donald R. Miller, Gregory W. Dalack, Kwan Hur; Diabetes Risk Associated with Use of Olanzapine, Quetiapine, and Risperidone in Veterans Health Administration Patients with Schizophrenia, American Journal of Epidemiology, Volume 164, Issue 7, 1 October 2006, Pages 672681, To evaluate risk of new-onset type 2 diabetes associated with use of selected antipsychotic agents, the authors conducted a new-user cohort study in a national sample of US Veterans Health Administration patients with schizophrenia (and no preexisting diabetes). The authors studied 15,767 patients who initiated use of olanzapine, risperidone, quetiapine, or haloperidol in 19992001 after at least 3 months with no antipsychotic prescriptions. Patients were followed for just over 1 year. New-onset diabetes was identified through diagnostic codes and prescriptions for diabetes medication. In Cox proportional hazards regression adjusting for potential confounders, with patients initiating haloperidol use designated the reference group, diabetes risk was increased equally with new use of olanzapine (hazard ratio (HR) = 1.64, 95% confidence interval (CI): 1.22, 2.19), risperidone (HR = 1.60, 95% CI: 1.19, 2.14), or quetiapine (HR = 1.67, 95% CI: 1.01, 2.76). Diabetes risks were higher in patients under age 50 y Continue reading >>

Patients On Atypical Antipsychotic Drugs

Patients On Atypical Antipsychotic Drugs

Patients with schizophrenia are more likely than the general population to develop diabetes, which contributes to a high risk of cardiovascular complications; individuals with schizophrenia are two to three times more likely to die from cardiovascular disease than the general population. The risk of diabetes, and hence cardiovascular disease, is particularly increased by some of the new atypical antipsychotic drugs. Individuals taking an atypical antipsychotic drug, particularly younger patients under 40 years of age (odds ratio 1.63, 95% CI 1.23–2.16), represent an underrecognized group at high risk of type 2 diabetes. The mechanisms responsible for antipsychotic-induced diabetes remain unclear. Hypotheses include these drugs’ potential to cause weight gain, possibly through antagonism at the H1, 5-HT2A, or 5-HT2C receptors. Other mechanisms independent of weight gain lead to elevation of serum leptin and insulin resistance. Patients with psychoses have difficulties with diet and lifestyle interventions for diabetes and weight management. If hyperglycemia develops, withdrawal from antipsychotic medication will often be inappropriate, and a change to an atypical antipsychotic drug with lower diabetogenic potential should be considered, especially in younger patients. Management of psychoses should routinely include body weight and blood glucose monitoring and steps to promote exercise and minimize weight gain. Careful collaboration between the psychiatric and diabetology teams is essential to minimize the risk of diabetes in patients taking atypical antipsychotic medication and for effective management when it develops. This collaboration will also help minimize the already high risk of cardiovascular disease in individuals with schizophrenia. IS THERE A LINK BETWEE Continue reading >>

Zyprexa And Diabetes

Zyprexa And Diabetes

Zyprexa (olanzapine) is an atypical antipsychotic used to treat emotional and neurologic conditions such as bipolar disorder and schizophrenia. Like any other medication, Zyprexa is not free of side effects. Aside from bothersome reactions, this medication can also cause a few side effects that should be taken seriously. Diabetes is one of these. Studies show that atypical antipsychotic medications, including Zyprexa, may increase the risk of diabetes. These medications can also worsen preexisting diabetes. Clinical studies show that between 1 in every 100 and 1 in every 1,000 users of Zyprexa developed diabetes. Post-marketing studies have shown several cases of abnormally high blood sugar (hyperglycemia) which has even led to coma or death. How Zyprexa causes diabetes is not entirely clear although there are several factors that can probably contribute to the development of diabetes in patients taking Zyprexa. Some studies suggest that people with schizophrenia are generally at increased risk of developing diabetes, regardless of the medication they currently take. The average diet and lifestyle of these patients put them at increased the risk of diabetes. It is also thought that the biochemical changes caused by atypical antipsychotic medications predispose users to diabetes. Zyprexa may have direct effects on the bodys insulin production, though the exact mechanism remains unknown. Perhaps, this is also the reason behind weight gain caused by Zyprexa . A recent study also shows that young children and adolescents using Zyprexa are at higher risk of developing diabetes and weight gain. These factors all contribute to the incidence of diabetes among patients using Zyprexa. For people with undiagnosed diabetes, Zyprexa can worsen the condition. Patients who are at hig Continue reading >>

Lilly Adds Strong Warning Label To Zyprexa, A Schizophrenia Drug

Lilly Adds Strong Warning Label To Zyprexa, A Schizophrenia Drug

Business Day |Lilly Adds Strong Warning Label to Zyprexa, a Schizophrenia Drug Eli Lilly yesterday added strong warnings to the label of Zyprexa, its best-selling medicine for schizophrenia , citing the drugs tendency to cause weight gain, high blood sugar, high cholesterol and other metabolic problems. For the first time, Zyprexas label now acknowledges that the drug causes high blood sugar more than some other medicines for schizophrenia and bipolar disorder , called atypical antipsychotics. Lilly previously argued that Zyprexa had not been proved to cause high blood sugar at a more frequent rate than its competitors. Concern about Zyprexas side effects has been increasing since at least 2004, and Zyprexas prescriptions and market share have fallen sharply over the period. As a result, the new warnings may have only a moderate impact among doctors and patients, said S. Nassir Ghaemi, director of the Bipolar Disorder Research Program at Emory University. The new label will also indicate that patients who take Zyprexa may keep gaining weight for as long as two years after starting therapy. That contradicts earlier public statements by Lilly that weight gain on Zyprexa tends to plateau after a few months of use. One in six patients who take Zyprexa will gain more than 33 pounds after two years of use, the label says. Weight gain and high blood sugar are risk factors for diabetes , although Lilly says there has been no proof that Zyprexa causes diabetes more than its competitors do. Obviously, we know that weight gain is a known risk factor for diabetes, said Marni Lemons, a Lilly spokeswoman. However, not all patients who gain weight develop diabetes. Ms. Lemons also noted that older antipsychotic medicines also have severe side effects, including a tendency to cause fa Continue reading >>

New-onset Diabetes And Ketoacidosis In A Patient Treated With Olanzapine

New-onset Diabetes And Ketoacidosis In A Patient Treated With Olanzapine

New-Onset Diabetes and Ketoacidosis in a Patient Treated with Olanzapine Henry L. McCurtis, MD, Charles U. Nnadi, MD, MS, and Olukayode O. Awosika, MD Several case reports published since the introduction of atypical antipsychotics suggest an association between these medications and both new-onset diabetes mellitus and diabetic ketoacidosis. The latter is a potentially life threatening medical emergency. We report the case of a 41-year-old African American woman with schizophrenia who developed type 2 diabetes and ketoacidosis 7 months after commencing olanzapine therapy. This case adds to the evidence in the literature that patients who develop ketoacidosis while taking antipsychotic medications tend to be female and relatively young, a disproportionate number of whom are African American. The frequency of these reports suggests that clinicians should monitor serum glucose levels periodically in all patients treated with atypical antipsychotics, particularly in those at increased risk for diabetes. Henry L. McCurtis, MD, Assistant Professor of Clinical Psychiatry; Charles U. Nnadi, MD, MS; Assistant Clinical Professor of Psychiatry; Olukayode O. Awosika, MD, Chief Resident, College of Physicians and Surgeons, Columbia University, Harlem Hospital Center, Department of Psychiatry, New York, NY A 41-year-old single African American woman with no history of diabetes mellitus was diagnosed with schizophrenia (paranoid type) in 1997. She started attending the psychiatric mental health clinic as an outpatient in 2001. Her medical history included peptic ulcer disease, obesity, dyslipidemia, hypertension, and a family history of diabetes (ie, mother and older sister). She smoked 3 cigarettes daily for the past 5 years. The patient was initially maintained on 4 mg/day of risp Continue reading >>

The Trouble With Zyprexa

The Trouble With Zyprexa

Home Psych Central Professional The Trouble with Zyprexa Zyprexa (olanzapine) became rapidly popular after its introduction in the United States in 1996. Its structural similarity to Clozaril (clozapine) led to hopes that it would be as effective for treatment-resistant cases as Clozaril but without the risk of agranulocytosis. It quickly proved itself as an effective agent for both schizophrenia and bipolar mania. In sales, it surpassed Risperdal, which had been released two years earlier. Unfortunately for Lilly, several significant side effect issues have emerged, and over the last year controlled studies have been giving clinicians second thoughts about prescribing Zyprexa at all. For example, a recent article in Archives of General Psychiatry included this rather astonishing caveat: The potential cardiovascular consequences of olanzapine therapy, and its association with the metabolic syndrome, warrant serious consideration of its risk-benefit ratio by treating physicians. (1) What is going on here? Is this is a sober assessment of the real risks of prescribing Zyprexa? Or is it an alarmist over-reaction based on one research groups ax-grinding? In this article I will apply the TCR magnifying glass to the data, claims, and counterclaims, and end up with something useful for you to apply to your practice. Wish me luck. Weight. Does Zyprexa cause weight gain? Theres little controversy here. Even Lilly reps agree that Zyprexa causes more weight gain than its firstline atypical peers (by first line atypicals I mean all those atypicals other than Clozaril, which is considered second-line because of its agranulocytosis risk). The most widely cited study documenting this effect is a meta-analysis written by Allison and colleagues (2), which includes a nice chart comparin Continue reading >>

What Is The Percentage Of People Who Get Diabetes While Taking Zyprexa?

What Is The Percentage Of People Who Get Diabetes While Taking Zyprexa?

Home Q & A Questions What is the percentage of... What is the percentage of people who get Diabetes while taking Zyprexa? lamictal , zyprexa , depression , bipolar disorder , anxiety , benzodiazepine withdrawal , insomnia , obsessive compulsive disorder , panic disorder , restless legs syndrome , periodic limb movement disorder , clonazepam , hydroxyzine , fear My doctor has just started me on 10 mg of Zyprexa and my biggest fear is getting Diabetes. I am Bi Polar and also take 100 mg Lamictal .5 mg Clonazepam 25 mg Hydroxyzine Pamoate. I am 65 years old and have been diaganosed with Bi Polar II at age 45. Since then I have been struggling with finding the right medication for my depression. While Zyprexa is considered safer than its predecessors like Haldol, it still has side effects that you need to be aware of. The extensive info that I found includes the following: Physicians should consider the risks and benefits when prescribing olanzapine to patients with an established diagnosis of diabetes mellitus, or having borderline increased blood glucose level (fasting 100-126 mg/dL, non-fasting 140-200 mg/dL). Patients taking olanzapine should be monitored regularly for worsening of glucose control. Patients starting treatment with olanzapine should undergo fasting blood glucose testing at the beginning of treatment and periodically during treatment. Any patient treated with atypical antipsychotics should be monitored for symptoms of hyperglycemia including polydipsia, polyuria, polyphagia, and weakness. Patients who develop symptoms of hyperglycemia during treatment with atypical antipsychotics should undergo fasting blood glucose testing. In some cases, hyperglycemia has resolved when the atypical antipsychotic was discontinued; however, some patients required continu Continue reading >>

Can Olanzapine Make You Diabetic?

Can Olanzapine Make You Diabetic?

Olanzapine is an atypical antipsychotic that has been widely used because of its better clinical efficacy, superior activity against negative symptoms, lesser extra-pyramidal symptoms, and better tolerability profile compared to typical antipsychotics. Recently, a flurry of reports have stated that olanzapine is associated with high blood sugar levels in new onset or pre-existing diabetes mellitus and ketoacidosis, which may be reversible after discontinuation of olanzapine. The exact cause of glucose dysregulation by olanzapine is not clear. It has been hypothesized that 5-HT1 antagonism may decrease the responsiveness of the pancreatic beta cells, thus reducing the secretion of insulin and causing hyperglycemia. In vivo studies suggest that olanzapine impairs glycogen synthesis via inhibition of the classical insulin signaling cascade and this inhibitory effect may lead to the induction of insulin resistance in olanzapine-treated patients. Since olanzapine is becoming more and more popular as a first line agent in the treatment of psychosis as well as in mood disorders, proper guidelines have to be established for monitoring blood glucose levels and determination of risk factors for diabetes mellitus. Hence, it is very important for clinicians that all patients started on olanzapine require regular monitoring of their blood sugar levels. Clinicians should take at most precaution in pre-existing diabetic patients before starting olanzapine. If olanzapine is suspected to being a causal factor for hyperglycemia, we can reduce that risk by withdrawal of olanzapine or switching over to some other medicines without worsening the psychiatric condition of patient. India being a diabetes rich country; the author strongly suggests at least a baseline survey should be undertaken Continue reading >>

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