Joslin 50-Year Medal Winner Triumphs over Diabetes

Gale Fullerton attended a

| Jun 16, 2009

Gale Fullerton is a 65-year-old Californian who has the distinction of being a Joslin 50-Year medal winner. Elliott P. Joslin, M.D., knew that good self-management was the key to minimizing long-term diabetes complications, and the medal program was designed as an incentive for those committed to good diabetes care. In 1970, Joslin Diabetes Center expanded the program and began awarding a 50-year bronze medal. They presented the first 75-year medal in 1996.

Since 1970, Joslin Diabetes Center has presented more than 2,632 50-year medals. Joslin has also awarded 23 distinctive 75-year medals from 1996 to the present. More than 636 people have received certificates recognizing 25 years with diabetes.

Diabetes Health interviewed Gale Fullerton to find out the secrets of his success.

Tell us a little about yourself

I was born in 1944 in Pasadena, California, and grew up in Eagle Rock. This was an ideal time and place to grow up-wonderful family and friends, especially great.  This idyllic situation was disrupted when I was diagnosed with type 1 diabetes in 1958 at the age of 14. It was the first semester of the ninth grade, and I knew something was wrong when I developed a voracious appetite and yet lost weight. I could hardly make it through the 50-minute classes without having to visit the restroom. When I went to our family physician, he performed tests and promptly referred me to a diabetes specialist.  I spent a week in the hospital so that I could learn about diabetes treatment protocols-weighing food, injecting insulin, testing urine, diet, and correcting insulin reactions.

I graduated from college in 1967 and worked for the U.S. government with the Air Force and the U.S. Geological Survey in the human resources field before retiring in the 1990s.

How many units of insulin do you use these days?

Needless to say, the insulin types and timing of injections have changed drastically over the years.  In 1958, it was one shot a day.  Now, I take many injections daily. Usually I inject about 14 units of slow-acting Lantus before bedtime, which covers the next 24 hours. To take care of mealtime carbs, I take approximately five to six units of fast-acting Humalog before each meal. The amount of Humalog can vary depending on the meal planned, exercise, and my current blood glucose reading. This insulin schedule works most of the time for me. Insulin pumps might be a better alternative, but my physician does not recommend changing because my control is satisfactory. I have few complications, and she does not want to alter something that is working.

Have you ever been embarrassed by diabetes?

I have never been embarrassed about having diabetes, but have been less than pleased regarding the effects of low blood glucose levels. Over the last 34 years of marriage, my wife, Bobbie, has had to rescue me many times when unexpected lows occurred, especially during the night. It is never an enjoyable experience when I do not have control of my diabetes and when I have to depend on others to recognize and resolve the hypoglycemia episodes. Having another person force me to eat or drink substances to correct the problem is not a pleasant experience for me, nor is it a delight for the person providing assistance. I always recommend that people should prevent an embarrassing situation from developing into a serious problem by telling relatives, friends, neighbors, and work peers about their diabetes.

How do your friends and family support you?

Family members have always been very supportive. They accepted my medical condition and have never made a derogatory comment or despaired that I may lose my sight, have kidney failure, or amputations. They expected me to live a long life, live it to the fullest, and encouraged the discipline to do so. They were knowledgeable and especially were cognizant regarding the symptoms and treatment of low blood glucose.

However, family is not enough. While growing up, I always told my friends about the problems of low blood glucose and advised them what to do.  Remember, in those days there were no meters to self-test, which made it very difficult to successfully self-identify low blood glucose.

I also have support beyond my friends and family. Since 1971, I have received excellent care from the Palo Alto Medical Clinic and Stanford Hospital. The Clinic recognizes that diabetes is only part of the health picture.  They also realize the importance of treating high blood pressure, high cholesterol, and other conditions that go along with diabetes care. The clinic also has an active Diabetic Support Group, which provides practical insights into day-to-day living.  However, none of these resources would be available without health insurance. Luckily, I have had coverage since 1968 and would not have been able to afford basic care without it.

One particularly helpful faculty member at Eagle Rock High School was the track coach, John Oden. He encouraged me to join the team and enabled me to participate by obtaining the bureaucratic approval to participate.  At that time, people with diabetes  were prohibited from participating without medical approval. Track enabled me to meet many life-long friends and to truly discover the value of exercise.

My supervisors and team members at the U.S. Geological Survey were always supportive. It helped that one manager had a spouse who had diabetes, and another had married an individual with diabetes. They especially understood the potential complications of diabetes because both of their spouses died in their late forties. They appreciated how well I took care of myself.Any negative comments about diabetes from other people?

I remember only one negative comment. In 1984, I was raising money for diabetes through a bike-a-thon sponsored by the Santa Clara Valley Diabetes Society.  One person at work said that she "did not believe in extending the life of those with medical deficiencies." I told her that if her wish were granted, I, along with millions of other people with type 1 diabetes, would have died years ago. I then asked if she would like that to happen a friend or family member.

Have you had any low blood sugars?

I have had my share of low blood sugars. I sometimes wonder how I managed from 1958 to 1983-the year I got my first BG meter. I must have had high blood sugars much of the time, but I only knew I was low when I had a reaction. Since 1983, most of my lows have been primarily during the night while asleep.  Fortunately, most of the time Bobbie recognizes my lows and provides juice, glucose pills, or another source of carbs.  A few times, when I was not cooperative, she called 911 and the fire department came and corrected the problem. They were very knowledgeable about diabetes and had the resources to raise blood sugars quickly.

What can you tell us about diabetes care then and now? Do you see progress?

1958 seems like the Stone Age compared to the present. Then there were glass syringes that were sterilized with alcohol or by boiling. Also, the needles were thick, long, and painful and had to sharpened by hand.  Now the disposable plastic syringes combine with a short, thin, and sharp needle that is usually pain-free.  Also, the insulin pumps and continuous glucose meters are remarkable advances.  Insulin management has changed from one shot a day with two types of insulin: Lente (slower acting), and regular (faster acting). It was difficult to predict when the insulin would peak, and lows and highs were virtually unpredictable without blood glucose meters. Now there is Lantus and Humalog administered several times a day.  Back then we had urine tests, which were virtually useless in identifying current blood glucose levels.  Now there are a variety of blood glucose meters available.

Tell us about receiving your Joslin 50-year medal.

I felt very honored to receive the medal and certificate through the mail in January, 2009. I am flying to Boston this September to participate in the 50-Year Medalist Study.*

What is the secret to your success?

I believe that exercise is an extremely important part of diabetic care. Having had diabetes for over 50 years, the only complication I have had is blood circulation to the left leg, which was corrected in 2006 by vascular surgery at Stanford Hospital.  The surgeon said that the problem cannot be solely attributed to diabetes because I had polio in the left leg in 1946 and now have some symptoms of post-polio syndrome. My ophthalmologist stated after examining my eyes that he would not know that I had diabetes.

I believe the lack of major complications is mostly related to exercise, starting as a teenager and continuing to the present.  I ride my bicycle six days a week, lift weights three days a week, kayak in the ocean once a week, and walk with my wife. I enjoy these activities, but I realize they may not be for everyone.  I think it is important that all of us (diabetes or no) find some type of enjoyable movement activity and do it regularly.

Do you have any tips or messages for the rest of us?

I feel very fortunate to have been honored by the Joslin Clinic and happy that I have truly lived (not merely existed) for those 50 years.  Since retirement, I have volunteered with local senior centers, the National Active and Retired Federal Employees (NARFE), the Eagle Rock High School Alumni Association, and the American Diabetes Association. Stay active, and do not let diabetes care and worries become the only activity in your life. Furthermore, I look forward to receiving the 75-year medal in 2033, at age 89.  Then I hope type 1 diabetes may be cured and there will no longer be a need for this recognition. 
In the meantime, participate and volunteer in community activities, learn everything you can about diabetes, follow medical advice, exercise, and do not be discouraged.  We may not have been the dealt the best health hand, but we can play it to the best of our ability.

*50-Year Medalist Study: Joslin's 50-year medalists are invited to participate in a special study that examines outcomes of long-term diabetes. The study attempts to understand what factors contribute to the longevity of individuals who have received this honor. Currently, over 400 medalists are interested in participating in the study. To date, over 300 of these have completed an extensive questionnaire about their life with diabetes. Data from this questionnaire suggest that the risk of kidney, eye, and nerve problems is different after 50 years with type 1 diabetes than the risk among all individuals with the disease.

A second study is currently being undertaken, which examines factors in the blood and DNA that may help in modifying the risk for complications and survival. Participation in this study is open to all individuals residing in the United States who have received the Joslin 50-Year Medal.

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Posted by Anonymous on 16 June 2009

My comment is directly for Gale Fullerton,
I want to thank you sir, for presenting such a positive and insightful message to those of us caring for children with diabetes. Your outlook on diabetes and life in general is very encouraging to me, as I am raising and caring for my 6 year old daughter with type 1. Thank you for the great message of hope, and inspiration.
I hope to read about you getting that 75 year medal too!
Alice Gaffey

Posted by greawen on 18 June 2009

Thanks Gale for positive words. I was diagnosed at age 50. It's definitely a new challenge but so far I am doing fine with and A1C of 5.6. I'm not sure I'll make that 50 years but it's a goal to work for.

Posted by nyiper on 22 June 2009

My comment is also for Gale.

I was curious that you said your "doctor" did not recommend trying an insulin pump because your control was "satisfactory." The fact that your wife is still finding you in difficulty in the middle of the night, even after all these years, suggests that an insulin pump might make "her" sleep, and yours, MUCH more pleasant, to say the least! An insulin pump allows much more control than shots do but unfortunately it takes using a pump to discover that little detail. I have had diabetes longer than you have, but I'm younger, and yes, I, too am a medal recipient, so I hope your "age" is not stopping you from seriously considering a pump. Who is in charge of the decisions about your diabetes? I hope you are, and not "just" your doctor.

Posted by Leroy from Austin on 23 June 2009

Thanks to Gale Fullerton regarding Type 1 insulin. I am a 37-year type 2 since 1972 (age 24). There is no question that hypoglycemia is the major challenge. There is no question that carbohydrate management is key. There is no question that humalog, lantus combined with metformin are the current BEST medicine available. There is no question that Diabetis will be gone with good science in the future. There is no question that exercise is key. Without reservation, aerobic (30 minutes) and anaerobic (15 minutes) combined with (stretching) will save the day (every other day). In addition, movement daily will keep any diabetic in the good graces of the endronologist. Furthermore, multiple testing is key and becoming a Doctor of one's own body regarding Diabetis. Our professionals are there to help a Diabetic become the BEST doctor of Diabetis. Our goal is to have a long term WIN on life management. I am looking forward to my 50-year recognition in 2022 (13 short years). There is no question that a diabetic can WIN the management and long term life sustaining game of becoming their own BEST doctor combined with there professional team. There is no question that GOOD insurance will keep us keeping on. Again, thanks Gale Fullerton for your wisdom and sharing your story.

Posted by Richard157 on 23 June 2009

Thanks for your story Gale. I am pleased to hear you are doing so well.

I was diagnosed with Type 1 in 1945 when I was 6. I have been diabetic for 63 years and currently have no complications. Receiving the Joslin award would be great but I cannot validate the date of my diagnosis. My parents and the doctors from when I was young have died. I don't know what hospital I was in when after being diagnosed. Participating in the Joslin medalist program would be an honor but I do not qualify if I cannot receive the medal.

My doctor also told me not to pump because I had good control. I then went to another doctor (an endocrinologist) and she approved of my pumping. I have now been pumping for 2 years. I had some beginning stages of neuropathy and retinopathy but the more consisten control provided by pumping has caused those complications to disappear. I encourage you to find a doctor who will approve of your pumping. You will not have many hypos at all after adjusting to pumping.

Good luck to you in the decades ahead.

Richard Vaughn

Posted by Jerry1423 on 23 June 2009

It was really wonderful to read this story.
I too was 14, and in the first semester of my Freshman year of HS when I was dianosed, on Oct 18th, 1975.
I brought that date up to a CDE and she mentioned that it tends to happen as the body was going thru adolescence.
I intend to make it to 75 yrs of being a diabetic, but that will be a while ... first I need to make it to the 50 year make.

Posted by Jerry1423 on 23 June 2009

It was really wonderful to read this story.
I too was 14, and in the first semester of my Freshman year of HS when I was dianosed, on Oct 18th, 1975.
I brought that date up to a CDE and she mentioned that it tends to happen as the body was going thru adolescence.
I intend to make it to 75 yrs of being a diabetic, but that will be a while ... first I need to make it to the 50 year make.

Posted by Maggie on 23 June 2009

Congratulations, Gale. I have had type 1 for 47 years and I looking forward to receiving my certificate in 3 years. It is not always easy, but a good healthy life is worth the incoveniences. When I get dicouraged, I also try to think positive and think that there are many diseases worse than diabetes.

Posted by Anonymous on 23 June 2009

I truly inspiration story. I have had diabetes for 33 years and have been pumping for 14 years. I am a specialist in diabetes and don't agree with your doctor. There is much evidence that pumping increase your awareness of hypoglycemia. You suffer from Hypoglycemia Unawareness which happens in longterm well-controlled diabetes. You are also eligible to wear a continuous glucose monitoring device which can communicate blood glucose level to your pump every 5 minutes and help detect hypoglycemia. If you want a second opinion about pumping go to the UCSF Diabetes Center and see Martha Nolte or Umesh Masharani. Goog Luck

Posted by Pat on 23 June 2009

It was interesting to read this article as I have been type 1 diabetic since 1944, diagnosed when I was 22 months old. I have many complications though a lack of knowledge when I was so young, lack of the wonderful equipment that is available now and a period of rebellion when young. But I am still very active. I too received the 50 year medal in 2004 and went throgh the Joslin medalist testing in 2006. I am also very fortunate to have 2 children, without diabetes, who were not the typical big babies that so many diabetics have. I kept very good control when pregnant, so this did not happen.
continued best wishes to Gayle.

Posted by Rick on 23 June 2009

I have had type 1 for 43 years. With all the advancements in care, meters, short needles, a1c tests, pumps, etc., someone who has had diabetes for a relatively short period of time, if they take good care of themselves, can expect to live a normal life. I have been on a pump for two years and really like it. It gives you much more control over the big "D". I would advise anyone who has acess to one to try it. And there are many diseases much worse that diabetes. But I will say this. Diabetes has affected my life in many ways, none of them good. And when I was young there was embarassment. I felt "inferior" to others my age. I was "not good enough" to fight for my country. I hated that. And althought I'm an exercise nut,(been working out for over thirty years), I have many complications. So, I think they could probably save a ton of money and just chalk some of it up to luck. Everybodys body responds differently to diabetes, maybe not a lot, but enough to make a difference in long term outlook. But I am gonna try and make that fifty year deal. Good luck and God bless all of us diabetics. Only we know, don't we?

Posted by Better Cell on 23 June 2009

I feel that Complications are inherently part of this complex Disease called T1DM regardless of how "good" blood sugar" numbers are.
It is just not politically correct to say so.

Posted by Maggie on 23 June 2009

Congratulations, Gale. I have had type 1 for 47 years and I looking forward to receiving my certificate in 3 years. It is not always easy, but a good healthy life is worth the incoveniences. When I get dicouraged, I also try to think positive and think that there are many diseases worse than diabetes.

Posted by warren on 23 June 2009

i was an athlete who worked out nregularly.5ft 10 and 235 pounds.Always went in for my checkups so life was a dream.One day i got so thirsty i could have drank a gallon of water.It got to the point i could not walk a block before having to urine.called the Doctor went to his office took the dip test and was blown away my sugar was 300.the doctor said the one thing we blew was to check sugar.I called my sister and she reminded me that my Grandmother had diabetes and i found that it had skipped a generation.In 30 days when i went back it was down to 130 with 2 a day workouts.i have now 8 years later developed increasing PSA and now i'm working on that.It is not an easy disease and some will deny that they have it.Support and consistant reminders will keep us in shape.

Posted by Maggie on 23 June 2009

Congratulations, Gale. I have had type 1 for 47 years and I looking forward to receiving my certificate in 3 years. It is not always easy, but a good healthy life is worth the incoveniences. When I get dicouraged, I also try to think positive and think that there are many diseases worse than diabetes.

Posted by Anonymous on 23 June 2009

Good for you Warren, getting yourself back on track, but let's not be confused that type 1 and type 2 are two completely different things.
Gale, I'm a long-term type 1 also and commend your hard work. I agree with the other comments encouraging you to consider the pump. I'm a recent converter (to CGM too) - two years ago - and see the positive results, including better management in the middle of the night.
My best to you, and to all of us.

Posted by Anonymous on 24 June 2009

I think these articles always prove one point: Genetics determine who gets what complications (if any) and when. At least when it comes to Type 1 diabetes (Type 2 diabetes is linked with obesity and other factors that can cause complications).

So often these awards go to people who are labelled as "taking good care of themselves" yet they will admit right in the article that their control was poor 'back in the day', which is to be expected with urine testing, etc.

The only thing that sets these people apart (many exercised every day and ate well and still died young from diabetes)is genetics.

It's a shame that we are sold test strip after test strip trying to 'live up' to a challenge that is really luck of the draw. Nobody (perhaps a lucky few) can have perfect control all of the time no matter what you do. It's the nature of the beast of Type 1 diabetes. I test 12x+ per day. Wear a pump. Weigh every bit of food and eat mostly raw and very healthy. I'll never have even NEAR normal stable glucose levels. EVER. Doesn't matter, it's luck of the genetic draw. Pick your parents wisely.

Posted by Anonymous on 24 June 2009

I agree with Rick and the comments he made. Diabetes has also affected my life in many ways and none of them are good!!! I also agree totally with what Better Cell had to say. No matter how much some of us try to have good control of our diabetes, we aren't all as fortunate as some others are. It truly is not politically correct to say that complications are part of the disease of type 1, but they are!! I get so angry when I hear some people say that there are lots worse things than diabetes. Yes, that is true but for those of us who are struggling with the disease on a daily basis, it isn't exactly a piece of cake (literally or figuratively). I think that each case of diabetes is so different that making a blanket statement about the disease does us all harm. Suffice it to say that I will be one of the millions of relieved individuals if this disease is ever cured. I frankly don't think it ever will be because it is a HUGE multi-billion dollar business for pharmaceutical companies and all sorts of companies out there.

Posted by Anonymous on 26 June 2009

I have been insulin dependant since age 12 and
now 74 years old. The insulin pump and continuous glucose meter have given much better
control and very few hypoglycemic episodes. As
of now I have no diabetic complications and
enjoy a very busy active life.

Posted by Rick on 29 June 2009

God bless you. This proves the point that luck has a lot to do with it.


Posted by AnnetteUK on 2 July 2009

It seems Gale wrote my almost exact history of Juvenile Diabetes!! I was diagnosed [in England] in 1958, from the one or two shots of NPH insulin a day and testing urine each bedtime, which told us absolutely the awesome variety of insulins and delivery systems of today!! I so wish my parents were still alive to see their 'bionic' daughter now!! By that I mean my 2nd insulin pump & my CGMS. As a teenager after being told I 'could' live 20 maybe 25 years with this disease, I decided that because my lifes road would be short I had better hurry and do what I want .. soon!! And I did. I was also told to always live with my parents because 'things' would happen to me.. and to never marry because I should NEVER get pregnant... :( I made the choice to not let the disease rule my life but for me to rule it! And I did.. I emigrated to America, alone, [with my big glass syringe, one needle that I had already used for 3 months & boiled & sharpened regularly] 5 weeks after my 21st birthday, a year later I married, had 2 babies and now have 4 super grandsons. And ... I am a patient and volunteer at a local Joslin affilliate where I live in Connecticut. I receieved my 50 year medal & certificate last year and yesterday spent the day at Harvard/Joslin in Boston taking the 50 Study tests... what a verification and honour that was/is! I have no complications at all.. thanks to my DNA plus doing the best I could to survive, which for each of us is different and at times extremely difficult!! Gale .. were you at the Medalist Event in Boston this May? If so ... I am the Brit who spoke almost last about my history.. with a sense of humour :) I was told yesterday there may be another medalist event next year.. there have only been two and it is such a hit they may do it more often. This year it was like a miracle actually meeting 40 others that have had J/D 50 years or more too .. finally someone to totally relate to and with!! To all long termers... I am proud of you... we are perhaps blessed with J/D because there are indeed way worse diseases, but .. ours is soooo long term... and still...for life. Every second, minute, hour, day, week, month, year, decade...etc etc.

Posted by Rick on 2 July 2009

Annette seems almost joyful to have been blessed with this "benign" disease. I read these stories of people with longterm diabetes and no complications and I am truly happy for them. But in my mind these people slipped through the cracks. There are millions of people with vision loss, amputations, nerve disorders that can affect many parts of the human body. I wish they would just consider themselves fortunate to have escaped these complications rather than act as if they did so much better than the rest of us in managing this "harmless" disease. Oh, did I forget to mention that 80% of people with diabetes die from cardiovascular disease? So please stop. And after thinking about it, I wouldn't want there 50 year award. So, if you don't make it fifty years you're a dismal failure who didn't have the self control to take better care of themselves. I might be losing my health insurance and if I do I doubt I'll be celebrating my 50th. Please. Stop.

Posted by cowboymom on 17 January 2010

I would like to congratulate every person who has made it 50 years without complications. You don't know what insight and encouragement that it gives the children who have been dianosed. Our son was diagnosed when he was ten. We made a vow to him when he was diagnosed that we would provide him with the best care possible and the best equipment possible.

From what I have been able to deduce on this insidious disease is that control is just that, control. Our son was one of the lucky ones. I caught it before he got past the stage of getting up a couple of times a night to urinate and get more water. He has been very stable and up until this point, knock wood, he has never had an "episode." I have always oontended that because we have livestock that we are all more atune to more subtle changes. I do not know but I thank our lucky stars.

We also take the mindset that he has diabetes, diabets does not have him. We have been to some conferences but they seem like mostly the same people and they are obsessed by it. No one is perfect and we all have to live with our imperfections. I have yet to meet a perfect person yet in this life.

The only wish I have besides curing Type 1 is that the names would be changed. Comparing Type 1 to Type 2 is like comparing night and day. A much higher percentage of complications occur in Type 2 than Type 1.

Our son contends that Diabetes might have saved his life since his father and his father's side of his family are a very, very long line of alcoholics.

Posted by Anonymous on 7 November 2011

I have had diabetes since the age of 8 which makes it over 50 years now!! I am lucky that I have not developed any complications and I feel that is due to a number of factors, including my inherited DNA. My parents, after my diagnosis, did as much as they could to learn about the condition and my mother had particular concerns about possible complications and so did some straight talking to me about how good control could help prevent these in the future. I remember being anxious myself about lacking energy and feeling ill, as happened before diagnosis and treatment, which made me pretty detirmined to do what I could to enable myself to "feel well" (in the eighties I discovered that attempts to feel well enabled my blood sugars to remain in the fours, as was recorded in my first blood tests with strips). At 16 I left home and moved to London as I had passed the audition for a professional London ballet school and so began whole and successive days of advanced training, for three years, which did more to lower and maintain low blood sugars than any amount of insulin. During this time I remained on a permanent low calorie diet in an attempt to remain as thin as possible (no company hires fat dancers as all the costumes are made in small sizes)!!! After ballet school I danced in Italy (went over aged 19) in the Italian Operetta Company and with other companies too. At home I worked with well known stars such as Frankie Vaughan, Bruce Forsyth, Matt Munro) and also taught ballet, national and modern dance. I married and then worked in advertising for 10 years which involved travelling and staying away from home. Unfortunately, in 1981, my husband had an accident in which he broke his neck, and became paralysed from the nipple area down, including hid hands and arms, so as well as working a 75 hour week I also became a carer which involved having very little sleep as I had to do everything, including the most basic tasks, for him. 7 years after the accident I received donor sperm and became pregnant after the first treatment (so lucky!!!). I had a beautiful baby boy who weighed in at 7 lbs. 2 years after his birth I had a wonderful baby girl who weighed in at 6lbs 7 ozs. After that I did not work until both children were 11 & 13 as it would have cost a fortune to have live in help for the children and my husband too. At 48 I applied for a degree course at a nearby university and graduated 3 years later with an upper second class honours degree. I was then accepted for a post graduate teaching course in London and qualified as a teacher. I have worked successfully for 7 years since, teaching in schools and at a college. I also survived a bout of bacterial meningitis 2 years ago and returned to work within 6 weeks. However I was recently made redundant but because of my age (58)and the fact that so many teachers have been made redundant in Great Britain recently, due to changes in the national curriculum and a falling birth rate, and I have been unable to secure another post. I feel that being diabetic has not affected my life negatively at all. Blood tests, jabs and counting carbs are rather like a routine such as brushing teeth before bed. I probably also exercise more than most people too.

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