How much sugar should a diabetic have: Sugars and type 2 diabetes
Sugars and type 2 diabetes
What is type 2 diabetes?
Diabetes is a lifelong condition that causes a person’s blood sugar to be too high. There are two forms of diabetes: type 1 and type 2 . Insulin is a hormone that is key in regulating blood glucose levels. Type 2 diabetes can occur either as a result of insulin receptors becoming desensitised and as a result no longer responding to insulin; or, due to the beta cells of the pancreas no longer producing insulin. Often it is a combination of these two factors that leads to this condition known as type 2 diabetes.
Type 2 diabetes is by far the most common type – of all the adults who have diabetes, 90% of them have type 2. Diabetes is an increasing health problem in the UK with 3.2million people diagnosed with diabetes and a further 850,000 estimated to be undiagnosed . Diabetes is a growing health burden and it is estimated that by 2025, 5 million people will have been diagnosed in the UK . Diabetes is the leading cause of blindness in the UK and the disease’s complications cause more than 100 amputations to take place each week. Each year, 24 000 people die early from diabetes-associated complications . Its total cost is estimated at £13.8billion each year . It is predicted that the annual NHS cost of the direct treatment of diabetes in the UK will increase to £16.9 billion over the next 25 years, which is 17 per cent of the NHS budget , believed to potentially bankrupt the NHS
What are the causes of Type 2 diabetes?
There is a complex combination of genetic and environmental risk factors that play a part in the development of diabetes – it tends to cluster in families, but there is also a strong link to environmental risk factors. Ethnicity also plays a major role in its development, with people of South Asian descent being six times more likely to contract the disease .
Obesity is the most potent risk factor, accounting for 80-85% of the total risk of developing type 2 diabetes . Given that almost 2 in 3 people in the UK are obese or overweight; their chances of developing Type 2 diabetes at some point are high unless they take evasive action.
Other risk groups include :
- People over the age of 40
- People with cardiovascular disease
- Women with polycystic ovary syndrome (PCOS)
- People who are taking medication for schizophrenia or bipolar disorder
How does sugar contribute to the risk of Type 2 diabetes?
Type 2 diabetes occurs as a result of a lack of insulin production or an increased resistance to insulin . Insulin is a hormone produced by the pancreas that allows for the regulation of the uptake of glucose. It is released in response to increased glucose levels in the blood and allows for individual cells to take up glucose from the blood to metabolise it.
A high-sugar diet has been linked with an increased incidence of type 2 diabetes due to the links between high sugar intake and obesity. The Scientific Advisory Committee on Nutrition (SACN) also conducted a meta-analysis, which includes nine cohort studies in 11 publications that suggest that there is a relationship between sugars-sweetened beverages and the incidence of type 2 diabetes . The link between sugar consumption and diabetes is both direct and indirect – with sugars-sweetened beverages being directly linked to the incidence of type 2 diabetes, and equally sugar consumption leading to obesity, one of the main risk factors for type 2 diabetes.
Complications associated with type 2 diabetes:
There are several complications associated with type 2 diabetes. The most common are :
- Kidney disease
- Eye disease including blindness
- Sexual dysfunction
- Complications in pregnancy
Current sugar intake and advice on how to prevent type 2 diabetes:
The current recommendation for sugar intake is that it does not exceed 10% of daily energy intake. The recent review published by the SACN has highlighted the need for this percentage to be further reduced to 5% (30g of sugars). The recommendation for children is 24g/day for children aged 5-11 and 19g/day for children aged 4-6. At present, we consume a much higher proportion of sugar each day, with percentage sugar consumption between 1.5 to 3 year olds at 11.9%; 4 to 10 year olds at 14.7% and 11 to 18 year olds at 15.6% .
It is also important to maintain a healthy lifestyle and diet by :
- Not exceeding the maximum amount of calories per day – 2,000 calories per day for women and 2,500 calories per day for men.
- Reducing sugar intake to a maximum of 6 teaspoons per day (25g).
- Reducing the consumption of sugars-sweetened beverages.
- Exercise for half an hour, 5 times a week (moderate intensity exercise).
- Maintaining body weight at a healthy BMI (between 18.5kg/m2 and 24.9kg/m2).
- Maintaining a healthy waist-to-hip ratio, as it is a good indicator of abdominal fat and thus diabetes.
 NHS Choices. 2014. “Diabetes.” URL: <http://www.nhs.uk/conditions/diabetes/pages/diabetes.aspx>. [Accessed 27th January 2015].
 Diabetes UK. 2014. “Diabetes Prevalence 2013,” URL: <http://www.diabetes.org.uk/About_us/What-we-say/Statistics/Diabetes-prevalence-2013/>. [Accessed 27th January 2015].
 Diabetes UK. 2014. “The Cost of Diabetes Report”. URL: <http://www.diabetes.org.uk/Documents/Diabetes%20UK%20Cost%20of%20Diabetes%20Report.pdf>. [Accessed 27th January 2015].
 Kanavos, van den Aardweg and Schurer. 2012. “Diabetes expenditure, burden of disease and management in 5 EU countries,” LSE.
 Diabetes UK. 2014. “Diabetes Facts and Stats,” URL: <http://www.diabetes.org.uk/Documents/About%20Us/Statistics/Diabetes-key-stats-guidelines-April2014.pdf>. [Accessed 27th January 2015].
 Health and Social Care Information Centre (HSCIC). 2014. “Statistics on Obesity, Physical Activity and Diet. ” URL: <http://www.hscic.gov.uk/catalogue/PUB13648/Obes-phys-acti-diet-eng-2014-rep.pdf>. [Accessed 27th January 2015].
 Scientific Advisory Committee on Nutrition. 2014. “Draft Carbohydrates and Health Report” pp.89-90 & 95-96.
 Health and Social Care Information Centre (HSCIC). 2014. “Statistics on Obesity, Physical Activity and Diet.” URL: <http://www.hscic.gov.uk/catalogue/PUB13648/Obes-phys-acti-diet-eng-2014-rep.pdf>. [Accessed 27th January 2015].
 Mayo Clinic Staff. 2014. “Obesity” URL: <http://www.mayoclinic.org/diseases-conditions/obesity/basics/treatment/con-20014834>. [Accessed 27th January 2015].
 Key statistics on health inequalities: Summary paper. 2007. The Scottish Government. URL: <http://www.scotland.gov.uk/Publications/2008/06/09160103/3>. [Accessed 27th January 2015].
How Much Sugar Is Allowed for People with Diabetes?
Sugar is often portrayed as a villain or main culprit when the topic of diabetes comes up.
While sugar does play an important role in the context of this condition, several misconceptions exist about people with diabetes being able to consume sugar.
People with diabetes can eat food and drink beverages that contain sugar. But just like everything, moderation is key.
This article will give you more information about the role that sugar plays in diabetes and glucose management, and how to approach it in appropriate and balanced ways.
Clinical guidelines or recommendations about anything, including sugar consumption by people with diabetes, are just that: guidelines. They are meant to guide many people to stay as healthy as possible.
Expert opinions differ on how much sugar is recommended each day.
- The World Health Organization (WHO) recommends that only 5 to 10% of your calories be from added sugars, or “free sugars.”
- In the United States, that recommendation is the same, according to the Dietary Guidelines for Americans. That translates to 12 teaspoons per day when following a 2,000-calorie diet.
- However, the American Heart Association advises limiting sugar to 6% of total calories per day. That means a limit of 7.5 teaspoons per day for a 2,000-calorie diet.
The Centers for Disease Control and Prevention (CDC) mentions that the average intake of added sugars was 17 teaspoons per day — or 19 teaspoons for men and 15 teaspoons for women — for Americans ages 20 and over in 2018.
If you’re used to eating a lot of sugar, you may want to reduce your intake to help manage blood glucose levels and keep them in target range.
Carbohydrates count, too
Calories and sugar are not the only things that matter when looking at a nutrition label. Carbohydrates are just as important for people with diabetes.
It’s important to keep in mind that carbs break down into sugars. So just because you see “no sugar” on a nutrition label, that doesn’t mean it’s free of any blood sugar effect. Carbs impact glucose levels just like forms of sugar do.
The American Diabetes Association does not recommend a specific daily carb limit for people with diabetes because it’s so individualized. However, the average American diet contains about 250 grams of carbs per day, and that’s too high for most people with diabetes.
If you decide to try carb counting, you’ll need to know the total grams of carbs in the foods or drinks you’re planning to consume and have a reasonably accurate estimation of the serving size.
One carb serving contains about 15 grams. However, a carb serving might not match what you’d normally consider a serving of food, so you’ll need to carefully balance carb servings and serving sizes.
You can learn more about carb counting here.
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Of course, everyone is different. Your weight, activity level, nutritional needs, and your body’s reaction to factors that affect your blood sugar levels will differ from those of another person with diabetes.
You and your diabetes care team should discuss your situation, including your history of managing your blood sugar levels, to determine how much sugar you can eat in a typical day. This can vary, too, depending on what type of diabetes you have and any medications you take.
Some people may worry that eating sugar will lead to diabetes, but diabetes is much more complex. Plus, your body does need some sugar to function. According to the National Institutes of Health, one type of sugar called glucose is an important source of fuel for your body and your brain.
The sugar in your body comes, in part, from carbohydrates. After you eat, your body breaks down the food you eat as you’re digesting, which sends glucose into your bloodstream.
Simple carbohydrates like candy or fruit break down quickly, sending a quick burst of sugar into your bloodstream. More complex carbohydrates like pasta break down more slowly and deliver a steadier dose of sugar over time.
If you don’t have diabetes, your pancreas will respond to the influx of sugar by releasing a hormone called insulin, which works to move that sugar out of your blood and into your cells to use as fuel.
However, if you have diabetes, your pancreas may not respond by producing enough (or any, in some cases) insulin to do the job. The sugar can build up in your bloodstream, which can eventually damage your blood vessels and cause other complications.
Different types of diabetes
Here’s what to know about each of the main types of diabetes:
- Type 1 diabetes (T1D): This autoimmune condition is when your pancreas is no longer able to produce any or enough insulin to help you naturally regulate your blood sugar (glucose) levels. You must take insulin (injection, insulin pump, inhaled) so your body can move the glucose into your cells from the bloodstream for energy. Roughly 5% to 10% of people with diabetes have this type.
- Latent autoimmune diabetes in adults (LADA): Sometimes known as type 1.5 diabetes, this is another name for type 1 diabetes diagnosed in adults.
- Type 2 diabetes (T2D): Those with T2D have developed a resistance to insulin, so it doesn’t work efficiently to move sugar from the bloodstream into your cells. Over time, your pancreas may also stop producing insulin. While many people use lifestyle measures (diet, exercise) to manage their T2D and keep blood sugars steady, many also take medications (like insulin or metformin) to manage their condition. T2D is the most common form, with roughly 90% of people with diabetes living with this type.
- Gestational diabetes: Some people develop diabetes during pregnancy, which often requires them to take insulin until delivery.
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It’s a common misconception that people with diabetes need to give up sugar and go sugar-free for the rest of their lives.
In other words, yes, people with diabetes actually can still eat sugar. They can eat foods with added sugars and also other foods containing carbohydrates that get broken down into sugar inside the body.
People with diabetes need to be careful about how much sugar they consume. The key word is “moderation,” according to the Association of Diabetes Care and Education Specialists.
Addressing diabetes stigma
No one chooses to have diabetes — regardless of the type. Food choices and lifestyle habits can play a part in developing type 2 diabetes, but science is also clear that genetics play a part in the development of this condition.
The most common diabetes stigma is the perception that people with diabetes are responsible for developing diabetes. Eating too much sugar does not directly cause diabetes.
Stigmatizing people by mentioning they are “eating too much sugar” or taking other actions to cause their diabetes can be damaging to that person’s mental health. A 2020 study shows a link between stigma to symptoms of depression, anxiety, and distress.
You can consider joining the American Diabetes Association’s online support community or visit diaTribe’s dStigmatize page for more information and resources.
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Limiting sugar content overall is a smart choice. A few commonly recommended strategies include:
- Try eating smaller portions to reduce your daily calorie count.
- Eat a variety of foods, including vegetables, fruits, grains, and low fat dairy, to get the most nutritional bang for your buck.
- Choose foods with lower amounts of fat.
- Watch out for highly processed foods, which may contain a lot of added sugars.
- Limit sugar-sweetened beverages. Instead, try substituting with a lower sugar option or choosing water more often.
You can also learn how to count carbohydrates. Many people with diabetes count carbs to help them keep track of what they’re eating so they can manage their blood sugar levels better.
According to the CDC, if you are overweight, you may help reverse prediabetes and delay or prevent type 2 diabetes by shedding 5% to 7% of your body weight. As this is not the only way to prevent type 2 diabetes and it may not be necessary for everyone, it’s best to speak with your doctor first.
If you have diabetes, you don’t have to resign yourself to a life without sugar. But you do need to be mindful of how much sugar you consume and how it affects your ability to control your glucose levels.
This includes not only sugary sweets but beverages and anything with carbohydrates, as those convert into sugar in your body. Your diabetes care team can help you design a plan that helps you achieve a healthy balance.
treatment and diagnostics in Moscow
What is it
Diabetes mellitus is an extremely common chronic disease, ranking third among the leading causes of death: after cardiovascular disease and cancer.
Sugar (it is more correct to call it “glucose”) is necessary for our body as a source of energy. Glucose enters the body with food and is absorbed in the intestines, and is also produced by the liver on an empty stomach. Insulin is an important hormone produced by the pancreas and is responsible for transporting glucose from the blood into cells. Cells, in turn, convert glucose into energy. Insulin also regulates the production of glucose by the liver.
The disease is divided into the first and second types.
In type 2 diabetes mellitus the cells of the body are less sensitive to insulin, so they do not take in the glucose they can tolerate and it remains in excess in the blood. Or, due to some reason, insulin ceases to effectively regulate the production of glucose by the liver, so blood sugar levels increase.
In insulin dependent type 1 diabetes own immunity destroys the cells of the pancreas responsible for the production of insulin. Thus, insulin does not enter the bloodstream and does not transfer glucose into the cells, which remains in the blood. This condition requires the introduction of insulin into the body by injection, which is why the first type is called insulin-dependent diabetes mellitus.
Causes of type 1 diabetes
Insulin-dependent type 1 diabetes refers to autoimmune diseases, i.e. to those caused by an aggressive reaction of the immune system in relation to the body’s own cells. Unfortunately, the reasons for this reaction are still unknown.
Most scientists tend to genetic predisposition and transmission of the disease by inheritance. There is also an assumption about the viral component: at risk are people who have had serious viral infections against the background of a genetic predisposition to diabetes.
Most often, insulin-dependent type 1 diabetes manifests itself already in childhood or adolescence, less often in adulthood. Diabetic coma is an extreme manifestation of an untreated disease, because about half of patients do not know about their disease until the first serious complications appear.
Type 1 diabetes symptoms
Late diagnoses and complications are a consequence of the fact that the first symptoms are often overlooked.
Among the main first symptoms can be listed:
- feeling of dry mouth,
- constant thirst,
- frequent urination,
- sleep disorders due to frequent urge to urinate,
- general weakness, lethargy, fatigue,
- weight loss,
- blurred vision.
One of the frequent complications of insulin-dependent type 1 diabetes – ketoacytosis – is an attempt by the body to make up for the lack of energy (after all, glucose is not absorbed) by burning fat, which releases ketone bodies.
The presence of a large amount of ketone bodies in the blood is toxic and manifests itself with the following symptoms:
- smell of acetone from the mouth,
- abdominal pain,
- loss of consciousness,
Often, a doctor is consulted only after the first symptoms of ketoacytosis appear, and this complication is life-threatening. Therefore, it is important to know and monitor the appearance of the primary symptoms of type 1 diabetes in yourself or your loved ones, especially children.
To make a diagnosis, an endocrinologist will first need a blood and urine test, which will show the level of glucose. In addition, additional tests may be ordered. For example, analysis for HBA1C (glycosylated hemoglobin) is a rather complex study that can only be carried out in well-equipped laboratories.
The analysis will show how much glucose was in the body in the last 12 days, based on the amount of glycosylated hemoglobin in red blood cells: hemoglobin has the property of combining with glucose, becoming glycosylated. In some cases (most often for pregnant women), the doctor may recommend a glucose tolerance test, i.e. resistance of body cells to insulin.
Thus, the diagnosis of type 1 diabetes is not difficult and is carried out in a short time. Therefore, it is extremely important for the patient to pay attention to his health and monitor the first symptoms of diabetes, to prevent serious complications due to the timely visit to a specialist.
Treatment of type 1 diabetes mellitus
Despite the fact that type 1 diabetes is a chronic disease (it is impossible to completely cure the patient), it is quite possible to turn the course of the disease into a controlled channel.
With diagnosed type 1 diabetes, in the vast majority of cases, insulin therapy is prescribed – hormone administration by injection. The injected hormone is used by the body to process the incoming glucose.
In addition to insulin therapy, depending on the patient’s condition, drugs that lower blood sugar levels may be prescribed. And a diet will definitely be prescribed, because the treatment of type 1 diabetes largely depends on following the recommendations for eating habits:
- frequent, moderate meals,
- a large number of vegetables in the diet,
- refusal of fast carbohydrates,
- restriction of sweet, starchy foods.
There are many myths surrounding type 1 and type 2 diabetes. But even with such a serious illness, with a proper responsible approach, people restore the quality of their lives. It should be noted that the success of treatment also depends on the experience and qualifications of the attending physician.
It is important for the patient to learn to live with his disease, and for this the doctor must choose the most effective therapy, answer all the patient’s questions, and help understand the treatment plan. This applies to diet, allowable physical activity, the correct doses of insulin, the way it is administered, as well as taking additional drugs if necessary.
At the FSCC FMBA, the management of patients with type 1 and type 2 diabetes mellitus is built on a long-term basis from early diagnosis to a stable course of the disease. Our doctors stay in touch, ready to answer all the patient’s possible questions about their condition and the disease in general.
We do not insist on regular consultations, we stand for maximum trust between the patient and the attending physician for prompt correction of the treatment regimen, if necessary. In addition, the specialists of our center have developed a special program for the early diagnosis of type 1 and type 2 diabetes – Diabetes under control.
This program is recommended for anyone who has noticed mild symptoms of diabetes, or who already has close relatives. The program includes the necessary tests and consultations with specialists who will give a professional opinion on the risk of developing type 1 and type 2 diabetes. After all, like any other disease, diabetes is much more effectively controlled when detected in the early stages.
Thanks to the versatility of the center, our endocrinologists, with the help of colleagues from other departments, successfully cope with the complications and consequences of type 1 diabetes. Earlier we touched on ketoacinosis, but in addition to it, there are often cardiovascular complications associated with a change in blood density against the background of high sugar content in it: the risk of developing atherosclerosis, vision problems (due to insufficient blood supply to the organs of vision), problems with the legs (with insufficient blood supply affects the nerve endings of the lower extremities, especially the feet, up to diabetic neuropathy), kidney damage, periodontitis.
Such a wide range of complications requires complex management of the patient by several specialists, and often by several departments. But it is precisely this multifunctional approach to treatment that is bearing fruit – we offer our patients qualified medical care in one place at a convenient time for them.
You can sign up for a consultation with an endocrinologist through the form on the website or by phone.
This article is for information only and is not intended for self-diagnosis or self-treatment. If signs of discomfort appear, you should contact your doctor.
What fruits can be eaten with type 1 and type 2 diabetes
What fruits can be eaten with type 1 and type 2 diabetes
Meals for diabetics often have to be limited, but a strict menu quickly gets boring and you want to please yourself with sweets. Are there any restrictions for fruits in diabetes?
Particular attention in diabetes should be paid to the glycemic index of fruits. The glycemic index (GI) is the rate of absorption of carbohydrates. GI is rated on a scale of 1 to 100. A score on this scale indicates how quickly a food raises blood sugar levels. It turns out that the sweeter the fruit, the higher the glycemic index. Low GI is considered to be up to 35 units, medium – from 50, high – more than 70 units.
To maintain normal blood sugar levels, the GI of a diabetic needs to be monitored and to know which fruits have a high GI and which ones have a low GI. Nutritionists recommend avoiding high GI foods because they quickly raise blood sugar levels.
Avocado is the fruit with the lowest GI, about 15 units. It became so because of the high fiber content – 7 grams per 100 grams of product, and vegetable fats – up to 30-40% of its total weight. For comparison, there are 65 units in a banana, 70-75 in watermelon and grapes. Low GI in apples, pears, plums, strawberries, oranges. High – in melon, grapes, raisins.
SO CAN PEOPLE WITH DIABETES SUPPLEMENT FRUIT TO THE DIET?
Everything is individual. In type 1 diabetes, you need to take into account the daily dose of insulin and clearly calculate the amount of carbohydrates consumed according to the system of bread units. Type 2 diabetics should exclude fats and fast carbohydrates from the diet.
Diabetics should not deprive themselves of fruits. But it is necessary to approach the issue of their selection reasonably, taking into account the recommendations of doctors. If fruits are included in your individual diet, do not be afraid and deprive yourself of tasty and healthy foods. They contain vitamins and minerals that speed up the metabolic process, fiber, which removes toxins and helps to reduce weight.
What fruits can be used for different types of diabetes
It is a myth that nutritionists categorically forbid the consumption of fruits for patients with diabetes. For example, diabetics can diversify the menu with fruits such as green apples, pears, pomegranates, limes, oranges, tangerines. In addition, berries are also allowed for diabetics: Gooseberries, strawberries, cherries, blackberries, currants, blueberries, lingonberries, blueberries.
Fruits not recommended for diabetics
For diabetics it is important to avoid foods high in glucose: banana, mango, grapes, melon, overripe pears and plums, as well as candied fruit and candied fruit. They contain a lot of sugar, have a high calorie content, respectively, these fruits significantly increase blood sugar levels.
Some studies report health benefits of mangoes for people with diabetes. This is due to the fact that most fruits contain sugar – fructose, but they have a different glycemic index and load. Glycemic load is an indicator that characterizes the increase in blood glucose levels after eating food. Mango, for example, has a high glycemic index (GI) but a low glycemic load, so check with a health professional before eating the sweet fruit. Do not overdo it with the amount: 1-2 fruits per day are allowed, but do not forget to control your blood sugar daily.
JUICES OR WHOLE FRUITS IN DIABETES?
Fruit contains fiber and vitamins that people with diabetes need. Fiber helps slow down the absorption of sugar. However, fruit juice consumption has been shown to increase the risk of type 2 diabetes, according to recent studies. Juice causes a rapid increase in blood glucose, and 1 liter of juice contains about 500 kcal. Therefore, diabetics are advised to choose fruit instead of juice so as not to lose vitamins and fiber and limit their sugar intake.
Unsweetened juices include: tomato, spinach, celery, beetroot, cabbage, cucumber and freshly squeezed citrus juices without added syrups. Nutritionists recommend preparing juices at home to be sure of the composition.
While low GI fruits are safe for people with diabetes to eat, don’t overdo it. Fructose is a natural sugar. It has a lower glycemic index than starch, but it is not recommended to consume it in excessive amounts. Studies have shown that fructose intake in diabetes should not exceed 25-40 grams per day.
DRIED FRUITS FOR DIABETES
Dried fruits contain minerals, vitamins, antioxidants and useful fiber. The polyphenolic antioxidants found in dried fruits improve blood flow, help support the digestive system, and reduce the risk of heart and gastrointestinal disease. Dry fruits with low GI have almost no effect on blood sugar.
Dates have high and medium GI (depending on the variety: from 60 to 140), raisins (59), figs (61), banana (65), mango (55-60), pineapple (50). The use of such dried fruits is highly undesirable for diabetes of any type.
Prunes (40), dried apples (35), dried apricots (35), dried dogwood (20), melon (35) have a low GI – these dried fruits can be eaten with diabetes. It is important to remember that some dry fruits are often coated in sugar and syrup before being dried. Such dried fruits for diabetics should be excluded from the diet.
It is important for people with diabetes to think about portion size and calories. Doctors believe that type 2 diabetes can be controlled through regular exercise, proper nutrition, and a healthy lifestyle.
- https://vrachnadom-spb. ru/info/chto-mozgno-nelzya-pri-saharnom-diabete
- Russian Association of Endocrinologists. Clinical guidelines: type 1 diabetes mellitus in adults; 2019.
- Federal Service for Supervision of Consumer Rights Protection and Human Welfare. RECOMMENDATIONS TO CITIZENS: About Sugar in Food, 2020
- Federal Service for Supervision of Consumer Rights Protection and Human Welfare. “RECOMMENDATIONS TO CITIZENS: Principles of Proper Nutrition”, 2019
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