Metabolic DiseasesIntermittent Fasting With Sort 1 Diabetes

Intermittent Fasting With Sort 1 Diabetes


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In case your first response to “intermittent fasting with kind 1 diabetes” is “Oh my gosh, my blood sugar could be so low! I might by no means try this!” then undoubtedly hold studying.

On this information, I’ll cowl every thing you could learn about intermittent fasting with kind 1 diabetes.

Clock on an empty plate

Key Factors:

  • Seek the advice of together with your healthcare crew earlier than adopting intermittent fasting, notably in case you have kind 1 diabetes.
  • Intermittent fasting is a viable choice for many individuals with kind 1 diabetes, providing potential advantages reminiscent of weight reduction, simplification of dietary administration, and elevated power ranges because the physique shifts to burning fats for gasoline.
  • Adjusting basal insulin ranges and conducting basal testing is important for sustaining steady blood sugar ranges throughout fasting and avoiding lows or highs. 
  • Varied fasting strategies can be found, together with time-restricted, 24-hour, alternate day, circadian rhythm, and periodic, and they are often tailored to completely different existence and dietary preferences.
  • It’s essential to personalize intermittent fasting schedules with the assistance of your healthcare crew to fit your particular person well being wants and every day routines. This medical steering and customization ensures that fasting is efficient, protected, and sustainable in the long run to your diabetes administration.

Desk of Contents

What’s the purpose of intermittent fasting?

Intermittent fasting has gained consideration for its potential in managing kind 1 diabetes alongside conventional therapy strategies. This strategy could provide a number of advantages, supported by rising analysis:

Diminished danger of hypoglycemia

Fasting might assist lower episodes of hypoglycemia in kind 1 diabetes by permitting for extra predictable blood sugar ranges on account of decreased frequency of meals.

Enhanced fats metabolism and blood sugar administration

Intermittent fasting could enhance fats metabolism and decrease glycemic variability, contributing to extra steady blood sugar ranges​​.

Elevated insulin sensitivity

There’s proof to counsel that intermittent fasting can enhance insulin sensitivity (how responsive the physique’s cells are to insulin) and scale back glucose manufacturing by the liver​.

Weight administration 

By serving to with weight reduction and bettering physique composition, intermittent fasting can play a task in managing the extra problem of weight achieve that’s typically related to sure diabetes therapies​​.

Ideas on using CGM

For folks with kind 1 diabetes, utilizing a steady glucose monitor (CGM) throughout intermittent fasting can present helpful insights into blood glucose patterns, serving to to determine durations of potential hypoglycemia (low blood sugar) and regulate fasting schedules accordingly​.

It’s value noting that whereas intermittent fasting exhibits promise, it’s vital for folks with kind 1 to proceed with warning and underneath medical supervision. Changes to insulin regimens and cautious monitoring of blood sugar ranges are important to keep away from adverse results reminiscent of hypoglycemia.

As analysis continues to evolve, using intermittent fasting as a part of a diabetes administration plan must be personalised and based mostly on suggestions from healthcare suppliers.

A notice on blood sugar ranges

Earlier than we get began: In case your blood sugar drops simply since you don’t eat for a handful of hours, you’re doubtless taking an excessive amount of basal (background) insulin by way of pump or injection. Speak to your licensed diabetes care & training specialist (CDCES) or main care doctor about “basal testing.” 

(Or try the e book Suppose Like a Pancreas by Gary Scheiner, MS, CDCES, and do the basal testing your self.)

Basal testing consists of purposefully skipping a meal (or two) to see in case your insulin retains your blood sugar regular or in case your blood sugar considerably rises or falls out of your private purpose vary. 

As a common rule, if it rises, you’re not getting sufficient basal insulin. If it falls, you’re getting an excessive amount of.

Particular precautions

Earlier than we focus on the nuts and bolts of intermittent fasting, an vital notice: If in case you have diabetes and are excited about making an attempt this strategy, communicate together with your healthcare crew first. 

They may also help you with methods to keep away from potential issues reminiscent of hypoglycemia, hyperglycemia (excessive blood sugar), dehydration, and diabetic ketoacidosis (DKA, a severe diabetes complication that may happen when blood sugar ranges have been too excessive).

They’ll additionally assess in case you have any circumstances that enhance your danger with intermittent fasting, advising whether or not you must keep away from or postpone this strategy. (The Affiliation of Diabetes Care & Training Specialists [ADCES] has revealed 4 danger classes of fasting for folks with diabetes.) 

Those that have kind 1 diabetes and usually are not in goal vary, for instance, are thought-about very excessive danger.

How intermittent fasting works

If you get up with an in-range blood sugar (ideally between 70 to 130 mg/dL [3.9 to 7.2 mmol/L] as an individual with kind 1 diabetes130 mg/dL being on the upper finish however providing some room for imperfection in a posh illness) and also you don’t eat breakfast, which implies you don’t take a bolus of insulin, your physique will proceed to burn fats for gasoline. 

It’s because you may have but to introduce a brand new provide of glucose from meals. You’ve got but to activate that swap telling your physique to depend on glucose for gasoline as an alternative of fats. The second you eat or drink one thing containing energy, your physique says, “All proper! Now it’s time to burn glucose!”

Intermittent fasting takes benefit of this physiologic course of by alternating durations of fasting with durations of consuming.

What an intermittent fasting schedule seems like

There are rather a lot of various methods you may strategy intermittent fasting, and after doing this myself for a number of years on and off, I’ve discovered I can flexibly create my very own strategy that feels most pure to me.

Varieties of intermittent fasting

There are a selection of various kinds of intermittent fasting, reminiscent of time-restricted fasting, in a single day fasting, alternate-day fasting, circadian rhythm fasting, and periodic fasting. 

For folks with kind 1 diabetes, intermittent fasting presents each alternatives and challenges. Whereas some preliminary analysis suggests potential advantages, cautious planning and monitoring are important.

Listed below are a number of of the commonest fasting schedules:

Time-restricted fasting (e.g., 12- or 16-hour fasting)

Consuming all meals inside a particular time window every day, typically leading to a every day fasting interval of 12 to 16 hours.

It’s vital to notice that you must nonetheless eat a traditional day’s value of energy throughout the consuming window. 

In the event you’re making an attempt to drop a few pounds, that quantity of energy may solely be, say, 1300 to 1600, however you continue to have to get your allotment of energy and vitamins whereas following a fasting program.

24-hour fasting

Going with out meals for a full 24 hours, a few times per week, from, say, dinner to dinner. This could usually solely be carried out as soon as per week. 

(Learn this information from John Berardi, PhD, and colleagues to see what occurs in case you do a 24-hour quick too typically.)

Alternate-day fasting 

Alternating days of standard consuming with days of both full fasting or vital calorie discount.

Circadian rhythm fasting

Aligning fasting durations with the physique’s pure circadian rhythm, reminiscent of incorporating nighttime fasting. This methodology includes consuming the day’s meals inside daylight and fasting throughout the night time, which may doubtlessly help metabolic well being.

Periodic fasting

Choosing particular days for fasting every week or month. 

For instance, within the 5:2 methodology, people may eat usually for 5 days after which select two days to considerably scale back calorie consumption. This methodology can provide flexibility and has been explored for its potential advantages in weight administration and metabolic well being. 

Nevertheless, for folks with kind 1 diabetes, it’s vital to strategy periodic fasting with warning, contemplating the necessity for constant carbohydrate consumption to handle blood glucose ranges and stop hypoglycemia.

Transferring ahead

Analysis into intermittent fasting and kind 1 diabetes is extraordinarily restricted. Nevertheless, latest explorations have begun to make clear its potential advantages for weight administration and metabolic enhancements in folks with kind 1. 

Preliminary research, reminiscent of a pilot research (a “small-scale check of the strategies and procedures for use on a bigger scale”) revealed in Weight problems Drugs, have proven promising outcomes when it comes to security and effectiveness, suggesting that rigorously monitored intermittent fasting could provide a viable technique for weight reduction with out growing the danger of adverse occasions like hypoglycemia. 

Equally, a narrative evaluation in Vitamins highlighted intermittent fasting’s potential to boost insulin sensitivity and scale back blood sugar variability. 

In early 2024, researchers on the College of Illinois Chicago began a pilot research that can finally present knowledge on how time-restricted consuming compares to calorie counting in folks with kind 1 diabetes. 

Nevertheless, it’s essential to notice that analysis on this space remains to be in its early phases, notably concerning the long-term results and greatest fasting protocols for folks with kind 1 diabetes. 

Subsequently, whereas intermittent fasting presents an attention-grabbing potential avenue for dietary administration in kind 1 diabetes, additional scientific trials are crucial to completely perceive its affect and safely combine it into therapy plans. It’s vital to seek the advice of the newest analysis and healthcare professionals for steering.

However received’t I be hungry?

Guess what — it’s OK to be a bit hungry. After you cease worrying about your stomach not feeling full 24/7 and push by means of it (being positive to maintain a detailed eye in your blood sugar ranges), round 10 a.m., you may really discover that you simply really feel a bit bit superior. A bit of extra clear-headed, a bit extra targeted, perhaps with even a bit extra power.

Drink some water — it’s good for you anyway — and embrace that feeling of your physique simply being empty. Sure, there are a lot of methods to drop a few pounds by consuming each 3 to 4 hours, however that’s not the one approach to eat, and it’s not the one approach to drop a few pounds.

Are you somebody who’s at all times excited about their subsequent meal? All the time snacking?

As Dr. Berardi explains, “Intermittent fasting could be useful for in-shape individuals who need to actually get lean with out following typical bodybuilding diets, or for anybody who must study the distinction between physique starvation and psychological starvation.”

For athletes and folks engaged in intense train, particular person power wants and responses to fasting can fluctuate. 

Whereas some could carry out effectively underneath an intermittent fasting routine, others may discover they want extra constant fueling to take care of peak efficiency. It’s vital to take heed to your physique and seek the advice of with a healthcare skilled to search out the strategy that works greatest for you.

However isn’t consuming breakfast actually vital?

Consuming breakfast can completely be an important a part of weight reduction and sustaining a wholesome metabolism, however it’s not the one approach, in response to some consultants.

“There haven’t been any conclusive research that discovered consuming breakfast to have a constructive impact on weight reduction or weight upkeep,” defined sports activities nutritionist and registered dietitian Leslie Bonci, MPH, RDN, CSSD, LDN, in Common Science in 2017. 

Additionally, the concept skipping breakfast causes weight achieve is oversimplified and never essentially true. It will not be the act of skipping breakfast itself that may trigger weight achieve. In research which have noticed this impact, a big majority of those that skipped breakfast additionally lacked different wholesome habits general, which can as an alternative have resulted within the weight achieve.

“It may very well be that consuming breakfast is solely a marker of a wholesome life-style and, in itself, doesn’t shield in opposition to weight problems,” explains a 2016 article on the web site ScienceAlert.

And more moderen analysis has continued to current combined outcomes on the significance of breakfast for weight administration.

A 2019 systematic evaluation and meta-analysis (evaluation of information from a number of research) revealed in The BMJ indicated that the affect of breakfast on weight and power consumption various. This research, which checked out a number of randomized managed trials, instructed that there wasn’t a clear-cut impact of consuming or skipping breakfast on weight reduction. 

The outcomes indicated that the final advice to eat breakfast won’t have a common affect on weight administration. These findings spotlight the complexity of dietary habits and their results on weight, suggesting that particular person dietary preferences and life-style decisions play a major position in weight-management methods.

How you can do intermittent fasting with kind 1 diabetes

First off, be sure you get the all-clear out of your physician earlier than you give intermittent fasting a attempt when dwelling with any kind of diabetes.

Utilizing a CGM may also help pinpoint once you’re in danger for hypoglycemia, making it simpler to grasp how your blood sugar responds to meals and fasting durations.

As you adapt to intermittent fasting, you might discover a sense of psychological freedom, particularly in case you have kind 1 diabetes. It’s because there’s much less concern about experiencing excessive or low blood sugar ranges after skipping breakfast.

Analysis signifies that intermittent fasting can affect insulin sensitivity and blood glucose stability, together with in folks with kind 1 diabetes. 

Whereas some research counsel that fasting can result in extra predictable blood sugar ranges on account of decreased meal frequency, it’s vital to bear in mind that particular person responses can fluctuate extensively. 

In the event you stick with your fasting program persistently, you’ll doubtless discover you drop a few pounds and due to this fact enhance your insulin sensitivity. This implies you’ll be capable to lower your basal insulin charges, which is an efficient factor. 

That is a part of weight reduction with diabetes, however in case you aren’t anticipating it, you’ll be irritated and pissed off with the low blood sugars, so be ready.

How you can regulate excessive or low blood sugar when fasting

Waking up with an in-range blood sugar is extraordinarily useful, however clearly, we’re not good and issues occur. Right here’s the way to handle your plan for fasting in case your blood sugar shouldn’t be in your perfect vary once you get up:

  • In the event you get up a bit excessive, positive, you may take a decreased correction dose (learn Suppose Like a Pancreas or communicate together with your healthcare crew for extra info on figuring out your correction dose) and keep it up with the quick, however bear in mind that introducing that bolus of insulin may very well be sufficient to change in your physique’s have to burn glucose for gasoline.
  • For legit “daybreak phenomenon” excessive blood sugars, you might merely want a bolus correction of insulin each morning that actually is a part of your “basal” insulin dose however is utilized by way of pump or injection as a bolus. If this prevents morning fasting highs, it’s a part of your fasting routine. Study extra about managing the “daybreak phenomenon” right here.
  • In the event you don’t take that correction dose of insulin, you then’re simply spending the following a number of hours with a excessive blood sugar, which is counterproductive (and doubtlessly harmful) if our general purpose is well being … proper? So, undoubtedly take the insulin you want as a way to be at your goal blood sugar ranges — that’s your first precedence.
  • In the event you get up low, you then clearly must eat and fasting is now not going to work. You’d be higher off consuming a wholesome breakfast, fueling your metabolism because it’s already burning glucose for gasoline, and making an attempt once more tomorrow.
  • Equally, in case you develop hypoglycemia throughout a quick, break the quick instantly and use your hypoglycemia therapy plan to convey your ranges again into goal vary. Bear in mind the 15-15 rule, which recommends having 15 grams of carbs, checking your blood sugar after quarter-hour, and repeating if it’s nonetheless low. Additionally be sure you have a glucagon therapy readily available within the occasion of extreme low blood glucose.
  • In the event you routinely get up with blood sugars which are too excessive or too low, you could return and do some basal testing or check the insulin-to-carbohydrate ratios that you simply’re utilizing for the meals you eat earlier than mattress.
  • An extra sneaky blood sugar situation to bear in mind: If this is applicable to you, it’s essential to cease binge consuming late at night time. In the event you’re at present up at midnight consuming your self out of home and residential, concentrate on this primary earlier than pursuing intermittent fasting. Folks typically blame excessive blood sugars within the morning on the daybreak phenomenon when it’s really the results of late-night binge-eating.

It’s not a magic trick. It’s not a fad. It’s simply fundamental science of how the physique responds in a fasted state.

Exercising within the morning when fasting … is definitely simpler (in my expertise)

If you’re fasting throughout your train, it’s usually noticed that cardio or cardiovascular actions are likely to decrease blood glucose ranges, which is sensible given the muscle’s elevated use of glucose for power. 

Nevertheless, sure workouts, particularly these which are high-intensity like weightlifting, can set off an increase in blood glucose. That is partly as a result of physique’s stress response, releasing hormones like adrenaline, which in flip prompts the liver to launch extra glucose. 

Chances are you’ll due to this fact discover that with weightlifting or different anaerobic exercises, you may really want a bolus of insulin for that kind of exercise.

This is not going to take away out of your fasted efforts — this merely helps use the glucose that’s produced when glycogen saved in your muscle tissue is damaged down throughout anaerobic train.

It’s vital to search out the appropriate stability for managing blood glucose ranges throughout various kinds of train and to seek the advice of together with your healthcare crew as wanted for steering. 

I LOVE fasted cardio! In truth, I be sure that all of my train periods occur both fasted within the morning or fasted within the night (by not consuming something after 1 p.m. after which getting on the treadmill round 7 p.m.). 

This ensures that each one bolused rapid-acting insulin is effectively out of my system. It really works. Once I used to elevate weights, I did discover that I wanted 1 unit of insulin within the morning if I used to be doing a fasted weightlifting exercise.

So in a nutshell:

  • Get up with an in-range blood sugar (or appropriate a slight excessive with half of your normal correction);
  • Start your exercise whereas fasted, or if managing fluctuating blood sugars is difficult, think about scheduling your exercise for a unique time;
  • Examine your blood sugar midway by means of your exercise for security’s sake;
  • In case your anaerobic exercise proves to usually elevate your blood sugar, take half of what you’d take to appropriate that top — however take it once you begin exercising to stop the excessive within the first place;
  • In case your exercise is cardio (cardio), simply proceed your exercise — you shouldn’t see an increase in blood sugar from cardio fasted train, however bear in mind that you may be at larger danger for hypoglycemia;
  • Examine your blood all through your exercises in case you’re not utilizing a CGM;
  • Bathe (thanks), and revel in the remainder of your fasting.

Regularly requested questions

Is intermittent fasting protected for folks with kind 1 diabetes?

For folks with any kind of diabetes, makes an attempt to attempt intermittent fasting must be carried out solely with the steering and suggestions of your doctor.

In lots of circumstances, it seems to be protected. However you could communicate together with your healthcare crew to just be sure you don’t have another circumstances for which intermittent fasting is contraindicated and that your insulin doses and drugs are correctly tuned. 

For folks with kind 2 diabetes who usually take morning drugs to decrease blood sugar, it’s advisable to seek the advice of together with your physician about taking the medicine with the first meal of the day as an alternative of the standard morning schedule in case you’re planning to quick within the morning. 

Along with your physician’s OK, this adjustment may also help you higher handle blood sugar ranges in accordance with the altered consuming schedule.

For folks with kind 1, as mentioned extensively above, your insulin doses must be finely tuned (even in case you don’t ever plan to quick) so to miss meals and your blood sugar is mostly regular and in a wholesome vary. 

Adjusting your insulin doses to fulfill this commonplace is known as “basal testing.” In the event you’ve by no means carried out any basal testing to evaluate the accuracy of your private insulin doses, undoubtedly try this first. And do it even in case you don’t ever intend to quick. It’s important to diabetes administration.

Throughout your first week of fasting, examine your blood sugar typically throughout your fasting window to see how your physique responds. In the event you keep it up long-term, you’ll doubtless discover you will have to cut back your basal charges (even inside per week or two) as a result of intermittent fasting typically has the unbelievable profit of accelerating your sensitivity to insulin.

What are you able to drink throughout intermittent fasting?

Throughout the timeframe that you simply’re not consuming energy, you shouldn’t be consuming any energy both. Black espresso or tea or water or seltzer (or weight-reduction plan soda, in case you should) are all protected to drink. 

Whereas I lean towards minimizing synthetic sweeteners and choosing pure hydration sources like water, it’s important to acknowledge that well being and vitamin are extremely particular person. 

Though some issues exist round synthetic sweeteners, together with their affect on well being, the scientific neighborhood’s views on this are various. It’s at all times greatest to seek the advice of healthcare professionals for recommendation tailor-made to your wants. 

Learn your labels rigorously, and when doubtful, attain for some all-natural plain water.

Be sure you drink sufficient water to keep away from dehydration, one of many potential dangers of intermittent fasting.

Do you could do intermittent fasting in case you already comply with a ketogenic weight-reduction plan?

You’re clearly going to be burning extra fats than the remainder of us after consuming a ketogenic breakfast, however even a few of that breakfast shall be transformed to glucose and require a little bit of insulin to digest, so intermittent fasting nonetheless applies to keto-folks, too.

Though there may be at present very restricted analysis knowledge on including fasting to an already disciplined ketogenic weight-reduction plan, my private hunch is that it could doubtless assist with weight-loss progress.

Simply beware, nonetheless, that in case you don’t already perceive the way to eat sufficient on a ketogenic weight-reduction plan, including fasting to the combination could be a recipe for a binge throughout the consuming interval of your fasting plan.

I extremely advocate finding out and training ketogenic consuming for a couple of months earlier than including fasting to it. It’s quite common for brand new low-carb eaters to eat too little as a result of they’re nonetheless afraid of consuming an excessive amount of fats. (And fats, as you’ve most likely heard, is a reasonably essential a part of a profitable ketogenic weight-reduction plan.)

Why I like intermittent fasting as a mother

I can get up within the morning, drink a cup of black espresso and guzzle some common ol’ water, then pack our luggage and head out the door to the playground or playgroup or the library. I can chase my youngsters round all morning lengthy and I don’t have to fret about my blood sugar.

If I awoke at 90 mg/dL (5.0 mmol/L), I do know my blood sugar remains to be in that zone.

I don’t must spend any time making my very own breakfast. Or making an attempt to search out the time to make my very own breakfast. I don’t have to fret about getting actual, wholesome meals into my very own stomach till we come house from our morning exercise, and I get the youngsters lunch and get all people settled.

(In the event you’re not a mother of two kids, let me inform you that discovering time to your personal breakfast is definitely extremely difficult some days amongst the diaper modifications and the bottles and playtime and the … on and on and on! When that second child pops out, parenting is ON in full-power mode, 24/7.)

By 1 or 2 p.m., I’m not ravenous, and I really really feel fairly energized after that morning quick. And making myself a wholesome meal feels very doable as a result of the busiest a part of the day is behind us.

Ultimate ideas: must you attempt intermittent fasting?

If the entire above sounds interesting to you, speak to your physician about giving it a attempt! (And do not forget that intermittent fasting received’t be acceptable or efficient for everybody with kind 1.)

A number of issues to bear in mind when embracing intermittent fasting with kind 1 diabetes:

  • Do you at present have a wholesome relationship with meals? If not, I might deal with that first. Fasting shouldn’t be perfect for the yo-yo dieter or somebody making an attempt to get better from an consuming dysfunction. Try my books Emotional Consuming With Diabetes or Dealing With Diabetes Burnout to get began.
  • Take good notes! The primary week you attempt fasting, write down the insulin you took earlier than mattress, what your blood sugar was within the a.m., and so forth., so you may pinpoint any diabetes-related variables which are inflicting lows or highs in your blood sugar throughout the fasting interval. For instance: In the event you’re nonetheless up at midnight consuming chips and ice cream, you may completely wager that can elevate your blood sugar throughout the hours of 6 a.m. to 12 p.m. once you’re fasting. Some folks blame the daybreak phenomenon for what is definitely late-night binge consuming.
  • Throughout the first few fasts, examine your blood sugar extra typically. Regardless that fasting itself shouldn’t trigger low blood sugars, your insulin doses merely won’t be acceptable. And nothing will reveal that ahead of fasting. Examine your blood sugar typically and take good notes. Studying the way to research and regulate your insulin doses is a vital half, I imagine, of long-term success in life with kind 1 diabetes.
  • It provides flexibility: Occasional deviations, like indulging in breakfast once you’re really hungry or throughout particular household outings, don’t derail its advantages. It’s about discovering a stability that works for you, listening to your physique, and never stressing over the occasional exception. It’s essential to remain according to this system, however understanding that life’s unpredictability typically requires adaptability. It’s not a giant deal! Make it give you the results you want. Observe this system as a lot as you may, and don’t freak out when life will get in the way in which.
  • Chances are you’ll discover it helpful to embrace fasting for a couple of months, then return to a traditional schedule. I’ve discovered that intermittent fasting has been actually great for me for a number of months at a time. Then I take a break from it for a few months, and finally I naturally really feel able to comply with that schedule once more. Hearken to your physique and keep in shut contact together with your healthcare crew to search out what works for you.
  • Be affected person together with your weight-loss journey, recognizing it as a long-term dedication fairly than a fast race. If you end up breaking your quick prematurely to eat a type of darn workplace muffins, keep in mind it’s a part of the educational course of. I’m a giant believer that creating your individual life round vitamin is a really lengthy work in progress. Be continually open to evolving, studying, making an attempt new issues, and by no means by no means by no means shaming your self for being imperfect. It’s one large science venture. Benefit from the venture, cease punishing your self, and study to like the meals you eat. Meals could be enjoyable, even once you’re making an attempt to drop a few pounds!

Study. Research. Experiment. Repeat!

Replace: I recorded this video by which I speak extra about why I do fasted cardio, how I do it, and the advantages. Please let me know what you assume within the feedback under.

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