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Canada's Original One Stop Shop for Insulin Pump Supplies est 2004

All prices in CAD dollars

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HOW DO YOU CARRY YOUR PUMP AND SUPPLIES?

Friday, May 6, 2016 3:13:43 PM America/New_York

Kamor Belt with 5 Pockets

Made of polyester/spandex fabric for moisture wicking, quick drying, stretch, softness against your skin, and machine washable. 3M™ reflective strip in the front of belt make your more visible during night.

  • Easily pull this over your head or up your legs and position it on your waist or hips, fitting nice and snug, without uncomfortable chafing. Turn over for double protection.
  • One large pocket, space continuous around the belt, which can hold a lot of personal belongings, another small separate pocket can take your cash, ID, cards more securely. An inner keychain to hook your key tightly plus a zippered pocket for extra security.

https://www.diabetesdepot.org/diabetes/catalogsearch/result?q=kamor

 

Universal Zipper Pump Pouch

This unbelievably small pouch will expand to accommodate more than just an insulin pump, epi pen, asthma inhaler, cell phone, keys, pocket camera, children's snacks, money, identification... or a combination of any other small items that you may want to carry with you on a daily basis, or as you travel.

The built in belt will adjust to comfortably fit waist measurements from approximately 28" to 42".

Assorted colours. https://www.diabetesdepot.org/diabetes/universal-zipper-pump-pouch.html

 

 

Universal Velcro Pump Pouch

Velcro Insulin Pump Pouch is universal for all pumps. Our elastic belts are adjustable to accommodate growing children and to allow the stretch required in active children's lives- 20-38". Assorted colours. https://www.diabetesdepot.org/diabetes/universal-velcro-pump-pouch.html

Clip-N-Go Pump Case

You can clip your insulin pump to your waistband so you can decide where the pump is most comfortable. The interlocking clip holds the pump securely in place. Made of water resistant nylon with a soft cotton lining. Fits all Animas Pumps. 

https://www.diabetesdepot.org/diabetes/clip-n-go-for-case.html

Belter Case

Belter™ for all insulin pumps.

The Belter™ holds your insulin pump on your belt. Just slip your belt through the back of the Belter and you can wear your pump in a horizontal position. The Belter accommodates belts up to 1.5" wide. Appropriate for business attire too.

https://www.diabetesdepot.org/diabetes/belter-case.html

Waist Pouch on Elastic Belt

Wear the pump around your waist for the ultimate in comfort. The soft, adjustable belt and case feel good under your clothing or pajama available in black or beige

https://www.diabetesdepot.org/diabetes/waist-pouch-on-elastic-belt-black.html black

https://www.diabetesdepot.org/diabetes/waist-pouch-on-elastic-belt-white.html beige

 

Bra Pouches in Black or Beige

BRA POUCH, Velcro is sewn onto bra and the pouch adheres to it. Pouch is made of soft Lycra.

https://www.diabetesdepot.org/diabetes/bra-pouch-black.html

FRIO Insulin Cooling Wallets

Travel wallet for insulin. No more messy ice bags. No more worry about refrigeration. Simply activate it with water and it keeps insulin cool for up to 48 hours. Re-usable. Available in a variety of sizes to accommodate insulin vials, pens and insulin pumps. https://www.diabetesdepot.org/diabetes/catalogsearch/result?q=frio

On Thigh or Leg

The Thigh Thing https://www.diabetesdepot.org/diabetes/thigh-thing.html (above the knee) and the Leg Thing (below the knee) https://www.diabetesdepot.org/diabetes/leg-thing.html allows you to wear any insulin pump under dresses, shorts, or pants. It is a discreet alternative to wearing a pump on your bra, belt or underwear. It is a sleeve with a pocket made of nylon/spandex so it won't lose its shape.

LEG POUCH on ELASTIC BELT can be worn discreetly under clothing. Wraps around the thigh or calf with a special pocket for the pump. The Vel Stretch nylon elasticized straps come in thigh width and can be altered to wear alternatively below the knee. Secure Velcro prevents slippage.

Available in black https://www.diabetesdepot.org/diabetes/leg-pouch-for-medtronic-universal.html
and beige https://www.diabetesdepot.org/diabetes/leg-pouch-for-medtronic-universal.html

GirlyGoGarter

 

https://www.diabetesdepot.org/diabetes/girlygogarter.html

This new product is the most talked about accessory at the Oscars.The GirlyGoGarter® is a sexy, lacey garter with pockets that adheres to your upper thigh with patented GentleFlex™ Grippers.  There are two types of pockets on the GirlyGoGarter®: easy-access (on the outside, just within the lace) and lock-flap (on the inside, against your thigh). Both types of pockets keep your insulin pump, BG meter, glucose tablets, money, I.D., lip gloss, mobile phone, keys, passport and all of your essentials safe, secure and right at your fingertips. Available in small (fits 0-6), medium (fits 8-12 and large (fits 14-18). Unsure of size? Go smaller rather than larger. Colours - Black, Nude, Red, Hot Pink, Wedding Blue. Check it out on Youtube http://www.youtube.com/watch?v=DgwQig0qNTQ

Clips, Cases and Holsters for Pumps

Clips, Cases and Holsters for Pumps

phone us with make and model of your pump for recommendations

Multi-Fit Case

Multi-Fit Case

The stylish Multi-fit Case carries everything that the Ezy-fit Case carries plus much more. This new design is suitable for both Type 1 and Type 2 diabetics. The outer case is made of a tough, easy to clean material with a lanyard loop handle, while Velcro and elastic features are used to hold equipment into place.

The top compartment carries a BG Meter, 2 x pen needles, foil or canister test strips, a lancet device, insulin vials, Test-wipes, a Record Book, a Card Sized Personalized Management Plan, a biro, a needle and lancet tips, as well as a rubbish bin. The compartment underneath can carry Insulin Pump Consumables, a Glucagon kit, jelly beans or food for hypo treatments, spare batteries, Test-wipes, test strips, other medications or even money and credit cards.

Finally, everything can truly be stored in the one place. https://www.diabetesdepot.org/diabetes/multi-fit-case.html

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Posted in Living With Diabetes Products By Tino Montopoli

Insulin Absorption and Infusion site Health

Wednesday, August 26, 2015 12:21:39 PM America/New_York

Considering that insulin pumps are new to more than a third of the population with type 1 diabetes in Canada, we continue to learn new positives as well as challenges in use of the therapy. An emerging challenge is long term infusion site health as it relates to absorption of insulin. In my experience, about one in four pump users have insulin absorption issues which ultimately affect overall Diabetes control (A1c).

Signs and observations:

  • increase in total daily dose of insulin over past year or more >/= 25%.
  • increasing A1c
  • new onset insulin resistance diagnosis or medications (applies to those without significant weight gain)

In other words, if you have been on a pump for a while, and have noticed it takes more insulin to bring your glucose down then it used to and your A1c is not in range, this issue may apply.

What are the contributing factors? 

Compared to injecting, placing an infusion set is tricky. Site rotation becomes limited to what you can reach with both hands. Usually, you need to see what you are doing clearly. This means pump users likely use half of 'injection-approved' site areas. (injection approved like the back of arms, lower back or side of upper thigh.)

Add to this the demand on the tissue for 3 days worth of absorption and the challenge emerges:

  • most adult pump users alternate between sides of the abdomen.
  • the abdomen has the most consistent absorption and therefore is the most used whether injections or infusion sites.
  • the cost of replacing an infusion set means sets can be left in too long.

All of the above set the groundwork for the development of scar tissue which ultimately affects the absorption of insulin.

Assessment

During a self-assessment of your infusion sites, you may notice:

  • differences in one side of the abdomen from the other when gently pinching up along your infusion areas.
  • you have more than 2 past sites still trying to heal.
  • your infusion set gets damp or seems to leak as it gets closer to day 3. 
  • the recommended cannula prime amount is not enough- usually have to take a non- food bolus to get the insulin absorption of your site "going".
  • more than one site infection requiring a course of antibiotics.

Treatment

As with injecting, areas of scar tissue are to be left alone / avoided. A challenge when using a pump! Development and frequency of site infections can also relate to the individual's immune defences. Leaving in painful , red looking infusion sets in beyond the 3 days increases the risk o site infection- leading case of scar tissue.

If you wish to try new areas for infusion placement, be aware you may need to lower your insulin amounts as much as 25% to prevent hypoglycaemia. You could try a temporary basal rate lowering with the usual meal bolus for simplicity until you are satisfied your usual rates apply in the new site area. More frequent glucose checks may be required while monitoring this change.

Routine use of a topical antiseptic ointment can help limit the risk of site infection beyond the basics of good hand washing and clean process of set placement. Expand the areas of use in your site rotation plan. Monitor your glucose response when using 'fresh' infusion areas. Talk to your diabetes team for tips or treatments to help you.

Hair removal may be used to find new ‘fresh’ infusion areas on hairy men.

Some hair removed on belly

Some Hair Removed

Hair removed on entire belly with Veet wax strips

All Hair Removed

Jill Milliken RN, is a Diabetes Nurse Educator in private practice who has been developing educational programs for people using insulin pumps since 1999. Ms. Milliken contributor to Pumping Insulin (Walsh) and Diabetes for Dummies for Canadians.

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Posted in Living With Diabetes Products By Jill Milliken RN, CDE

Pumping Insulin during Water Activities and more

Tuesday, August 4, 2015 12:03:35 PM America/New_York

Pumping Insulin during Water Activities and more

Insulin pumps are designed to be able to comfortably withstand temporary exposure to water. This means that if you get splashed or your insulin pump drops into the sink when washing, it shouldn’t malfunction if it’s dried quickly with a towel. Some pumps have been designed specifically with greater waterproof protection in mind and have been tested to confirm their waterproof capabilities.

If you are planning to go for a short swim, you may simply disconnect your pump and enjoy the water. Doing so is the best way to avoid risk of any water damage to your pump. You may make up the basal insulin you normally would get as a bolus when you reconnect your pump. For example, if you are disconnected for 1 hour and your basal rate during that hour is 1U per hour, simply give yourself 1 U as a bolus. However, if you are fairly active during the hour you disconnected, you likely don’t need to make up that basal dose- in fact you may need a snack to compensate for the activity. It's recommended to test your blood glucose before and after your activity. Speak to your diabetes healthcare provider for further instructions.

Which insulin pumps are waterproof?

Insulin pumps need to be waterproof to some degree but some have been shown to be more waterproof than others.

Animas Pumps are waterproof for up to 24 hours at 3.6 meters however battery caps should be changed every 6 months. If you are a frequent swimmer or work in a dusty environment, you should change your battery cap every 3 months.

Animas Battery Cap

Animas Battery Cap

SKU: A100-158-01 https://www.diabetesdepot.org/diabetes/animas-battery-cap.html

Accu-Chek Combo Insulin Pumps are rated as water tight so they are protected against the effects of temporary immersion in water for up to 60 minutes at a depth of 8 feet. It is very important to replace the battery cap every 2 months to prevent water leakage.
https://www.diabetesdepot.org/diabetes/accu-chek-spirit-battery-cover-kit.html

Medtronic Paradigm Insulin Pumps are NOT waterproof and must be protected from water damage. For more information about the water resistant rating of Medtronic Pumps see
http://www.medtronic-diabetes-me.com/8784.html

Aquapac Insulin Pump Case may be used to protect any insulin pump from water damage.
https://www.diabetesdepot.org/diabetes/aquapac-insulin-pump-case.html

Delicate Insulin Pumps and water don't often mix well, so this case allows the user to bathe, go boating or enjoy water sports with peace of mind.

Protected against temporary immersion - The case will withstand immersion for up to 5 seconds to a depth of 3 feet/1 metre.

Refer to Aquapac's manufacturer site:
http://store.aquapac.net/waterproof-rating.html

Aquapac Insulin Pump Case

Features:

Protects from dust, dirt and sand
Supplied with a belt, or feed your own belt through the case
It will float if you drop it in the water
The seams are high-frequency welded to form a super-strong bond
The Aquaclip® (a patented, ultra-secure, rustproof, injection-molded plastic seal) opens and closes with a simple twist of two levers, and everything stays in one piece even when open
The case comes with an adjustable belt & works with the majority of Insulin Pumps.

Sharps while travelling

Wondering how to handle your sharps while travelling? Save your empty test strip containers and use them as a temporary sharps container. When you get home just transfer them into your regular sharps container. In a pinch you can use an empty can of soda pop with tape over the opening.

FRIO Insulin Cooling Wallets

Black FRIO Insulin Cooling Wallet Blue FRIO Insulin Cooling Wallet 

https://www.diabetesdepot.org/diabetes/catalogsearch/result?q=Frio

No more messy ice bags. No more worries about refrigeration. Simply activate it with water and it keeps insulin cool for up to 48 hours. Re-usable and available in a variety of sizes to accommodate insulin vials, pens and insulin pumps.

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Posted in Living With Diabetes Products By Tino Montopoli

Infusion Site Sticking Problems

Wednesday, June 3, 2015 10:04:26 AM America/New_York

Infusion Site Sticking Problems

As we know, infusion sites are "prime real estate" and care is required to maintain a good number of effectively absorbing areas. Absorption of insulin becomes very limited in the presence of swelling due to infection and or scar tissue. People with frequent site issues may be infusing more insulin than they need. Glucose levels may increase initially due to lack of absorption and then as a result of inflammation and eventually, scar tissue. 


For those who have been using a pump long term adhesion may be less of an issue but site rotation can become more limited as a result of using these preferred sites. Our aim in this discussion is to share some tips which have helped solve infusion site issues.

So let's talk about infusion sites! Some of the variables which relate to whether your site will last 3 days or 3 hours include:

  1. location of the site is best in areas which are as protected as possible from being dislodged by moving alone. The sides of the body are more vulnerable to site dislodgement from movement and being caught on things than sites closer to your core.
  2. Body hair can affect the longevity of an infusion site. If you can , use areas with the least amount of hair. Use products to remove hair instead of a razor to avoid later itch at the site. Apply hair removal product to the area a few days before placing the infusion site to decrease the likelihood of skin irritation under the new site. 
  3. Skin preparation process and adherence products (Skin Prep and Liquid Spray Bandage). To maintain a site for 3 days, the site area should be clean and air dried with the use of site preparation products unless you have sensitivities to these products. About one in 5 people seem to have skin sensitivities. If you have signs of skin sensitivity such as red itchy marked area where the tape was, or angry raised looking areas, speak to your diabetes care provider. Use the process of elimination to evaluate which compound is causing the problem if more than one product is being used. Sensitivity to one product does not translate to sensitivity to all. Some pump manufacturers provide samples of various site prep products.

    Skin Prep MMT-175

    Skin Prep MMT-175
    Spray Liquid Bandage MED 070487

    Spray Liquid Bandage MED 070487
     
  4. Site change routines. Many people stretch their dollars worth out of a good infusion site. In general, the older the person and the longer duration of diabetes can extend their infusion sites longer than 3 days where children cannot. This is likely due to the blunting of the immune response to the cannula in adults than in children who's sites usually start failing after 48 hrs as their body actively rejects the cannula. In all ages and stages, when a site becomes painful or uncomfortable to touch it's better to change it out. The pain means infection or irritability which result in the development of scar tissue. 
  5. Technique. There are many kinds of infusion sets in optional lengths and angles. It may be that there is some trial and error needed to find a product right for you. For example, some brands have stickier backing than others! 

For some people the backing of their infusion set alone will carry them through to day 3. Success is often based on the site prep product used. Allow to dry to at least "tacky" before applying the site. Use anti - perspirant spray if needed on the area a few hours before the site prep pad is used is one trick which helps improve adhesion in the summer.

An occlusive dressing such as IV 3000 ( looks like plastic wrap) can be used against the skin and does help anchor the infusion set which is inserted directly through the dressing or a small hole in the centre. This "sandwiching" technique helps hold the cannula securely. It will also prevent "set migration' when the site stretches over time and can cause a kinked cannula. 

iv3000

In the case of tape, more is not better. The added tape means the whole site becomes more vulnerable to dislodgement. Some people use a site prep pad to circle the perimeter of their infusion set occasionally to encourage the edges to stay down. Always go by your blood sugar no matter how beautiful or ugly and beat up your site looks! 

Rarely, allergies to the cannula itself occur. The process to get to this point in troubleshooting is long painful and frustrating usually because it isn't the top of mind reason. The way to rule this out is to try a steel needle-based infusion set. This solution has been miraculous to those who were considering coming off of their pump due to this issue.

If the preceding techniques or products have failed, there are a couple of other products that may help secure the infusion set in place.

Skin Tac Adhesive Wipes

Skin Tac  Adhesive Wipes

Mastisol-01

Mastisol-01

written by Jill Milliken


Jill Milliken RN is a Diabetes Nurse Educator in private practice who has been developing educational programs for people using insulin pumps since 1999. Ms. Milliken contributor to Pumping Insulin (Walsh) and Diabetes for Dummies for Canadians.

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Posted in Living With Diabetes Products By Tino Montopoli

Diabetes Depot's Blog on Infusion Set Site Problems

Monday, January 19, 2015 11:55:09 AM America/New_York

When To Change The Infusion Set

The infusion set and site should be changed frequently and regularly. A general rule of thumb is that a metal needle should be changed at least every two days (though some users successfully use them for longer), while a Teflon set should be changed at least every three days. However, your doctor or educator may recommend a different schedule based on your particular situation. For example, many doctors recommend more frequent set changes during pregnancy. Make sure you know and follow your team's advice about frequency of set changes. Do not change the infusion set before bed as you will need to be awake to know if the set is performing properly.

Your set and site should also be changed whenever you notice any irritation or discomfort at the infusion site and always when you have two unexplained high blood glucose readings in a row. Also, leaving the set in for too long may promote hardening of the skin tissue leading to poor absorption of insulin. This is often referred to as losing your site.

Pump users and health care professionals alike stress the fact that "if it's noticeable, something is wrong." Check or change your site at the first sign of irritation or discomfort. Irritation, discomfort or pain may be the first sign of a developing infection. Taking action immediately will keep little problems from turning into big ones.

Skin Irritation

Skin Irritation at the the infusion set site is much more common than infections. This may be caused by sensitivity to the tape being used or by sensitivity to the metal needle or plastic parts of the infusion set. If the irritation appears around the edges of your tape or dressing, try lifting the edges slightly all around the dressing. This creates a new contact edge and often alleviates the problem.

If the irritation appears wherever the tape touches the skin, you may be sensitive to the tape's adhesive or material. There are a couple of products which may prevent this kind of skin irritation.

Skin Prep (SKU MMT-175) is available in boxes of 50 pads/wipes. The wipes are applied to the skin like an alcohol wipe and allowed to dry. This will disinfect, cleanse and leave a protective film on the skin thus preventing direct contact of the adhesive from the infusion set to the skin. Skin Prep will also enhance adhesion.

Skin Prep

 

3M's Nexcare Spray Liquid Bandage (SKU MED 070482) is another very effective product which leaves a protective film on the skin. Simply point and spray then wait for it to dry and then apply the infusion set to the sprayed area.

Nexcare Spray

 

Another way to protect the skin from irritation caused by the infusion set adhesive or plastic part of infusion set housing is to apply a transparent dressing like IV 3000 or Tegaderm to the skin first and then insert the infusion set through the dressing.

IV 3000tegaderm

 

Metal sensitivity is another possible cause of irritation. If you experience irritation in areas that come in contact with a metal needle, try an infusion set with a Teflon cannula.

Treatment of Skin Irritations

First and foremost it is important to remove whatever is causing the irritation (infusion site, adhesive tape, dressing, etc). Relocate the infusion set to another location taking care to protect the skin as discussed previously. If there is no sign of infection, the skin may be treated with hydrocortisone cream 0.5% twice daily. This may be purchased at any pharmacy without a prescription. An infected site may be treated with a topical antibiotic ointment like Polysporin or Bacitracin applied 2-3 times daily.

IN UP COMING BLOG, I WILL DISCUSS STICKING PROBLEMS

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Posted in Products By Tino Montopoli

CGMS-Continuous Glucose Monitoring Systems

Monday, October 27, 2014 4:15:58 PM America/New_York

I have been using CGMS since 2007 because it allows me to better manage my diabetes. My current Veo Medtronic pump works with the Enlite sensor to measure my interstitial glucose level every 5 minutes. This level correlates with my blood glucose and is displayed as a graph on the insulin pump. You may ask, why is such close monitoring necessary? Dr. Steven Edelman of UCSD said it best when he made a presentation at the Best Center (Ajax), Type 1 Diabetes Educational session May 2013, “ I use CGMS because every day is different”. This is very true. We do not expend the same energy, or eat or experience exactly the same stress every day. CGMS allows a user to micro manage his/her diabetes because we can see the trend of the glucose level and make decisions regarding more or less insulin or more or less food instantaneously. In my own personal situation, I experience some delayed digestion (gastroparesis) and CGMS allows me to gauge my insulin needs. I have experienced a reduction in A1C of ½ percent (7.2 to 6.7) with the help of CGMS.

There are 2 CGM systems available in Canada. Animas sells a standalone CGM system called the Dexcom G4 Platinum CGM as well as the Vibe Insulin Pump which features Dexcom CGM. Medtronic sells a standalone CGM system called the Guardian as well as the Veo Insulin Pump which features the Enlite CGM system. Each system has a disposable sensor which is specific for their system.

Anna of http://www.insulinindependent.com/ has written a blog comparing both systems. Anna is based in the UK where these systems were available before they were introduced in North America.

An adapted version of the chart on Anna’s blog

http://www.insulinindependent.com/2013/07/dexcom-g4-vs-medtronic-enlite-low-down.html

 

Vibe with Dexcom G4

Medtronic Enlite

     

Calibrations needed

2 per day although more results can be entered

2 per day. No more than 4.

Length of wear (according to manufacturer’s guidance)

7 days (CE approved)

6 days (CE approved)

Actual wear by customer’s choice (not advised)

Personal experience of between eight and 36 days wear before sensors expired

Personal experience of only 8 days before sensors expired

Comfort

Extremely comfortable. Longest time worn for 36 days ith no irritation and very small entry hole.

Extremely secure when in place

Comfortable.

Longest worn for 8 days, but aware of the sensor site at this time and reasonably irritated on removal.

Not as secure feeling when in place

Integrated into pump

Yes, only with Animas Vibe

Yes, only with Medtronic Paradigm Veo

Low Glucose suspend (safety feature to suspend pump temporarily when hypo)

No

Yes , when integrated with Paradigm Veo pump

Alarms

Very good. Audible, simple, easy to amend upper and lower limits

Good but less audible when pump under covers. Somewhat over sensitive (alarms when changing very slightly).

Paracetamol use while wearing sensor?

No. It interacts with the fluid giving a false high

Yes. No issue with fluid interaction.

Range

20 ft, can work between rooms (with stand alone unit)

6 ft (with standalone unit)

Accuracy (MARD score – the gold standard of glucose testing. The lower the MARD, the more accurate the device is considered)

14%

15.3%

Sensor technology has been improving over the last few years with smaller and more sensitive sensors however they still require calibration with a blood glucose meter 2-4 times daily. CGMS will not eliminate the need for a finger poke. Coverage for the sensors is not universal. Some insurance companies pay for these while many do not.

If you have used CGMS, please share you experiences with others through this blog.

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Posted in Living With Diabetes Products By Tino Montopoli

Saving Money on Infusions sets

Friday, March 14, 2014 2:09:00 AM America/New_York

There are a number of ways to stretch your dollars when purchasing your infusion sets. Consider using a combination package. Some sets are available with 10 sites and 5 tubing sets with the idea that the tubing may be used for 6 days while the sites (Teflon) may be changed every 3 days.

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Posted in Living With Diabetes Guides Products By Tino Montopoli

Simplicity of Steel Infusion Sets

Friday, February 7, 2014 1:58:22 AM America/New_York

Why use a steel set? They will not kink which is a risk with any Teflon set. The gauge or thickness of steel is much smaller that Teflon so that when you change sets there usually is NO trace or wound. Anybody using Teflon will see a small hole that scabs over as it heals.

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Posted in Products By Tino Montopoli

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