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Available online at ajdhs.com 

Asian Journal of Dental and Health Sciences 
Open Access to Dental and Medical Research 

Copyright  © 2023 The  Author(s): This is an open-access article distributed under the terms of the CC BY-NC 4.0 
which permits unrestricted use, distribution, and reproduction in any medium for non-commercial use provided the 

original author and source are credited  

 

 

Relationship between family history, diet and sedentary behavior with the 
incidence of diabetes mellitus  

Ace Sudrajat, Maharani Romadhona, Santa Manurung*, Suratun, Nelly Yardes, Dewi Lusiani, Tin Hartini 

Health Polytechnic of Jakarta III, Indonesia 

Article Info: 
______________________________________ 

Article History: 

Received    30 March 2022      
Reviewed  09 May 2023 
Accepted   28 May 2023 
Published 15 June 2023 

______________________________________ 

Cite this article as:  

Sudrajat A, Romadhona M, Manurung S, 
Suratun, Yardes N, Lusiani D, Hartini T, 
Relationship between family history, diet and 
sedentary behavior with the incidence of 
diabetes mellitus , Asian Journal of Dental and 
Health Sciences. 2023; 3(2):26-31 

DOI: http://dx.doi.org/10.22270/ajdhs.v3i2.42        

_______________________________________
*Address for Correspondence:   

Santa Manurung, Health Polytechnic of Jakarta 
III, Indonesia 

Abstract 
________________________________________________________________________________________________________________________ 

Diabetes Mellitus (DM) is a degenerative disease that is a public health problem throughout 
the world. Diabetes mellitus has become one of four non-communicable diseases that will 
cause around 6.7 million people to die in 2021. Currently, the number of cases and 
prevalence of diabetes mellitus continues to increase. There are several risk factors that can 
cause diabetes mellitus, including family history, food patterns and sedentary behavior. This 
study aims to determine the relationship between family history, diet and sedentary 
behavior on the incidence of diabetes mellitus. The population in this study were all patients 
aged 45- 75 years who were treated at the Chronic Disease Management Program (Prolanis), 
Public Health Rebo District Market Center. Samples were taken as many as 68 respondents 
with a purposive sampling technique. The data was collected using a questionnaire and then 
analyzed using the chi square test. The results showed that there is a relationship between 
family history (p-values = 0.003 with OR = 5.061), diet (p-values = 0.002 with OR = 5.667) 
and sedentary behavior (p-values = 0.011). with OR value = 3829) with the incidence of 
diabetes mellitus 

Keywords: Family History, Food Patterns, Sedentary Behavior, Diabetes Mellitus, Incidence 

 

INTRODUCTION 

Diabetes mellitus (DM) is one of the degenerative diseases 
that affect the health of individuals worldwide. Diabetes 
mellitus is a metabolic disorder caused by hyperglycemia 
(increased blood sugar levels) that occurs due to decreased 
insulin secretion, impaired insulin metabolism, or both. This 
makes blood sugar in the blood unable to be utilized by the 
body's cells as energy resulting in hyperglycemia.1,2 

Diabetes mellitus is one of the four non-communicable 
diseases which will cause around 6.7 million deaths in 2021. 
Currently, diabetes mellitus continues to increase every year. 
According to a report by the International Diabetes Federation 
(IDF), the number of people with diabetes mellitus worldwide 
in 2021 has reached 537 million. It is estimated that the 
number of people with diabetes mellitus in Indonesia will 
continue to increase in 2045 to 28.6 million sufferers. 
Indonesia is the only country in Southeast Asia on the list. 
Thus, Indonesia has a significant contribution to the incidence 
of diabetes mellitus in Southeast Asia.3 

According to the 2018 Basic Health Research, the incidence of 
diabetes mellitus in Indonesia according to doctors' diagnoses 
at the age of ≥ 15 years has increased to 2%. This figure 
represents that there was an increase in cases of diabetes 
mellitus previously in 2013, which was 1.5%. Meanwhile, the 
prevalence of diabetes mellitus based on blood sugar 

examination results in 2018 increased in percentage from 
6.9% to 8.5%. DKI Jakarta has the highest incidence of 
diabetes mellitus at 3.4%.4 According to data the author 
obtained from the Pasar Rebo District Health Center, the 
number of people with diabetes mellitus during the July-
December 2021 period was 3,038 sufferers. Diabetes mellitus 
is the second most common disease in the Pasar Rebo Health 
Center. 

One of the risk factors that cause diabetes mellitus is a family 
history of diabetes mellitus. Judging from the results of 
research conducted by Irwan et al it is said that individuals 
with a family history of diabetes mellitus, especially parents 
and siblings, are at higher risk of developing diabetes mellitus 
than someone who has no family history. In addition, there are 
other studies which explain that if one of the two parents 
suffers from diabetes mellitus, there is a 15% risk of suffering 
from diabetes. However, if both parents have diabetes 
mellitus, the risk of developing diabetes mellitus increases to 
75%.5,6 

Diet can also contribute to the occurrence of diabetes mellitus. 
Diet is the accuracy and consistency of the patient in 
controlling the type, amount and frequency of eating. A person 
can be said to have a healthy diet if they follow dietary 
guidelines such as type, amount and frequency. Conversely, if 
someone does not do less than these three indicators, then the 
eating pattern of people with diabetes mellitus will be bad. 

                       Open Access                                                                                                                                                                                                         Research Article                                          

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Based on the results of research conducted, it was found that 
someone who has a bad diet is twice as likely to suffer from 
diabetes mellitus compared to those who have a healthy diet. 
This unhealthy eating pattern is about people who often eat 
foods high in calories, fat and cholesterol, such as fast food.1,7,8 

The results of the 2018 Basic Health Research stated that 
there was an increase in the number of people who were less 
active, including sedentary behavior, namely by 33.5%, 
compared to 26.1% in 2013. Sedentary behavior is a risky 
behavior that can cause metabolic syndrome, namely coronary 
heart disease, diabetes mellitus, and stroke. Based on the 
results of a research study conducted by Yusfita, explaining 
that someone who engages in sedentary behavior ≥ 6 hours 
per day has a 16 times greater risk of metabolic syndrome, one 
of which is diabetes mellitus, compared to people who engage 
in sedentary behavior < 6 hours per day.4,9–11 

Based on the description above, the researcher is interested in 
proving that there is a correlation between family history, diet, 
and sedentary behavior on the incidence of diabetes mellitus 
at the Pasar Rebo District Health Center, East Jakarta City. 

METHODS AND MATERIALS 

The research used an analytic observational study and used a 
cross sectional design. The population in this study were all 
polyprolanis patients at the Pasar Rebo District Health Center. 
The sample calculation in this study used a simple size 
application with the results of 68 respondents consisting of 
patients who suffer from diabetes mellitus and do not suffer 
from diabetes mellitus. The sampling technique used was 
purposive sampling. The research began in mid-May 2022 at 
the Pasar Rebo District Health Center. 

Data collection was carried out by collecting primary data in 
the form of questionnaires given to respondents and 
secondary data in the form of patient visit data. The 
questionnaires used in this study were the Food Frequency 
Questionnaire (FFQ) and the Sedentary Behavior 
Questionnaire (SBQ). Prior to conducting the research, the 
researcher obtained ethical approval from the health research 
ethics committee of the Poltekkes Kemenkes Jakarta III and 
obtained the Ethic Number LB.02.02/KEPK/029/2022. 

Data analysis was carried out in a univariate manner, namely 
to explain data on the characteristics of the respondents (age, 
gender, education level, occupation) and research variables 
(family history, diet, sedentary behavior). Bivariate analysis 
was conducted to determine the relationship between the 
independent variables and the dependent variable. Processing 
with Chi Square statistical test. 

RESULTS AND DISCUSSION 

Table 1 shows that most of the respondents are in the middle 
adult range (45-65 years) (77.9%), where the majority of 
respondents are female (61.8%). As for the educational level 
of the majority of the respondents, the majority of 
respondents had basic education, and in the employment 
category, most of the respondents did not work (57.4%). 

Table 1: Characteristics of respondents 

Characteristics Frequency % 

Age   

45-65 53 77.9 

>65 15 22.1 

Gender   

Male 26 38.2 

Female 42 61.8 

Level of education   

Basic education 30 41.1 

Higher education 38 55.9 

Employment   

Work 29 42.6 

No work 39 57.4 

 

Based on table 2, it can be seen that most of the respondents 
were patients with diabetes mellitus (66.2%), where the 
majority of respondents had a family history of diabetes 
mellitus (54.4%). As for the eating patterns of the majority of 
respondents, the majority of respondents had unhealthy 
eating patterns (52.9%), and the sedentary behavior of most 
respondents had sedentary behavior ≥ 6 hours/day (60.3%). 

Table 2: Frequency Distribution Based on Research 
Variables 

Characteristics Frequency % 

Incidence of Diabetes 
Mellitus 

  

Yes 23 33.8 

No 45 66.2 

Family history of diabetes 
mellitus 

  

Yes 30 44.1 

No 38 55.9 

Dietary habit   

Good 32 47.1 

Bad 36 52.9 

Sedentary Behavior   

< 6 hours/day 24 39.7 

≥ 6 hours/day 41 60.3 

 

 

 

 

 

 

 

 



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Table 3: Relationship of Respondent Characteristics with the Incidence of Diabetes Mellitus 

Variable 

Incidence of Diabetes Mellitus 

p-value OR (CI95%) Yes No Total 

f % f % f % 

Age         

45-65 22 41.5 31 58.5 53 100 
0.012 

9.935 

>65 1 6.7 14 93.9 15 100 (1.215-81.21) 

Gender         

Male 14 53.8 12 46.2 26 100 
0.006 

4.279 

Female 9 21.4 33 78.6 42 100 (1.273-12.43) 

Level of education         

Basic education 16 46.7 14 33.3 30 100 
0.003 

0.198 

Higher education 7 18.4 31 81.6 38 100 (0.006-0.527) 

Employment         

Work 15 51.7 14 48.3 29 100 
0.007 

0.241 

No work 8 20.5 31 79.5 39 100 (0.083-0.699) 

 

In this study it was found that the average age of the 
respondents was mostly in the middle adult age range (45-60 
years) (57.4%). However, almost all of the respondents in the 
late adult age range (> 65 years) suffered from diabetes 
mellitus (93.9%). The results showed that there was a 
relationship between age and the incidence of diabetes 
mellitus (p-value = 0.012). The results of this study are in line 
with research conducted by Riris and Siregar, namely that 
there is a relationship between age and the incidence of 
diabetes mellitus (p-value = 0.001). Likewise with the 
research conducted by Arania et al, that there is a relationship 
between age and the incidence of diabetes mellitus (p-value = 
0.032 <0.05), where a person aged > 45 years has a 5.6 times 
greater risk of suffering from diabetes mellitus. Referring to 
the research by Setyorogo and Trisnawati (2013), that at the 
age of more than 50 years, most patients suffer from diabetes 
mellitus due to lifestyle factors. At that age began to occur 
increased glucose intolerance. The aging process causes a 
decrease in the ability of pancreatic β cells to produce insulin 
accompanied by lifestyle impacts in adolescents and 
productive ages, thereby increasing the risk of suffering from 
diabetes mellitus. In addition, in older individuals, there is a 
35% decrease in mitochondrial activity in muscle cells. This is 
related to an increase in fat content in the muscles by 30% and 
triggers insulin resistance. There is another theory that 
suggests that as we get older, the ability of the tissues to take 
up glucose in the blood decreases. This is what causes diabetes 
mellitus to occur more in people aged over 40 years. The 
assumption of the researchers based on the results of the 
study is that the older you get, the greater the risk of suffering 
from diabetes mellitus.12–14 

The results showed that there was a relationship between 
gender and the incidence of diabetes mellitus (p-value = 
0.006), where female respondents had a 4.297 times greater 
risk of suffering from diabetes mellitus than male 
respondents. In this study it was known that the majority of 
respondents were female (61.8%). These results are in line 
with research conducted by Rosita et al, that there is a 
relationship between gender and the incidence of diabetes 
mellitus (p-value = 0.012). The main cause of the large number 
of women affected by diabetes mellitus is because women gain 
weight more easily. In addition, women experience a decrease 

in the hormone estrogen, especially during menopause. The 
hormones estrogen and progesterone have the ability to 
increase insulin response in the blood. At the age of 
menopause, insulin response will decrease due to low 
estrogen and progesterone hormones. However, there are 
other opinions which state that people with male sex are more 
at risk of suffering from diabetes mellitus. Musdalifah and 
Nugroho's research, explains that this difference in risk is 
caused by the amount of fat in the body, in which men 
accumulate a lot of fat around the abdomen, causing central 
obesity which is more at risk of causing metabolic disorders, 
in other words, men are more at risk for diabetes. The 
researcher's assumption based on the research results is that 
gender can influence the occurrence of diabetes mellitus in a 
person. Women have a greater risk of suffering from diabetes 
mellitus than men. However, this returns to each individual, if 
a person has a bad lifestyle, such as eating sweet foods and 
rarely exercising, both women and men have the same risk of 
developing diabetes mellitus.15,16 

In this study it was known that most of the respondents had 
primary education (55.9%). The results showed that there 
was a significant relationship between education level and the 
incidence of diabetes mellitus (p-value = 0.003), where 
respondents with a basic education level had a 0.198 times 
greater risk of suffering from diabetes mellitus than 
respondents with a higher education level. These results are 
based on research by Arania et al, that the level of learning is 
associated with the incidence of diabetes, with a relative value 
of -0.304, a negative value is obtained, which means that the 
higher the level of education, the lower the incidence of 
diabetes.13 This phenomenon is also based on the research of 
Pahlawati et al. (2019), that there is a relationship between 
grade grade and the incidence of diabetes mellitus with a p-
value of 0.002. Education is one of the efforts to develop 
personality and abilities inside and outside of school and lasts 
a lifetime. Education affects the learning process, the higher a 
person's education, the easier it is for that person to receive 
information, both from other people and from the mass media, 
the more information that comes in, the more knowledge one 
gets.17,18 Irwan also argues that there is an attachment 
between people with a higher level of education where they 
are more able to accept themselves as sick if they experience 



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symptoms related to an illness compared to groups of people 
who have lower education. It is also indicated that people with 
higher levels of education seek help from the health team 
more quickly than people with lower social status. From the 
description above, the researchers assume that the level of 
education greatly influences the incidence of diabetes mellitus. 
Those with basic education are more at risk of suffering from 
diabetes mellitus than those with higher education, because 
someone with higher education has better knowledge about 
diabetes mellitus and its effects on health so they have 
awareness to take better care of their health.5 

In this study it is known that most of the respondents do not 
work (60.3%). The results showed that there was a significant 
relationship between work and the incidence of diabetes 
mellitus (p-value = 0.007), where respondents who worked 
had a 0.241 times greater risk of suffering from diabetes 
mellitus than respondents who did not work. These results are 
in line with research conducted by R. Mahmud (2018), that 

there is a relationship between work and the incidence of 
diabetes mellitus (p-value = 0.003). Research conducted by 
Cahyaningrum and Sugiharti, also argues that there is a 
relationship between work and the incidence of diabetes 
mellitus (p-value = 0.04). Based on research by Hanif et al. 
entitled Gender - Specific Epidemiology of Diabetes states that 
a person's job affects the level of physical activity which 
affects health so that he is at risk of suffering from diabetes 
mellitus. Someone who doesn't work, such as housewives, 
unemployed, and retirees, spends more time at home so they 
have less movement and can trigger obesity. This can lead to 
insulin resistance because the body's tissues are less sensitive 
to the effects of insulin. Thus, blood sugar levels in cells 
increase. The researcher's assumption based on the research 
results is that work has a significant relationship with the 
incidence of diabetes mellitus. someone who does not work 
has a greater risk of suffering from diabetes mellitus than 
those who work.19,20 

 

Table 4: Relationship of Research Variables with the Incidence of Diabetes Mellitus 

Variable 

Incidence of Diabetes Mellitus 

p-value OR (CI95%) Yes No Total 

f % f % f % 

Family history of diabetes 
mellitus 

        

Yes 16 53.3 14 46.4 31 100 
0.006 

5.061 

No 7 18.8 31 81.6 37 100 (1.702-15.04) 

Dietary habit         

Good 17 53.1 15 46.9 32 100 
0.003 

5.667 

Bad 6 16.7 30 83.3 36 100 (1.852-17.33) 

Sedentary Behavior         

< 6 hours/day 14 51.9 13 48.1 24 100 
0.011 

3.829 

≥ 6 hours/day 9 22.0 32 78.0 41 100 (1.331-11.01) 

 

The results showed that there was a significant relationship 
between family history and the incidence of diabetes mellitus 
(p-value = 0.003), where respondents who had a family 
history had a 5.061 times greater risk of developing diabetes 
mellitus than respondents who did not have a family history. 
The results of this study are in line with research conducted 
by Irwan, genetic factors are associated with the incidence of 
diabetes mellitus with a p-value = 0.000. In this research it is 
also said that someone who has a family history has a 4 times 
greater risk of suffering from diabetes mellitus.5 

A family history of diabetes mellitus is closely related to 
genetics and is thought to affect pancreatic beta cells, insulin 
action, and glucose metabolism. People who have a history of 
diabetes mellitus in the family have a 1.093 times greater 
chance of suffering from type 2 diabetes mellitus than people 
who do not have a history of diabetes mellitus in the family, 
the family in question is father, mother and siblings.21,22 Gene 
inheritance mainly occurs from the mother's side while in the 
womb. However, because the genes of the child and his 
siblings come from the mother and father, even if the father 
has DM, the risk of a child suffering from DM is still there. The 
risk of getting DM from a mother is 10-30% greater than a 
father with DM. If a sibling suffers from DM, the risk of 
suffering from DM is 10% and 90% if the sufferer is an 
identical twin.6  

There is another opinion which says that family history is 
closely related to the incidence of type 2 diabetes mellitus, this 
is inseparable from environmental habits. For example, 
parents with healthy eating habits tend to pass them on to the 
next generation. Unhealthy eating habits accompanied by 
infrequent physical activity are more at risk of experiencing 
high sugar levels, so they are at risk of developing type 2 
diabetes mellitus when they are at productive age or the 
elderly.23 Unlike previous studies, Cahyaningrum and 
Sugiharti stated that family history had no relationship with 
the incidence of diabetes mellitus (p value = 0.117).19 Wardiah 
and Emilia explain that diabetes mellitus can occur in 
individuals who have a family history of diabetes, but do not 
rule out the possibility for individuals who do not have a 
family history. Individuals who do not have a family history of 
diabetes may suffer from diabetes mellitus if their lifestyle 
deviates, such as frequently consuming foods high in sugar 
and fat and rarely doing physical activity. From the description 
above, researchers assume that there is a relationship 
between family history and the incidence of diabetes mellitus. 
However, it is possible for someone who has no family history 
to suffer from diabetes mellitus, because diabetes mellitus can 
be influenced by other risk factors such as unhealthy diet and 
lack of physical activity.24 

The results of this study indicate that there is a significant 
relationship between diet and the incidence of diabetes 



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mellitus (p-value = 0.002). Where it is known that most of the 
respondents in this study had a bad diet (57.1%). So it can be 
seen that respondents who have a bad diet have a tendency to 
suffer from diabetes mellitus. This finding is in line with 
research conducted by Isnaini and Ratnasari, that there is a 
relationship between diet and the incidence of diabetes 
mellitus at the Wangon I Public Health Center with p = 0.031. 
In a study conducted by Hariawan et al, it was also stated that 
there was a relationship between diet and the incidence of 
diabetes mellitus (p-value = 0.023). In this study it was found 
that most of the respondents often consumed foods containing 
carbohydrates.22,25 Suprapti in his research stated that 
someone who has a frequent carbohydrate diet has a risk 4 
times higher than those who have a rare carbohydrate diet. 
Carbohydrate intake that exceeds the need will further 
increase blood sugar and cannot be controlled within normal 
limits. In carrying out its functions, the body needs energy 
obtained from potential energy in the form of chemical energy 
stored in food ingredients. The energy will be released after 
experiencing metabolic processes in the body. Carbohydrates 
are foods that can meet energy needs. Carbohydrates will be 
absorbed by the body in the form of glucose in the process of 
metabolism. In this metabolic process, insulin is needed to 
enter glucose and other nutrients into cells to be used as fuel 
and become energy. If insulin is lacking or cells are resistant to 
insulin, blood sugar levels will increase.26,27 

Diet is defined as a person's accuracy in controlling the type, 
amount and frequency of food to maintain health. Diet is a 
modifiable risk factor and is closely related to diabetes 
mellitus. People who cannot control their eating patterns will 
be more susceptible to disease than people who are careful in 
consuming food. In accordance with the Guidelines issued by 
PERKENI (2021), the recommended carbohydrate intake for 
DM patients is 45-68% of total calories in food. Adjusting 
eating patterns such as a healthy diet with balanced nutrition 
is very important for controlling blood sugar, but people with 
diabetes mellitus still often consume foods or drinks high in 
carbohydrates. It is important for people with diabetes 
mellitus to start consuming less food or drinks that are high in 
carbohydrates by reducing the amount and frequency, for 
example someone who usually drinks tea (3-4 times a day) 
should reduce tea consumption (1-2 times a day). This should 
also be applied to rice intake and other eating habits.24 Based 
on the description above, researchers assume that diet greatly 
influences the occurrence of diabetes mellitus. someone who 
has a bad diet is more at risk of suffering from diabetes 
mellitus than those who have a good diet. 

In this study it was found that the majority of respondents 
(68.8%) performed sedentary behavior < 6 hours/day. The 
results showed that there was a relationship between 
sedentary behavior and the incidence of diabetes mellitus (p-
value = 0.011). Respondents who engage in sedentary 
behavior ≥ 6 hours/day have a 3.829 times greater risk of 
developing diabetes mellitus compared to respondents who 
engage in sedentary behavior < 6 hours/day. 

The results of this study are in line with research conducted 
by Irwan et al that sedentary behavior carried out for ≥ 6 
hours/day is associated with diabetes mellitus with a p-value 
= 0.000.5 In addition, research conducted by Yanti also 
obtained the same results as this study, namely that there was 
a significant relationship between sedentary behavior and the 
incidence of diabetes mellitus at the Fish Market Health Center 
in Bengkulu City in 2016 with p-values = 0.049. Someone who 
is physically active for 150 to 300 minutes per week, will 
probably engage in sedentary behaviors such as sitting for 
several hours a day at work or during their leisure time. 
According to Henson et al, those who do not do much physical 
activity and have high sedentary behavior have twice the risk 

of developing type 2 diabetes mellitus. The effect of physical 
activity is directly related to increasing the speed of muscle 
glucose recovery (how much muscle takes glucose from the 
bloodstream). blood). When doing physical activity, the 
muscles use glucose stored in the muscles and if glucose is 
reduced, the muscles fill the void by taking glucose from the 
blood. This will result in a decrease in blood glucose thereby 
increasing blood glucose control. Therefore, lack of physical 
activity will cause an increase in blood sugar levels so that it 
can cause diabetes mellitus.28–30 

Physical activity is any bodily movement produced by skeletal 
muscles that requires energy. Activities such as spending a lot 
of time watching tv and lying down make the energy in the 
body not much used, meanwhile the energy that comes from 
food continues to increase. This causes an imbalance between 
incoming energy and used energy. Excess energy can lead to 
excess body weight (obesity). According to the Indonesian 
Ministry of Health, central obesity is a risk factor that can 
cause chronic diseases including diabetes mellitus. The 
researcher's assumption based on the results of the study is 
that sedentary behavior that is carried out ≥ 6 hours can cause 
diabetes mellitus. If this behavior is carried out continuously it 
can cause various diseases such as diabetes mellitus, 
cardiovascular disease, obesity and so on. For this reason, it is 
important to do physical activity such as exercising for 30-45 
minutes 3-5 days a week so that blood sugar levels can be 
controlled.31 

CONCLUSION 

Based on the results of the study, it was found that there was a 
relationship between age (p-value = 0.012), gender (p-value = 
0.003), education (p-value = 0.003) and occupation (p-value = 
0.003) and the incidence of diabetes mellitus. In addition, it 
was also found that there was a relationship between family 
history (p-value = 0.003), diet (p-value = 0.002), and 
sedentary behavior (p-value = 0.011) with the incidence of 
diabetes mellitus. It is hoped that the results of this study can 
be used as a guideline for health services in order to further 
improve counseling or health education for patients with 
diabetes mellitus. 

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