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Erschienen in: Wiener klinische Wochenschrift 2/2016

01.04.2016 | leitlinien für die praxis

Insulintherapie bei Diabetes mellitus

verfasst von: Monika Lechleitner, Michael Roden, Raimund Weitgasser, Bernhard Ludvik, Peter Fasching, Friedrich Hoppichler, Alexandra Kautzky-Willer, Guntram Schernthaner, Rudolf Prager, Thomas C. Wascher

Erschienen in: Wiener klinische Wochenschrift | Sonderheft 2/2016

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Zusammenfassung

Die vorliegende Leitlinie nimmt Bezug auf die praktische Umsetzung der Insulintherapie bei Typ 1 und Typ 2 Diabetes. Die unterschiedlichen Formen der Insulintherapie sowie die Berechnung und Anpassung des Insulinbedarfs werden dargestellt.
Literatur
1.
Zurück zum Zitat American Diabetes Association. Approaches to glycemic treatment. Diabetes Care. 2015;38 Suppl 1:S41–S8. CrossRef American Diabetes Association. Approaches to glycemic treatment. Diabetes Care. 2015;38 Suppl 1:S41–S8. CrossRef
2.
Zurück zum Zitat Cheng A, Hanna A, Kader T, Richardson S. Insulin therapy in type 1 diabetes. Canadian Diabetes Association Clinical Practice Guidelines Expert Committee. 2008;46–52. Cheng A, Hanna A, Kader T, Richardson S. Insulin therapy in type 1 diabetes. Canadian Diabetes Association Clinical Practice Guidelines Expert Committee. 2008;46–52.
3.
Zurück zum Zitat The Diabetes Control and Complication Trial Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complication in insulin-dependent diabetes mellitus. N Engl J Med. 1993;329:977–86. CrossRef The Diabetes Control and Complication Trial Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complication in insulin-dependent diabetes mellitus. N Engl J Med. 1993;329:977–86. CrossRef
4.
Zurück zum Zitat Diabetes Control and Complication Trial/Epidemiology of Diabetes Interventions and Complications Research Group. Effect of intensive therapy on the microvascular complications of type 1 diabetes mellitus. JAMA. 2002;287:2563–69. CrossRef Diabetes Control and Complication Trial/Epidemiology of Diabetes Interventions and Complications Research Group. Effect of intensive therapy on the microvascular complications of type 1 diabetes mellitus. JAMA. 2002;287:2563–69. CrossRef
6.
Zurück zum Zitat De Boer IH, Rue TC, Cleary PA, Lachin JM, Molitch ME, et al. Long-term renal outcomes of patients with type 1 diabetes mellitus and microalbuminuria. Arch Intern Med. 2011;171:412–20. CrossRefPubMedPubMedCentral De Boer IH, Rue TC, Cleary PA, Lachin JM, Molitch ME, et al. Long-term renal outcomes of patients with type 1 diabetes mellitus and microalbuminuria. Arch Intern Med. 2011;171:412–20. CrossRefPubMedPubMedCentral
7.
Zurück zum Zitat Pop-Busui R, Herman WH, Feldman EL, Low PA, Martin CL, Cleary PA, Waberski BH, Lachin JM, Albrers JW, DCCT/EDIC Research Group. DCCT and EDIC studies in type 1 diabetes: lessons for diabetic neuropathy regarding metabolic memory and natural history. Curr Diab Rep. 2010;10:276–82. CrossRefPubMedPubMedCentral Pop-Busui R, Herman WH, Feldman EL, Low PA, Martin CL, Cleary PA, Waberski BH, Lachin JM, Albrers JW, DCCT/EDIC Research Group. DCCT and EDIC studies in type 1 diabetes: lessons for diabetic neuropathy regarding metabolic memory and natural history. Curr Diab Rep. 2010;10:276–82. CrossRefPubMedPubMedCentral
8.
Zurück zum Zitat Nathan DM, Bayless M, Cleary P, Genuth S, Gubitosi-Klug R, Lechin JM, Lorenzi G, Zinman B, DCCT/EDIC Research Group. Diabetes controls and complications trial/epidemiology of diabetes intervention and complications study at 30 years: advances and contributions. Diabetes. 2013;62:3976–86. CrossRefPubMedPubMedCentral Nathan DM, Bayless M, Cleary P, Genuth S, Gubitosi-Klug R, Lechin JM, Lorenzi G, Zinman B, DCCT/EDIC Research Group. Diabetes controls and complications trial/epidemiology of diabetes intervention and complications study at 30 years: advances and contributions. Diabetes. 2013;62:3976–86. CrossRefPubMedPubMedCentral
9.
Zurück zum Zitat Nathan DM, Cleary PA, Backlund Yu, et al.; Diabetes Control and Complication Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) Study Research Group. Intensive diabetes treatment and cardiovascular disease in patients with type 1 diabetes. N Engl J Med. 2005;353:2643–53. Nathan DM, Cleary PA, Backlund Yu, et al.; Diabetes Control and Complication Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) Study Research Group. Intensive diabetes treatment and cardiovascular disease in patients with type 1 diabetes. N Engl J Med. 2005;353:2643–53.
10.
Zurück zum Zitat Gruden G, Giunti S, Barutta F, Chaturvedi N, Witte DR, Tricarico M, Fuller JH, Perin P, Bruno G. QTc interval prolongation is independently associated with severe hypoglycaemia attacks in type 1 diabetes from the EURODIAB IDDM complications study. Diabetes Care. 2012;35:125–7. CrossRefPubMedPubMedCentral Gruden G, Giunti S, Barutta F, Chaturvedi N, Witte DR, Tricarico M, Fuller JH, Perin P, Bruno G. QTc interval prolongation is independently associated with severe hypoglycaemia attacks in type 1 diabetes from the EURODIAB IDDM complications study. Diabetes Care. 2012;35:125–7. CrossRefPubMedPubMedCentral
11.
Zurück zum Zitat UK Prospective Diabetes Study (UKPDS Group). Intensive blood glucose control with sulfonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet. 1998;352:837–52. CrossRef UK Prospective Diabetes Study (UKPDS Group). Intensive blood glucose control with sulfonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet. 1998;352:837–52. CrossRef
12.
Zurück zum Zitat Holman RR, Paul SK, Bethel A, Matthews DR, Neil AW. 10-year follow up of intensive glucose control in type 2 diabetes. N Engl J Med. 2008;359:1577–89. CrossRefPubMed Holman RR, Paul SK, Bethel A, Matthews DR, Neil AW. 10-year follow up of intensive glucose control in type 2 diabetes. N Engl J Med. 2008;359:1577–89. CrossRefPubMed
13.
Zurück zum Zitat Duckworth W, Abraira C, Moritz T, et al. Glucose control and vascular complications in veterans with type 2 diabetes. N Engl J Med. 2009;360:129–39. CrossRefPubMed Duckworth W, Abraira C, Moritz T, et al. Glucose control and vascular complications in veterans with type 2 diabetes. N Engl J Med. 2009;360:129–39. CrossRefPubMed
14.
Zurück zum Zitat ADVANCE Collaborative Group. Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes. N Engl J Med. 2008;358:2560–72. CrossRef ADVANCE Collaborative Group. Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes. N Engl J Med. 2008;358:2560–72. CrossRef
15.
Zurück zum Zitat The Action to Control Cardiovascular Risk in Diabetes Study Group. Effects of intensive glucose lowering in type 2 diabetes. N Engl J Med. 2008;358:2545–59. CrossRefPubMedCentral The Action to Control Cardiovascular Risk in Diabetes Study Group. Effects of intensive glucose lowering in type 2 diabetes. N Engl J Med. 2008;358:2545–59. CrossRefPubMedCentral
16.
Zurück zum Zitat Inzucchi SE, Bergenstal RM, Buse JB, Diamant M, Ferrannini E, Nauck M, Peters AL, Tsapas A, Wender R, Matthews DR. Management of hyperglycaemia in type 2 diabetes, 2015: a patient-centered approach. Update to a position statement of the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care. 2015;38:140–4. CrossRefPubMed Inzucchi SE, Bergenstal RM, Buse JB, Diamant M, Ferrannini E, Nauck M, Peters AL, Tsapas A, Wender R, Matthews DR. Management of hyperglycaemia in type 2 diabetes, 2015: a patient-centered approach. Update to a position statement of the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care. 2015;38:140–4. CrossRefPubMed
17.
Zurück zum Zitat Inzucchi SE, Bergenstal RM, Buse JB, Diamant M, Ferrannini E, Nauck M, Peters AL, Tsapas A, Wender R, Matthews DR. Management of hyperglycaemia in type 2 diabetes, 2015: a patient-centered approach. Update to a position statement of the American Diabetes Association and the European Association for the Study of Diabetes. Diabetologia. 2015;58:429–42. CrossRefPubMed Inzucchi SE, Bergenstal RM, Buse JB, Diamant M, Ferrannini E, Nauck M, Peters AL, Tsapas A, Wender R, Matthews DR. Management of hyperglycaemia in type 2 diabetes, 2015: a patient-centered approach. Update to a position statement of the American Diabetes Association and the European Association for the Study of Diabetes. Diabetologia. 2015;58:429–42. CrossRefPubMed
18.
Zurück zum Zitat Ismail-Beigi F, Moghissi E, Tikin M, Hirsch IB, Inzucchi SE, Genuth S. Individualizing glycemic targets in type 2 diabetes mellitus: implications of recent clinical trials. Ann Intern Med. 2011;154:554–9. CrossRefPubMed Ismail-Beigi F, Moghissi E, Tikin M, Hirsch IB, Inzucchi SE, Genuth S. Individualizing glycemic targets in type 2 diabetes mellitus: implications of recent clinical trials. Ann Intern Med. 2011;154:554–9. CrossRefPubMed
19.
Zurück zum Zitat Lipska KJ, Ross JS, Miao Y, Shah NO, Lee SJ, Steinman MA. Potential overtreatment of diabetes mellitus in older adults with tight glycemic control. JAMA. Intern Med. 2015;175:356–62. CrossRefPubMedPubMedCentral Lipska KJ, Ross JS, Miao Y, Shah NO, Lee SJ, Steinman MA. Potential overtreatment of diabetes mellitus in older adults with tight glycemic control. JAMA. Intern Med. 2015;175:356–62. CrossRefPubMedPubMedCentral
20.
Zurück zum Zitat Wong JC, Foster NC, Maahs DM, Raghinaru D, et al; T1D Exchange Clinic Network. Real-time continuous glucose monitoring among participants in the T1D Exchange clinic registry. Diabetes Care. 2014;37:2702–4. Wong JC, Foster NC, Maahs DM, Raghinaru D, et al; T1D Exchange Clinic Network. Real-time continuous glucose monitoring among participants in the T1D Exchange clinic registry. Diabetes Care. 2014;37:2702–4.
21.
Zurück zum Zitat Plank J, Siebenhofer A, Berghold A, et al. Systematic review and meta-analysis of short-acting insulin analogues in patients with diabetes mellitus. Arch Intern Med. 2005;165:1337–44. CrossRefPubMed Plank J, Siebenhofer A, Berghold A, et al. Systematic review and meta-analysis of short-acting insulin analogues in patients with diabetes mellitus. Arch Intern Med. 2005;165:1337–44. CrossRefPubMed
22.
Zurück zum Zitat Horvath K, Jeitler K, Berghold A, Ebrahim SH, Gratzer TW, Plank J, Kaiser T, Pieber TR, Siebenhofer A. Long-acting insulin analogies versus NPH-insulin (human isophane insulin) for type 2 diabetes mellitus. Cochrane Database Syst Rev. 2007;18:CD005613. Horvath K, Jeitler K, Berghold A, Ebrahim SH, Gratzer TW, Plank J, Kaiser T, Pieber TR, Siebenhofer A. Long-acting insulin analogies versus NPH-insulin (human isophane insulin) for type 2 diabetes mellitus. Cochrane Database Syst Rev. 2007;18:CD005613.
23.
Zurück zum Zitat Jensen MG, Hansen M, Brock B, Rungby J. Differences between long-acting insulins fort the treatment of type 2 diabetes. Exp Opin Pharmacother. 2010;11:2027–35. CrossRef Jensen MG, Hansen M, Brock B, Rungby J. Differences between long-acting insulins fort the treatment of type 2 diabetes. Exp Opin Pharmacother. 2010;11:2027–35. CrossRef
24.
Zurück zum Zitat The ORIGIN Trial Investigators. Basal insulin and cardiovascular and other outcomes in dysglycemia. N Engl J Med. 2012;367:319–28. CrossRef The ORIGIN Trial Investigators. Basal insulin and cardiovascular and other outcomes in dysglycemia. N Engl J Med. 2012;367:319–28. CrossRef
25.
Zurück zum Zitat Riddle MC, Bolli GB, Ziemen M, et al. New insulin Glargin 300 Units/mL versus Glargine 100 Units/mL in people with type 2 diabetes using basal and mealtime insulin: glucose controls and hypoglycemia in a 6-months randomized controlled trial (EDITION 1). Diabetes Care. 2014;37:2755–62 CrossRefPubMed Riddle MC, Bolli GB, Ziemen M, et al. New insulin Glargin 300 Units/mL versus Glargine 100 Units/mL in people with type 2 diabetes using basal and mealtime insulin: glucose controls and hypoglycemia in a 6-months randomized controlled trial (EDITION 1). Diabetes Care. 2014;37:2755–62 CrossRefPubMed
26.
Zurück zum Zitat Yki-Järvinen H, Bergenstal R, Ziemen M, et al. New insulin Glargine 300 Units/mL versus Glargine 100 Units/mL in people with type 2 diabetes using oral agents and basal insulin: glucose controls and hypoglycemia in a 6-month randomized controlled trial (EDITION 2). Diabetes Care. 2014;37:3235–43 CrossRefPubMed Yki-Järvinen H, Bergenstal R, Ziemen M, et al. New insulin Glargine 300 Units/mL versus Glargine 100 Units/mL in people with type 2 diabetes using oral agents and basal insulin: glucose controls and hypoglycemia in a 6-month randomized controlled trial (EDITION 2). Diabetes Care. 2014;37:3235–43 CrossRefPubMed
27.
Zurück zum Zitat Haahr H, Heise T. A review of the pharmacological properties of insulin deglutec and their clinical relevance. Clin Pharmacokinet. 2014;53:787–800. CrossRefPubMedPubMedCentral Haahr H, Heise T. A review of the pharmacological properties of insulin deglutec and their clinical relevance. Clin Pharmacokinet. 2014;53:787–800. CrossRefPubMedPubMedCentral
28.
Zurück zum Zitat Vora J, Cariou B, Evans M, et al. Clinical use of insulin deglutec. Diabetes Res Clin Pract. 2015;109:19–31. CrossRefPubMed Vora J, Cariou B, Evans M, et al. Clinical use of insulin deglutec. Diabetes Res Clin Pract. 2015;109:19–31. CrossRefPubMed
29.
Zurück zum Zitat Becker RH, Dammen R, Bergmann K, Lehmann A, Jax T, Heise T. New insulin glargine 300 units/ml provides a more even activity profile and prolonged glycemic control at study state compared with insulin glargine 100 units/ml. Diabetes Care. 2015;38:637–43. PubMed Becker RH, Dammen R, Bergmann K, Lehmann A, Jax T, Heise T. New insulin glargine 300 units/ml provides a more even activity profile and prolonged glycemic control at study state compared with insulin glargine 100 units/ml. Diabetes Care. 2015;38:637–43. PubMed
30.
Zurück zum Zitat Smith U, Gale EM. Does diabetes therapy influence the risk of cancer? Diabetologia. 2009;52:1699–708. CrossRefPubMed Smith U, Gale EM. Does diabetes therapy influence the risk of cancer? Diabetologia. 2009;52:1699–708. CrossRefPubMed
31.
Zurück zum Zitat Ruiter R, Visser LE, van Herk-Sukel MP, Coebergh JW, et al. Risk of cancer in patients on insulin glargin and other insulin analogues in comparison with those on human insulin: results from a large population-based follow-up study. Diabetologia. 2012;55:51–62. CrossRefPubMedPubMedCentral Ruiter R, Visser LE, van Herk-Sukel MP, Coebergh JW, et al. Risk of cancer in patients on insulin glargin and other insulin analogues in comparison with those on human insulin: results from a large population-based follow-up study. Diabetologia. 2012;55:51–62. CrossRefPubMedPubMedCentral
32.
Zurück zum Zitat Gristina V, Cupri MG, Torchio M, Mezzogori C, Cacciabue L, Panova M. Diabetes and cancer: a critical appraisal of the pathogenetic and therapeutic links. Biomed Rep. 2015;3:131–6. PubMedPubMedCentral Gristina V, Cupri MG, Torchio M, Mezzogori C, Cacciabue L, Panova M. Diabetes and cancer: a critical appraisal of the pathogenetic and therapeutic links. Biomed Rep. 2015;3:131–6. PubMedPubMedCentral
33.
Zurück zum Zitat Holman RR, Farmer AJ, Davies MJ, et al.; 4-T Study Group. Three-year efficacy of complex insulin regimens in type 2 diabetes. N Engl J Med. 2009;361:1736–47. Holman RR, Farmer AJ, Davies MJ, et al.; 4-T Study Group. Three-year efficacy of complex insulin regimens in type 2 diabetes. N Engl J Med. 2009;361:1736–47.
34.
Zurück zum Zitat Garber AJ, Wahlen J, Wahl T, et al. Attainment of glycaemic goals in type 2 diabetes with once-, twice- or thrice-daily dosing with biphasic insulin aspart 70/30 (The 1-2-3 study). Diabetes Obes Metab. 2006;8:58–66. CrossRefPubMed Garber AJ, Wahlen J, Wahl T, et al. Attainment of glycaemic goals in type 2 diabetes with once-, twice- or thrice-daily dosing with biphasic insulin aspart 70/30 (The 1-2-3 study). Diabetes Obes Metab. 2006;8:58–66. CrossRefPubMed
35.
Zurück zum Zitat Pickup JC. Management of diabetes mellitus: is the pump mightier than the pen? Nat Rev Endocrinol. 2012;8:425–33. CrossRefPubMed Pickup JC. Management of diabetes mellitus: is the pump mightier than the pen? Nat Rev Endocrinol. 2012;8:425–33. CrossRefPubMed
36.
Zurück zum Zitat Goudswaard AN, Furlong NJ, Valk GD, Stolk RP, Ruiten GEHM. Insulin monotherapy versus combination of insulin with oral hypoglycemic agents in patients with type 2 diabetes. Cochrane Database Syst Rev. 2004;4:CD003418. PubMed Goudswaard AN, Furlong NJ, Valk GD, Stolk RP, Ruiten GEHM. Insulin monotherapy versus combination of insulin with oral hypoglycemic agents in patients with type 2 diabetes. Cochrane Database Syst Rev. 2004;4:CD003418. PubMed
37.
Zurück zum Zitat Herman WH, Buse JB, Arakaki RF, Dungan KM, Jiang HH, Jacobson JG, Fahrbach JL. Concomitant oral antihyperglycemic agent use and associated outcomes after initiation of insulin therapy. Endocr Pract. 2011;17:563–7. CrossRefPubMed Herman WH, Buse JB, Arakaki RF, Dungan KM, Jiang HH, Jacobson JG, Fahrbach JL. Concomitant oral antihyperglycemic agent use and associated outcomes after initiation of insulin therapy. Endocr Pract. 2011;17:563–7. CrossRefPubMed
38.
Zurück zum Zitat Donner T, Munoz M. Update on insulin therapy for type 2 diabetes. J Clin Endocrinol. 2012;97:1405–13. CrossRef Donner T, Munoz M. Update on insulin therapy for type 2 diabetes. J Clin Endocrinol. 2012;97:1405–13. CrossRef
39.
Zurück zum Zitat Hemmingsen B, Christensen LL, Wetterslev J, Vaag A, Gluud C, Lund SS, Almdal T. Comparison of metformin and insulin versus insulin alone for type 2 diabetes: systematic review of randomised clinical trials with meta-analyses and trial sequential analyses. BMJ. 2012;344:e1771. CrossRefPubMed Hemmingsen B, Christensen LL, Wetterslev J, Vaag A, Gluud C, Lund SS, Almdal T. Comparison of metformin and insulin versus insulin alone for type 2 diabetes: systematic review of randomised clinical trials with meta-analyses and trial sequential analyses. BMJ. 2012;344:e1771. CrossRefPubMed
40.
Zurück zum Zitat Roumie CL, Greevy RA, Grijalva CG, Hung AM, Liu X, Murff HJ, Elasy TA, Griffin MR. Association between intensification of metformin treatment with insulin vs sulfonylureas and cardiovascular events and all-cause mortality among patients with diabetes. JAMA. 2014;311:2288–96. CrossRefPubMedPubMedCentral Roumie CL, Greevy RA, Grijalva CG, Hung AM, Liu X, Murff HJ, Elasy TA, Griffin MR. Association between intensification of metformin treatment with insulin vs sulfonylureas and cardiovascular events and all-cause mortality among patients with diabetes. JAMA. 2014;311:2288–96. CrossRefPubMedPubMedCentral
41.
Zurück zum Zitat Wilding JP, Woo V, Rohwedder K, Sugg J, Parikh S; Dapagliflozin 006 Study Group. Dapagliflozin in patients with type 2 diabetes receiving high doses of insulin: efficacy and safety over 2 years. Diabetes Obes Metab. 2014;16:124–36. CrossRefPubMed Wilding JP, Woo V, Rohwedder K, Sugg J, Parikh S; Dapagliflozin 006 Study Group. Dapagliflozin in patients with type 2 diabetes receiving high doses of insulin: efficacy and safety over 2 years. Diabetes Obes Metab. 2014;16:124–36. CrossRefPubMed
42.
Zurück zum Zitat Scheen AJ. Pharmacodynamics, efficacy and safety of sodium-glucose co-transporter type 2 (SGLT2) inhibitors for the treatment of type 2 diabetes mellitus. Drugs. 2015;75:33–59. CrossRefPubMed Scheen AJ. Pharmacodynamics, efficacy and safety of sodium-glucose co-transporter type 2 (SGLT2) inhibitors for the treatment of type 2 diabetes mellitus. Drugs. 2015;75:33–59. CrossRefPubMed
43.
Zurück zum Zitat Peters AL, Buschur EO, Buse JB, Cohan P, Diner JC, Hirsch IB. Euglycemic diabetic ketoacidosis: a potentail complications of treatment with sodium-glucose cotransporter 2 inhibition. Diabetes Care. 2015;38:1687–93. CrossRefPubMed Peters AL, Buschur EO, Buse JB, Cohan P, Diner JC, Hirsch IB. Euglycemic diabetic ketoacidosis: a potentail complications of treatment with sodium-glucose cotransporter 2 inhibition. Diabetes Care. 2015;38:1687–93. CrossRefPubMed
44.
45.
Zurück zum Zitat Digenio A, Karve S, Candrilli SD, Dalal M. Prandial insulin versus glucagon-like peptide-1 added to basal insulin: comparative effectiveness in the community practice setting. Postgrad Med. 2014;126:49–59. CrossRefPubMed Digenio A, Karve S, Candrilli SD, Dalal M. Prandial insulin versus glucagon-like peptide-1 added to basal insulin: comparative effectiveness in the community practice setting. Postgrad Med. 2014;126:49–59. CrossRefPubMed
Metadaten
Titel
Insulintherapie bei Diabetes mellitus
verfasst von
Monika Lechleitner
Michael Roden
Raimund Weitgasser
Bernhard Ludvik
Peter Fasching
Friedrich Hoppichler
Alexandra Kautzky-Willer
Guntram Schernthaner
Rudolf Prager
Thomas C. Wascher
Publikationsdatum
01.04.2016
Verlag
Springer Vienna
Erschienen in
Wiener klinische Wochenschrift / Ausgabe Sonderheft 2/2016
Print ISSN: 0043-5325
Elektronische ISSN: 1613-7671
DOI
https://doi.org/10.1007/s00508-015-0925-1

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