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Oral Medication For Type 2 Diabetes

New Type 2 Diabetes Medications

New Type 2 Diabetes Medications

Even if you can manage your diabetes now by just eating well and being active, you may need medication someday. We've come far since the 1920s, when insulin was first used to treat diabetes. There's no magic pill yet, but you have more options than ever before to help control your blood sugar. And more are coming. Most type 2 diabetes drugs work by helping your body make insulin or use it better. Some new medicines are different because they don't have anything to do with insulin. Your kidneys try to keep glucose, a kind of sugar your cells use for energy, out of your pee. Proteins called sodium-glucose transporters (SGLTs) help your kidneys keep glucose in your blood instead of your pee. But with type 2 diabetes, if your blood sugar level is already creeping up, you don't need the glucose in your body. Pills known as SGLT2 inhibitors turn off one of those proteins so that you pee it out instead. Canagliflozin (Invokana) Dapagliflozin (Farxiga) Empagliflozin (Jardiance) These drugs have some extra benefits, says John B. Buse, MD, PhD, director of the Diabetes Care Center at the University of North Carolina at Chapel Hill. "You're losing calories through urine, so there is weight loss -- usually about 5 to 10 pounds in 6 to 12 months." When you take them, you lose a little bit of salt, too, which can help with your blood pressure. These drugs aren't perfect, he says. "The downside is that, because there is sugar in your nether regions, women have a higher risk of yeast infections, and uncircumcised men can get foreskin infections." To avoid the risk of dehydration, Buse says that elderly people with kidney disease and people who are taking diuretics, pills that make you pee out extra water, shouldn't take SGLT2 inhibitors. Another downside in taking SGLT2 inhibitors is t Continue reading >>

Pharmacologic Treatment Of Type 2 Diabetes: Oral Medications.

Pharmacologic Treatment Of Type 2 Diabetes: Oral Medications.

Pharmacologic treatment of type 2 diabetes: oral medications. Chalmers P. Wylie Veterans Affairs Ambulatory Care Center, Columbus, OH, USA [email protected] Chalmers P. Wylie Veterans Affairs Ambulatory Care Center, Columbus, OH, USA. Ann Pharmacother. 2015 May;49(5):540-56. doi: 10.1177/1060028014558289. Epub 2015 Feb 9. OBJECTIVE: To review the oral and injectable pharmacologic treatment options for type 2 diabetes. DATA SOURCES: A literature search was conducted using PubMed electronic database for studies published in English between 1993 and September 2014. Search terms included diabetes mellitus, type 2 diabetes, and the individual name for each antidiabetic medication reviewed. In addition, manual searches were performed for cross-references from publications. Package inserts, United States Food and Drug Administration (FDA) Web site, Institute for Safe Medication Practices Web site, American Diabetes Association Web site and scientific session poster presentations, and individual drug company Web pages were also reviewed. STUDY SELECTION AND DATA EXTRACTION: This review focused on information elucidated over the past 10 years to assist prescribers in choosing optimal therapy based on individual patient characteristics. Studies leading to the approval of or raising safety concerns for the antidiabetic medications reviewed in this article were included. DATA SYNTHESIS: In the past 10 years, there have been 4 novel oral antidiabetic medication classes and 9 new injectable agents and insulin products approved by the FDA for the treatment of type 2 diabetes as well as new information regarding the safety and use of several older antidiabetic medication classes. The distinctions were reviewed for each individual agent, and a comparison was completed if there was mo Continue reading >>

Oral Pharmacologic Treatment Of Type 2 Diabetes Mellitus: A Clinical Practice Guideline Update From The American College Of Physicians Free

Oral Pharmacologic Treatment Of Type 2 Diabetes Mellitus: A Clinical Practice Guideline Update From The American College Of Physicians Free

Abstract Description: The American College of Physicians (ACP) developed this guideline to present the evidence and provide clinical recommendations on oral pharmacologic treatment of type 2 diabetes in adults. This guideline serves as an update to the 2012 ACP guideline on the same topic. This guideline is endorsed by the American Academy of Family Physicians. Methods: This guideline is based on a systematic review of randomized, controlled trials and observational studies published through December 2015 on the comparative effectiveness of oral medications for type 2 diabetes. Evaluated interventions included metformin, thiazolidinediones, sulfonylureas, dipeptidyl peptidase-4 (DPP-4) inhibitors, and sodium–glucose cotransporter-2 (SGLT-2) inhibitors. Study quality was assessed, data were extracted, and results were summarized qualitatively on the basis of the totality of evidence identified by using several databases. Evaluated outcomes included intermediate outcomes of hemoglobin A1c, weight, systolic blood pressure, and heart rate; all-cause mortality; cardiovascular and cerebrovascular morbidity and mortality; retinopathy, nephropathy, and neuropathy; and harms. This guideline grades the recommendations by using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) system. Target Audience and Patient Population: The target audience for this guideline includes all clinicians, and the target patient population includes adults with type 2 diabetes. Recommendation 1: ACP recommends that clinicians prescribe metformin to patients with type 2 diabetes when pharmacologic therapy is needed to improve glycemic control. (Grade: strong recommendation; moderate-quality evidence) Recommendation 2: ACP recommends that clinicians consider adding either a Continue reading >>

Best Treatments For Type 2 Diabetes

Best Treatments For Type 2 Diabetes

At-a-glance Six classes of oral medicines (and 12 individual drugs) are now available to help the 25.8 million people in the U.S. with type 2 diabetes control their blood sugar when diet and lifestyle changes are not enough. Our evaluation of these medicines found the following: Newer drugs are no better. Two drugs from a class called the sulfonylureas and a drug named metformin have been around for more than a decade and work just as well as newer medicines. Indeed, several of the newer drugs, such as Januvia and Onglyza, are less effective than the older medications. Newer drugs are no safer. All diabetes pills have the potential to cause adverse effects, both minor and serious. The drugs’ safety and side effect “profiles” may be the most important factor in your choice. The newer drugs are more expensive. The newer diabetes medicines cost many times more than the older drugs. Taking more than one diabetes drug is often necessary. Many people with diabetes do not get enough blood sugar control from one medicine. Two or more may be necessary. However, taking more than one diabetes drug raises the risk of adverse effects and increases costs. Taking effectiveness, safety, adverse effects, dosing, and cost into consideration, we have chosen the following as Consumer Reports Best Buy Drugs if your doctor and you have decided that you need medicine to control your diabetes: Metformin and Metformin Sustained-Release — alone or with glipizide or glimepiride Glipizide and Glipizide Sustained-Release — alone or with metformin Glimepiride — alone or with metformin These medicines are available as low-cost generics, costing from $4 to $35 a month. If you have been diagnosed with diabetes, we recommend that you try metformin first unless it's inappropriate for your hea Continue reading >>

Type 2 Diabetes Oral Medications

Type 2 Diabetes Oral Medications

Some people with type 2 diabetes need medications to help control blood glucose levels. Medications are prescribed by a physician should be used in conjunction with eating well and exercising as a way to better manage type 2 diabetes. Oral Diabetes Medications The following classes of oral medications work in different ways to help treat diabetes by lowering blood glucose levels:1,2,3* • Alpha-glucosidase inhibitors • Biguanides • Bile acid sequestrants • DPP-4 inhibitors • Meglitinides • SGLT2 inhibitors • Sulfonylureas • Thiazolidinediones. Combination Therapy The goal for medication therapy of type 2 diabetes is generally an HbA1c of less than 7%.1 However, your health care provider will determine your HbA1c goal based on individual factors. Used alone, oral drugs generally lower HbA1c by less than 2%.1 Your healthcare provider may consider a combination therapy, usually comprised of metformin and one of these six treatment options: a sulfonylurea, thiazolidinedione, DPP-4 inhibitor, SGLT2 inhibitor, GLP-1 receptor agonist, or basal insulin.123 Which medications you wind up using depends on your preference, medical history, and will take the goal of reducing blood glucose levels while minimizing side effects into consideration. Here's an overview of each class of oral diabetes medications, along with info on how the class of drugs works; the generic and brand name drugs within the class; possible side effects; possible additional benefits; suggested dosing schedule, and a cost category. Alpha-Glucosidase Inhibitors What they do: block the breakdown of carbohydrates into sugar and slow glucose absorption. Names: acarbose (Precose); miglitol (Glyset). Possible side effects: gastrointestinal (flatulence, diarrhea). Possible additional benefits: slow the Continue reading >>

Diabetes Medicines You Don’t Inject

Diabetes Medicines You Don’t Inject

When you think about diabetes drugs, you may think of insulin or other medications that you get from a shot or a pump. But there are others that you take as a pill or that you inhale. Your doctor will consider exactly what you need, which may include more than one type of diabetes medicine. The goal is to get your best blood sugar control, and the oral drugs do that in several ways. How it works: Blocks enzymes that help digest starches, slowing the rise in blood sugar. It belongs to a group of drugs called “alpha-glucosidase inhibitors.” Side effects for these kinds of drugs include stomach upset (gas, diarrhea, nausea, cramps). Alogliptin (Nesina) How it works: Boosts insulin levels when blood sugars are too high, and tells the liver to cut back on making sugars. Your doctor may call this type of drug a “DPP-IV inhibitor.” These drugs do not cause weight gain. You may take them alone or with another drug, like metformin. Bromocriptine mesylate (Cycloset, Parlodel) How it works: This tablet raises the level of dopamine, a brain chemical. It’s approved help improve blood sugar control in adults with type 2 diabetes, along with diet and exercise. It’s not used to treat type 1 diabetes. Canagliflozin (Invokana) How it works: Boosts how much glucose leaves your body in urine, and blocks your kidney from reabsorbing glucose. Your doctor may call this type of drug a “SGLT2 inhibitor.” Side effects can include: Urinary tract infections Dizziness, fainting Ketoacidosis or ketosis Increased risk of bone fracture Decreased bone mineral density Chlorpropamide (Diabinese) How it works: Lowers blood sugar by prompting the pancreas to release more insulin. Your doctor may call this type of drug “sulfonylureas.” This drug is not used as often as newer sulfonylurea Continue reading >>

Table Of Medications

Table Of Medications

Medications used to treat type 2 diabetes include: Use this table to look up the different medications that can be used to treat type 2 diabetes. Use the links below to find medications within the table quickly, or click the name of the drug to link to expanded information about the drug. Table of oral medications, incretion-based therapy and amylin analog therapy: Medicine FDA Approval Formulations (color indicated if available by Brand only) Dosing Comments (SE = possible side effects) STIMULATORS OF INSULIN RELEASE (Insulin Secretagogues) – increase insulin secretion from the pancreas1 SULFONYLUREAS (SFUs) Tolbutamide Orinase® various generics 1957 500 mg tablets Initial: 1000-2000 mg daily Range: 250-3000 mg (seldom need >2000 mg/day) Dose: Taken two or three times daily SE: hypoglycemia, weight gain Preferred SFU for elderly Must be taken 2-3 times daily Glimepiride Amaryl® various generics 11/95 1 mg, 2 mg, 4 mg tablets Initial: 1-2 mg daily Range: 1-8 mg Dose: Taken once daily SE: hypoglycemia, weight gain Need to take only once daily Glipizide Glucotrol® Glucotrol XL® various generics 5/84 4/94 5 mg, 10 mg tablets ER: 2.5 mg, 5 mg, 10 mg tablets Initial: 5 mg daily Range: 2.5-40 mg2 (20 mg for XL) Dose: Taken once or twice (if >15 mg) daily SE: hypoglycemia, weight gain Preferred SFU for elderly ER = extended release/take once a day Glyburide Micronase®, DiaBeta® various generics 5/84 1.25 mg, 2.5 mg, 5 mg tablets Initial: 2.5-5 mg daily Range: 1.25-20 mg2 Dose: Taken once or twice daily SE: hypoglycemia, weight gain Glyburide, micronized Glynase PresTab® various generics 3/92 1.5 mg, 3 mg, 4.5 mg, 6 mg micronized tablets Initial: 1.5-3 mg daily Range: 0.75-12 mg Dose: Taken once or twice (if >6 mg) daily SE: hypoglycemia, weight gain GLINIDES Repaglini Continue reading >>

Oral Diabetes Medications Summary Chart

Oral Diabetes Medications Summary Chart

What Oral Medications Are Available for Type 2 Diabetes? Type 2 diabetes results when the body is unable to produce the amount of insulin it needs to convert food into energy or when it is unable to use insulin appropriately. Sometimes the body is actually producing more insulin than is needed by a person to keep blood glucose in a normal range. Yet blood glucose remains high, because the body's cells are resistant to the effects of insulin. Physicians and scientists believe that type 2 diabetes is caused by many factors, including insufficient insulin and insulin resistance. They increasingly believe that the relative contribution each factor makes toward causing diabetes varies from person to person. It is important to know the name of your diabetes medicine (or medicines), how it is taken, the reasons for taking it and possible side-effects. Diabetes Pills How to Take How They Work Side Effects Of Note Biguanides Metformin (Glucophage) Metformin liquid ( Riomet) Metformin extended release (Glucophage XR, Fortamet, Glumetza) Metformin: usually taken twice a day with breakfast and evening meal. Metformin extended release: usually taken once a day in the morning. Decreases amount of glucose released from liver. Bloating, gas, diarrhea, upset stomach, loss of appetite (usually within the first few weeks of starting). Take with food to minimize symptoms. Metformin is not likely to cause low blood glucose. In rare cases, lactic acidosis may occur in people with abnormal kidney or liver function. Always tell healthcare providers that it may need to be stopped when you are having a dye study or surgical procedure. Sulfonylureas Glimepiride (Amaryl) Glyburide (Diabeta, Micronase) Glipizide (Glucotrol, Glucotrol XL) Micronized glyburide (Glynase) Take with a meal once or twice Continue reading >>

Diabetes Medication - Guides And Information

Diabetes Medication - Guides And Information

Tweet Diabetes medications are a common form of treatment for people with diabetes. There are many different types of diabetes medicines, or anti-diabetic drugs, and this includes insulin, which has its own area within the site. Whilst each drug is unique in the way it works to help patients with diabetes keep their condition under control, some act similarly to one other and are grouped in the same class of drugs. The way in which they are administered can also differ, with some medicines taken orally and others injected directly into the blood. Are diabetes drugs suitable for all diabetics? Most diabetes drugs are designed for people with type 2 diabetes who are unable to control their blood sugar levels through strict diet and exercise alone. But some, such as metformin, are sometimes taken alongside insulin treatment for people with type 1 diabetes. Medication guides Explore the 18 most common medications for diabetes: Assists insulin in controlling post-meal glucose levels. Can more than one drug be taken at the same time? Depending on individual circumstances, a GP may prescribe more than one anti-diabetic drug to help treat a patient’s diabetes. Watch the video below for more information on the types of diabetes medication available. What are the side effects of anti-diabetic medicines? As with any type of medication, blood glucose-lowering drugs can have a number of side effects. These potentially harmful effects are listed in the patient information leaflet that accompanies the medication, so make sure you check this before starting your drug treatment. You may not experience any of the adverse effects listed, but if you do, consult your doctor and/or diabetes care team as they may be able to suggest another suitable medication for your condition. They will a Continue reading >>

Understanding Oral Diabetes Medications

Understanding Oral Diabetes Medications

by Gail Brashers-Krug Today, almost 21 million Americans have diabetes, and more than 90 percent of those have type 2, or insulin resistant diabetes. Doctors often prescribe oral medications to treat type 2 diabetes, either alone or combination with insulin therapy. This article provides a guide to those oral medications. Which Diabetics Use Pills? With a few exceptions, diabetes comes in two types. Type 1 diabetes occurs when the body does not produce enough insulin on its own. To treat type 1, you must restore the proper amount of insulin—either by taking insulin (through injection or inhalation), or by receiving a transplant, either of an entire pancreas or of specialized pancreas cells, called islet cells. Type 1 cannot be treated with oral medications. Type 2 diabetes occurs when the body produces enough insulin, but gradually becomes insulin resistant—that is, loses the ability to process insulin. Type 2 is usually controlled first through diet and exercise, which improve your body’s ability to process its insulin. For most type 2 diabetics, however, diet and exercise changes are not enough. The next step is oral diabetes medication. Moreover, most type 2 diabetics eventually stop producing enough insulin, and often cease insulin production altogether. As a result, many type 2 diabetics will ultimately need insulin therapy in combination with their pills. How Do the Different Pills Work? Oral diabetes medications attack the problem in three ways. More insulin: Some pills stimulate your pancreas to produce more insulin. The first successful “diabetes pills” were the sulfonylureas (glyburide, glipizide, glimepiride, tolazamide, chlorpropamide, and tolbutamide). These are insulin secretagogues, that is, chemicals that cause your pancreas to produce more ins Continue reading >>

Type 2 Oral Diabetes Medications Side Effects, Differences, And Effectiveness

Type 2 Oral Diabetes Medications Side Effects, Differences, And Effectiveness

What are the types of oral diabetes medications? Currently, there are nine drug classes of oral diabetes medications approved for the treatment of type 2 diabetes. α-glucosidase inhibitors Biguanides Sulfonylureas Meglitinides Thiazolidinediones DPP-4 inhibitors Sodium-glucose cotransporter (SGLT)-2 inhibitors These medications differ in the way they function in the body to reduce blood glucose. Metformin (Glucophage) is the only biguanide available in the United States and is generally the first choice for oral treatment of type 2 diabetes mellitus. Metformin improves Sulfonylureas are the oldest classes of oral diabetes medications. Sulfonylureas work primarily by stimulating the release of insulin. Insulin is the hormone responsible for regulating blood glucose by increasing the uptake of blood glucose by tissues and increasing storage of glucose in the liver. Meglitinides and sulfonylureas have a similar mechanism of action. Meglitinides are short acting glucose lowering medications. They stimulate the secretion of insulin from the pancreas. Thiazolidinediones enhance insulin sensitivity meaning that the effect of a given amount of insulin is greater. Thiazolidinediones also are referred to as peroxisome proliferator-activated receptor ? or PPAR-? agonists. α-glucosidase inhibitors delay the digestion and absorption of starch or carbohydrates by inhibiting enzymes in the small intestine which help breakdown these molecules. The starches and carbohydrates are broken down into glucose, which then is absorbed from the intestine and increases the level in the blood. DPP-4 inhibitors help lower blood glucose by increasing the production of insulin from the pancreas and reducing the release of glucose from the liver. SGLT2 inhibitors or sodium-glucose cotransporter 2 in Continue reading >>

Type 2 Diabetes

Type 2 Diabetes

Print Diagnosis To diagnose type 2 diabetes, you'll be given a: Glycated hemoglobin (A1C) test. This blood test indicates your average blood sugar level for the past two to three months. It measures the percentage of blood sugar attached to hemoglobin, the oxygen-carrying protein in red blood cells. The higher your blood sugar levels, the more hemoglobin you'll have with sugar attached. An A1C level of 6.5 percent or higher on two separate tests indicates you have diabetes. A result between 5.7 and 6.4 percent is considered prediabetes, which indicates a high risk of developing diabetes. Normal levels are below 5.7 percent. If the A1C test isn't available, or if you have certain conditions — such as if you're pregnant or have an uncommon form of hemoglobin (known as a hemoglobin variant) — that can make the A1C test inaccurate, your doctor may use the following tests to diagnose diabetes: Random blood sugar test. A blood sample will be taken at a random time. Blood sugar values are expressed in milligrams per deciliter (mg/dL) or millimoles per liter (mmol/L). Regardless of when you last ate, a random blood sugar level of 200 mg/dL (11.1 mmol/L) or higher suggests diabetes, especially when coupled with any of the signs and symptoms of diabetes, such as frequent urination and extreme thirst. Fasting blood sugar test. A blood sample will be taken after an overnight fast. A fasting blood sugar level less than 100 mg/dL (5.6 mmol/L) is normal. A fasting blood sugar level from 100 to 125 mg/dL (5.6 to 6.9 mmol/L) is considered prediabetes. If it's 126 mg/dL (7 mmol/L) or higher on two separate tests, you have diabetes. Oral glucose tolerance test. For this test, you fast overnight, and the fasting blood sugar level is measured. Then you drink a sugary liquid, and blood s Continue reading >>

Oral Diabetes Medications

Oral Diabetes Medications

Oral diabetes medicines (taken by mouth) help control blood sugar (glucose) levels in people whose bodies still produce some insulin, such as some people with type 2 diabetes. These medicines are prescribed along with regular exercise and changes in the diet. Many oral diabetes medications may be used in combination with each other or with insulin to achieve the best blood glucose control. This guide provides general information about the different oral medicines for diabetes. It will help you learn more about your medication. Always take your medicine exactly as your doctor prescribes it. Discuss your specific questions and concerns with your health care provider. Sulfonylureas Glipizide (Glucotrol®, Glucotrol XL®,), Glimepride (Amaryl®), Glyburide (DiaBeta®, Glynase PresTab®, Micronase®) These medications lower blood glucose by causing the pancreas to release more insulin. Biguanides Metformin (Glucophage®, Glucophage XR®, Glumetza®, Fortamet®, Riomet®) These medications reduce how much glucose the liver produces. It also improves how insulin works in the body, and slows down the conversion of carbohydrates into sugar. Thiazolidinediones Pioglitozone (Actos®), rosiglitozone (Avandia®) These medications improve the way insulin works in the body by allowing more glucose to enter into muscles, fat, and the liver. Alpha-glucosidase inhibitors Acarbose (Precose®,) miglitol (Glyset®) These medications lower blood glucose by delaying the breakdown of carbohydrates and reducing glucose absorption in the small intestine. They also block certain enzymes in order to slow down the digestion of some starches. Meglitinide Repaglinide (Prandin®), nateglinide (Starlix®) These medications lower blood glucose by getting the pancreas to release more insulin. DPP-4 inhib Continue reading >>

Oral Medication For Type 2 Diabetes

Oral Medication For Type 2 Diabetes

Type 2 diabetes is a complex condition, which affects not only the pancreas but other organs as well. People with type 2 diabetes have what is called “insulin resistance,” which means that their bodies don’t effectively use the insulin they make. They may also have a condition called “insulin deficiency” in which their bodies don’t produce enough insulin. If you have type 2 diabetes and meal planning and exercise alone are not enough to control your blood glucose levels, your doctor may prescribe one or more oral medications to treat your diabetes. Procedural Details There are five main classes of oral medications that your health-care provider may prescribe to treat your type 2 diabetes: Insulin secretagogues: These medications stimulate your pancreas to release more insulin. Biguanide: This medication decreases the amount of glucose the liver releases into your bloodstream. DPP-IV inhibitor: This medication increases the amount of insulin released into your bloodstream and decreases glucagon levels. Thiazolidine-diones: These medications improve the ability of your cells to use insulin. Alpha glucosidase inhibitors: These medications slow the breakdown of carbohydrates from the food you eat. Medications Insulin secretagogues: Examples include the drugs glyburide, glipizide, repaglinide (or the brand name Prandin) and nateglinide (or the brand name Starlix). Biguanides: Examples include meformin. DPP-IV inhibitors: Examples include sitagliptin (or the brand name Januvia). Thiazolidine-diones: Examples include rosiglitazone (or the brand name Avandia) and pioglitazone (or the brand name Actos). Alpha glucosidase inhibitors: Examples include acarbose (or the brand name Precose) and miglitol (or the brand name Glyset). Your health-care provider may prescribe o Continue reading >>

9 Types Of Medication That Help Control Type 2 Diabetes

9 Types Of Medication That Help Control Type 2 Diabetes

Sometimes people with type 2 diabetes are able to bring their blood glucose levels under control through a combination of weight loss, diet, and exercise, but many people with diabetes take medication to manage their condition. For some, a single diabetes medication is effective, while in other cases a combination of drugs works better. “If diabetes control is suboptimal on the maximum dose of one medication, it’s prudent to add on a second agent,” says Deepashree Gupta, MD, assistant professor of endocrinology at Saint Louis University in Missouri. There are many drugs available to treat type 2 diabetes. Your diabetes care team can help you understand the differences among the types of medication on this long list, and will explain how you take them, what they do, and what side effects they may cause. Your doctor will discuss your specific situation and your options for adding one or more types of medication to your treatment. Types of Medication for Type 2 Diabetes In type 2 diabetes, even though insulin resistance is what leads to the condition, injections of insulin are not the first resort. Instead, other drugs are used to help boost insulin production and the body’s regulation of it. Insulin resistance occurs when the body’s cells don’t respond properly to insulin, which is a hormone made in the pancreas that’s responsible for ferrying glucose to cells for energy. When cells are resistant to insulin, they don’t use the insulin effectively to bring the glucose from the bloodstream into the cell. The pancreas needs to produce more insulin to overcome this resistance in an effort to normalize blood sugar levels. When the pancreas can’t keep up with the insulin demands in a person with insulin resistance, that person develops diabetes. Below is an ov Continue reading >>

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