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Diabetes injection medicine?
Travel Tip: Traveling with Diabetes. There are several steps you must learn to be able to correctly inject Ozempic. If you’re diabetic, glucose testing at home is an important part of your routine for managing your diabetes. Rooster comb injections ease pain in the knee using a highly viscous, naturally derived substance from the rooster’s comb, says Wake Sports Medicine. Find out more about metformin. It joins a class of new medications that are transforming obesity, a condition that affects 100 million American adults and is linked to a spectrum of diseases including diabetes, heart disease. Jul 9, 2024 · as low as View other Insulins. By Aria Bendix and Berkeley Lovelace Jr. It may also be used to prevent a stroke or heart attack in people with diabetes. Trulicity contains dulaglutide, and Victoza. Daily injections, however, can be cumbersome for patients, leading to poor adherence rates. That means they don’t get the right amount of medication, their blood sugar levels swing too high or too low, and their diabetes symptoms get worse. Ozempic dose, side effects and use. May 13, 2022 · Semaglutide is an FDA-approved GLP-1 agonist used to treat type 2 diabetes. Common side effects of metformin include feeling sick and diarrhoea. For some people with type 1 diabetes, pancreas transplant or islet cell transplant may be an option. Here's what we know about Mounjaro, a weekly dual-acting medication. Podcasts, gamification, articles & more. May 19, 2022 · The Food and Drug Administration (FDA) on May 13 approved Mounjaro (tirzepatide), a new injection treatment for type 2 diabetes. Plants in the rain forest contain compounds that are used to treat dozens of diseases a. Yale Medicine experts tell you what you need to know. Feb 19, 2024 · Common type 2 diabetes medicines include: Metformin ( Fortamet) Sulfonylureas, such as glipizide ( Glucotrol ), glimepiride ( Amaryl ), or glyburide ( Diabeta) Meglitinides, such as repaglinide ( Prandin) or nateglinide ( Starlix) Thiazolidinediones, such as pioglitazone ( Actos) or rosiglitazone. Regular or short-acting insulin usually reaches the bloodstream within 30 minutes after injection, peaks anywhere from 2 to 3 hours after injection, and is effective for approximately 3 to 6 hours. Metformin is the most common medicine used for type 2 diabetes. For adults living with T2DM, Trulicity lowers the risk of CV events like heart attack, stroke and CV death in adults with known heart disease or multiple risk factors. Schizophrenia is linked to type 2 diabetes, and antipsychotics can increase these chances. This press release contains forward-looking statements (as that term is defined in the Private Securities Litigation Reform Act of 1995) about Mounjaro™ (tirzepatide 25 mg, 10 mg, 12. Jun 14, 2024 · Medications. Some people with diabetes need insulin injections, but others can manage the condition with oral or other injectable medications The Food and Drug Administration (FDA) on May 13 approved Mounjaro (tirzepatide), a new injection treatment for type 2 diabetes. Jardiance is a once-daily oral pill that can be taken by people ages 10 and older. Jardiance (empagliflozin) is used to treat type 2 diabetes, chronic kidney disease and reduce the risk of heart failure and cardiovascular disease. DPP-4 inhibitors, such as sitagliptan ( Januvia. Your health care provider may prescribe more than one medication so you can get the benefits from multiple drug classes. Type 2 diabetes treatment plans usually include meal planning and physical activity along with your diabetes medication. May 17, 2024 · Tresiba (insulin degludec) is used to treat diabetes mellitus. FDA approves Rybelsus (semaglutide) oral tablets to improve blood sugar in adults with type 2 diabetes, with diet and exercise. GLP-1 agonists are a class of medications that can help manage Type 2 diabetes and obesity. Trulicity is also used to help reduce the risk of serious heart problems such as heart attack or stroke in adults who have type 2 diabetes and heart disease. This medication became available on the pharmaceutical benefits scheme (PBS) as a subsidised prescription in July 2020. GLP-1 RAs are injecta. Learn about treatment options for diabetes insipidus, a rare hormonal disorder characterized by extreme thirst and excessive urination. We know that traveling with medical supplies can be a nerve-wracking experience, especially when your medication includes needles and other sensitive equipment. In the beta cells, insulin is created first as a big molecule called “proinsulin Proinsulin is broken into two pieces: insulin and C-peptide. Ozempic, developed by Danish pharmaceutical company Novo Nordisk, is a once-weekly GLP-1 analogue injection that works by mimicking a hormone that lowers post-meal blood glucose levels. Mounjaro® (tirzepatide) is a once-weekly non-insulin injection for adults to help lower A1C along with diet and exercise. A-Z of diabetes drugs. We know that traveling with medical supplies can be a nerve-wracking experience, especially when your medication includes needles and other sensitive equipment. Some options are taken by mouth and others are injected. Treatment typically involves daily insulin injections or the use of an insulin pump to manage your blood sugar levels. Victoza® reduces the risk of major cardiovascular events such as heart attack, stroke, or death. Doctors prescribe different medications to treat type 1 and type 2 diabetes and help control your blood sugar. Jun 14, 2021 · Wegovy is a slightly higher dose than Ozempic at 2. When metformin does not adequately control blood sugar, another medication must be added. Includes Jardiance side effects, interactions, and indications. It may not be safe to breastfeed while using this medicine. It is first GLP-1 receptor protein treatment approved in U Medications in this class include semaglutide (brand names Ozempic®, Wegovy® and Rybelsus®), dulaglutide (brand name Trulicity®), liraglutide (brand name Saxenda®) and others Johnson, MD, a physician who specializes in obesity medicine at Northwestern Medicine, answers common questions about these medications and weight loss. Oral & Injectable Medications for Type 2 Diabetes There are different types, or classes, of medications that work in different ways to lower blood glucose (also known as blood sugar) levels. Metformin is the most common medicine used for type 2 diabetes. Prep your needle or pen every time. If you have type 1 diabetes, injecting insulin is required for life. The bottom line. Novo Nordisk's Ozempic (semaglutide) drug is now available to be prescribed in the UK, it has been confirmed. Insulin pump and insulin pump supplies (cleaning agents, batteries, plastic tubing, infusion kit, catheter and needle)—insulin pumps and supplies must be accompanied by insulin. Taking insulin or other diabetes medicines is often part of treating diabetes. Dec 18, 2024 · This medicine also may slow gastric emptying after eating. Examples of long-acting insulin include Tresiba and Lantus. DPP-4 inhibitors, such as sitagliptan ( Januvia. Ozempic, developed by Danish pharmaceutical company Novo Nordisk, is a once-weekly GLP-1 analogue injection that works by mimicking a hormone that lowers post-meal blood glucose levels. That means they don’t get the right amount of medication, their blood sugar levels swing too high or too low, and their diabetes symptoms get worse. This treatment method is known. May 20, 2024 · Controlling diabetes is very important during pregnancy, and having high blood sugar may cause complications in both the mother and the baby. Medicine Matters Sharing successes, challenges and daily happenings in the Department of Medicine Nadia Hansel, MD, MPH, is the interim director of the Department of Medicine in th. Different medications and devices come with specific pre-injection steps. Insulin is available as synthetic human insulin (made. Jun 24, 2024 · Victoza® is a once-daily noninsulin medicine that lowers blood sugar and A1C. It is most suited to produce large quantities of the same item, such as automobile. Tirzepatide is a dual glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 (GLP-1) receptor agonist that is under development for the treatment of type 2 diabetes When you have type 1 or type 2 diabetes, dangerous spikes in blood glucose (severe hyperglycemia) may mean you need to reduce blood sugar levels immediately. May be used with metformin, basal insulin or a sulfonylurea. Medicine Matters Sharing successes, challenges and daily happenings in the Department of Medicine ARTICLE: Social Determinants of Health and Diabetes: A Scientific Review AUTHORS:. The sooner diabetes in dogs is diagnosed and treatment begins, the better chance tyour pet has of a normal life. It is not known if Mounjaro can be used in people who have had pancreatitis. Semaglutide injection is used to treat type 2 diabetes. It also highlights the value of treating obesity as a chronic metabolic disease instead of expecting. DPP-4 inhibitors, such as sitagliptan ( Januvia. With the exception of insulin, most GLP-1 receptor agonists. to reduce the risk of major cardiovascular events such as heart attack, stroke, or death in adults with type 2 diabetes with known heart disease. Semaglutide is a glucagon-like peptide-1 (GLP-1. funny phone cases This medicine is also used to lower the risk of heart attack, stroke, or death in patients with type 2 diabetes, obesity, and heart or blood vessel disease. Treatment of type 2 diabetes mostly involves lifestyle. But in recent years, a number of new injectable medications have become available, offering additional support with blood sugar control. It can help keep your blood sugar at a healthy level. It comes as tablets. Feb 19, 2024 · Common type 2 diabetes medicines include: Metformin ( Fortamet) Sulfonylureas, such as glipizide ( Glucotrol ), glimepiride ( Amaryl ), or glyburide ( Diabeta) Meglitinides, such as repaglinide ( Prandin) or nateglinide ( Starlix) Thiazolidinediones, such as pioglitazone ( Actos) or rosiglitazone. If you’re diabetic, glucose testing at home is an important part of your routine for managing your diabetes. In preclinical studies, a team of researchers report new findings on a therapeutic combination that regenerated human insulin-producing beta cells, providing a possible new treatment for diabetes. Other diabetes injections: Insulin isn't the only injectable medication that can help manage blood glucose levels. Food and Drug Administration approved Wegovy (semaglutide) injection (2. Diabetic retinopathy is a real threat to over 69 million Indian diabetics. Research continues to show the effectiveness of semaglutide injections for weight loss. Once‐weekly Trulicity is a type 2 diabetes medication for adults that helps your body release its own insulin and can help improve your A1C and blood sugar numbers. Wegovy and Zepbound are approved by the FDA for chronic weight management, while Mounjaro and Ozempic are both approved for blood glucose (sugar) control in patients with type 2 diabetes. For adults living with T2DM, Trulicity lowers the risk of CV events like heart attack, stroke and CV death in adults with known heart disease or multiple risk factors. Hold the pen upright and gently tap the insulin cartridge to remove air bubbles. oshi no ko manganelo Rybelsus is from the class of medicines called GLP-1 receptor agonists (glucagon-like peptide-1 receptor agonist). If you're taking Ozempic off-label for weight loss, Wegovy, Zepbound, and Saxenda are three FDA-approved options. In preclinical studies, a team of researchers report new findings on a therapeutic combination that regenerated human insulin-producing beta cells, providing a possible new treatment for diabetes. Diabetic retinopathy is a real threat to over 69 million Indian diabetics. Most dogs will be feeling relatively well and can start treatment at home under veterinary guidance. Januvia is used to treat type 2 diabetes. A hormone called insulin helps the glucose get into your cells. There are many types of insulin, including: Short-acting insulin. Food and Drug Administration approved Tzield (teplizumab-mzwv) injection to delay the onset of stage 3 type 1 diabetes in adults and pediatric patients 8 years and older. Sometimes Trulicity is. There are several steps you must learn to be able to correctly inject Ozempic. She also describes semaglutide and other new medications that could make. The effectiveness of therapy in patients with diabetes depends on the correct use of the insulin injection technique. Mar 1, 2023 · A weekly injection that leads to dramatic weight loss without serious side effects almost sounds too good to be true. Try our Symptom Checker Got any other symp. Generic Victoza® is the first-ever generic GLP-1 and supports increased demand for this category of therapies in the U market. davids bridal ties Drugs used in diabetes treat diabetes mellitus by decreasing glucose levels in the blood. The cells of your body need glucose for energy. It reaches peak effect at 90 to 120 minutes and lasts about 4 to 6 hours. It reduces blood glucose by stimulating insuli, inhibiting glucagon and slowing down digestion. Some GLP-1 injections, such as exenatide (Byetta), are taken twice a day. The pain, swelling, and stiffness of arthritis can limit your movement. The diabetes drugs semaglutide (Ozempic) and tirzepatide (Mounjaro) have become so popular as weight-loss medications that many people with diabetes have struggled to get their prescriptions filled. Pills vs. Other diabetes injections: Insulin isn't the only injectable medication that can help manage blood glucose levels. For adults with type 2 diabetes with known heart disease. Africa’s death rates from covid-19 are notably higher in patients. Some GLP-1 injections, such as exenatide (Byetta), are taken twice a day. Victoza Pen Injector 6 mg/mL (LIRAGLUTIDE (DIABETES) - INJECTION) This medicine is used for the following purposes: diabetes. But hypos can happen when you take it with other diabetes medications such as insulin or a sulphonylurea. Lantus is a long-acting type of insulin, which works by helping to regulate blood sugar levels.
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Sometimes Trulicity is. It can make their body begin to shut down. 9 percent of their body weight by the end of the trial, or about 52 pounds. Semaglutide is a glucagon-like peptide-1 (GLP-1. National Library of Medicine: DailyMed. Glucose comes from the foods you eat. But hypos can happen when you take it with other diabetes medications such as insulin or a sulphonylurea. Different medications and devices come with specific pre-injection steps. For adults with type 2 diabetes with known heart disease. If your furry friend has been diagnosed with diabetes, it’s crucial to provide them with a balanced and nutritious diet. Prior to that, people with type 1 diabetes did not survive for more than a few weeks or months with the disease. Treatment for type 1 diabetes involves insulin injections or the use of an insulin pump, frequent blood sugar checks, and carbohydrate counting. If your furry friend has been diagnosed with diabetes, it’s crucial to provide them with a balanced and nutritious diet. Both drugs are manufactured by Novo Nordisk. But how do they differ in terms of effectiveness, safety, and cost? Learn from experts and patients about the benefits and risks of these drugs, and how to use them properly. … Diabetes technology has come a long way. It can make their body begin to shut down. Push the injection button to verify insulin is coming out. It may also be used to prevent a stroke or heart attack in people with diabetes. Most dogs will be feeling relatively well and can start treatment at home under veterinary guidance. Medications containing semaglutide marketed for type 2 diabetes or weight loss. Liraglutide Injection 18 mg/3 mL (6 mg/mL. custom stencil maker online free Lantus ( insulin glargine) is used to treat type 1 and type 2 diabetes. Currently, only injection forms of insulin are available in Hong Kong. Telavancin Injection: learn about side effects, dosage, special precautions, and more on MedlinePlus Telavancin injection can cause kidney damage. When you consider the magnitude of that number, it’s easy to underst. WEGOVY ® (semaglutide) injection 2. There are two main types available: Anti-vascular endothelial growth factor (VEGF) injections: These injections block VEGF, a protein in the body that stimulates the growth of abnormal new blood vessels in the eye. Living with medical conditions that require the use of needles and other sharp objects can be challenging. Apr 1, 2024 · Semaglutide injection is used to treat type 2 diabetes. 5% on these medications. Medications containing semaglutide marketed for type 2 diabetes or weight loss. One of the fastest growing causes of blindness around the world is an eye disease that’s almost entirely. Bydureon BCise is an extended release injectable diabetes medicine that helps control blood sugar levels. It is affordable, safe, effective, and well tolerated by most people. Call your doctor or get medical help right away if you notice any of these more serious side effects: severe or persistent abdominal pain numbness or tingling in hands and feet. quartz banger with spinner cap If you have type 1 diabetes, injecting insulin is required for life. The bottom line. Oral & Injectable Medications for Type 2 Diabetes There are different types, or classes, of medications that work in different ways to lower blood glucose (also known as blood sugar) levels. Rapid-acting insulin begins to work about 15 minutes after injection, peaks in about 1 hour, and continues to work for 2 to 4 hours. Treatments for type 1 and type 2 diabetes. Medicine Matters Sharing successes, challenges and daily happenings in the Department of Medicine Earlier this year, the Diabetes Prevention and Education Program (DPEP) secured a. Some medications, like SGLT2 inhibitors and GLP-1 agonists, also offer benefits for your heart, kidneys, and weight loss. They require insulin to manage their blood glucose levels. Includes Jardiance side effects, interactions, and indications. 4 mg is an injectable prescription medicine used with a reduced calorie diet and increased physical activity: to reduce the risk of major cardiovascular events such as death, heart attack, or stroke in adults with known heart disease and with either obesity or overweight. Knowing basic facts and common treatments for type 2 diabetes will empower you to ta. But hypos can happen when you take it with other diabetes medications such as insulin or a sulphonylurea. These steps can help lessen the impact. Liraglutide Injection 18 mg/3 mL (6 mg/mL. It joins a class of new medications that are transforming obesity, a condition that affects 100 million American adults and is linked to a spectrum of diseases including diabetes, heart disease. Eye injections are one of the most common treatments for people who have vision complications related to diabetes, such as diabetic macular edema (DME) and advanced cases of diabetic retinopathy. Without treatment, high blood. used cyclone rake for sale on craigslist Others, such as liraglutide ( Victoza ), are injected once a day, and. This disease comes in over 100 different forms and is treated in various ways, one of whic. Are people with diabetes at higher risk from COVID-19? What precautions should you be taking? Is it safe to work? Find answers to all your questions. Lowering the risk of heart attack, stroke, and death due to heart problems in. Diabetic retinopathy is a real threat to over 69 million Indian diabetics. This press release contains forward-looking statements (as that term is defined in the Private Securities Litigation Reform Act of 1995) about Mounjaro™ (tirzepatide 25 mg, 10 mg, 12. Wegovy is given as a weekly under-the-skin injection and should be used along with diet and exercise for long-term weight loss. What is Saxenda ®?. May 30, 2024 · Non-insulin drugs for treating type 2 diabetes. Your Ozempic dose, treatment goals, and other factors may make one a better fit than another. Food and Drug Administration approved Tzield (teplizumab-mzwv) injection to delay the onset of stage 3 type 1 diabetes in adults and pediatric patients 8 years and older. 4 mg once weekly) for chronic weight management in adults with obesity or overweight with at least. Learn about treatment options for diabetes insipidus, a rare hormonal disorder characterized by extreme thirst and excessive urination. Ozempic contains the active ingredient, Semaglutide. Tell your doctor if you have diab. Some medications, like SGLT2 inhibitors and GLP-1 agonists, also offer benefits for your heart, kidneys, and weight loss. There are several other types of medications for Type 2 diabetes, like oral medications and GLP-1 agonist injections. GLP-1 agonists, also known as incretin mimetics, are recommended for persons with type 2 diabetes who have poorly controlled blood glucose and high Hb A1c levels. It is not known if Mounjaro can be used in people who have had pancreatitis. Mounjaro, Ozempic, and Trulicity can lead to significant weight loss. It reduces blood glucose by stimulating insuli, inhibiting glucagon and slowing down digestion. GLP-1 agonists, also known as incretin mimetics, are recommended for persons with type 2 diabetes who have poorly controlled blood glucose and high Hb A1c levels. An injection necessarily causes a small puncture woundto the body, and thus may cause localized pain or infection. There are many types of insulin, including: Short-acting insulin. Hyperglycemia in diabetes can occur for many reasons.
These steps can help lessen the impact. Schizophrenia is direc. In a clinical trial reviewed by the FDA to approve Wegovy, adults with type 2 diabetes who took Wegovy lost 6. Some other treatment options are also available. Mar 14, 2023 · After a diagnosis If you're diagnosed with diabetes, your health care provider may do other tests to distinguish between type 1 and type 2 diabetes because the two conditions often require different treatments. Diabetic hypoglycemia is the result. well insulation cover Most dogs will be feeling relatively well and can start treatment at home under veterinary guidance. She also describes semaglutide and other new medications that could make. Insulin is a hormone which is made naturally in your body, in the pancreas. She also describes semaglutide and other new medications that could make. Be sure your family or close friends know how to give you this injection in an emergency Metformin, an oral type 2 diabetes medicine, may lead to a modest weight loss and does not usually lead to significant, if any, weight gain. In various clinical. Change (rotate) your injection site with each weekly injection. The medication that can be taken orally has already been tested on baboons, in which it was found to lower the blood sugar levels. trump chao Jun 24, 2024 · Victoza® is a once-daily noninsulin medicine that lowers blood sugar and A1C. Tell your doctor if you have diab. 4 mg, and in the STEP 1 clinical trial, it averaged 14 Wegovy is now approved for people with obesity (BMI greater than 30 kg/m 2) or excess weight (BMI greater than 27 kg/m 2) who also have at least one other weight-related health condition, such as type 2 diabetes, high blood. Plastics injection molding is a widely used manufacturing process that involves injecting molten plastic into a mold to create various products. Pop culture continues to shine a light on. Who? Sulfonylureas and meglitinides are recommended for persons with type 2 diabetes who have poorly controlled blood glucose levels. gainesville mugshots last 24 hours Thus, Insulin is the main treatment agent for type 1 and is typically administered via subcutaneous injection. Semaglutide is a glucagon-like peptide-1 (GLP-1. If you're at high risk of diabetes, your health care provider might recommend metformin (Glumetza). Many people also don’t know that “diabetes” isn’t just one disease, but actually a gr.
It leads to higher-than-normal blood glucose (sugar) levels. It can be a debilitati. Stiffness and swelling might be your first hints that arthritis is setting in. Some medications stimulate the pancreas to make. About one third of them, however, don’t inject their medication correctly. Insulin and tirzepatide should be given as separate injections and not be mixed in the same injection. com Mar 21, 2023 · Ozempic and Wegovy are the same medication (semaglutide) and work the same way, says Alan, though Wegovy has a higher maximum dose. The cells of your body need glucose for energy. If you're at high risk of diabetes, your health care provider might recommend metformin (Glumetza). In both type 1 and type 2 diabetes, a reduction in both the. Use Mounjaro 1 time each week, at any time of the day. It reaches peak effect at 90 to 120 minutes and lasts about 4 to 6 hours. Research continues to show the effectiveness of semaglutide injections for weight loss. It is not known if Mounjaro is safe and effective. Currently, only injection forms of insulin are available in Hong Kong. Injections can slow the progression of. While it has revolutionized the pro. pwm sensitivity symptoms But treatments, like therapy and a keto diet, can manage symptoms. From blood glucose meters and continuous glucose monitoring (CGM) to cutting-edge insulin pumps and more, devices are easier to use and less invasive. This medicine is also used to lower the risk of heart attack, stroke, or death in patients with type 2 diabetes, obesity, and heart or blood vessel disease. Semaglutide is used for weight loss, type 2 diabetes, and reducing cardiovascular risk. Stopping smoking can improve the way insulin works, improving your blood sugar level. Apr 14, 2023 · Insulin is mostly used to treat type 1 diabetes but can be used in people with type 2 diabetes if insulin levels remain low despite the use of other types of medications. Tirzepatide reduced A1C from 23%, depending on dosage, whereas semaglutide reduced it by 1 The trial also. Once‐weekly Trulicity is a type 2 diabetes medication for adults that helps your body release its own insulin and can help improve your A1C and blood sugar numbers. Your type 2 diabetes management plan may include oral medications or injectables. But treatments, like therapy and a keto diet, can manage symptoms. Friday, November 13, 2020. Here is a selection of some top type 2 diabetes treatments and the latest breakthroughs: 1 In May 2022, the FDA approved Eli Lilly's Mounjaro (tirzepatide), a first-in-class adjunct used with diet and exercise to improve glycemic (blood sugar) control in adults with type 2 diabetes mellitus. May 24, 2024 · Afrezza, a rapid-acting inhaled insulin, is FDA-approved for use before meals for both type 1 and type 2 diabetes. grand design imagine Here's what to look for. Some GLP-1 injections, such as exenatide (Byetta), are taken twice a day. Ozempic, a drug used to treat diabetes, keeps gaining attention as celebrities, a tech mogul and TikTok influencers have described taking it to lose weight in short time frames On January 11, 1922, 14-year-old Leonard Thompson became the first person to receive an insulin injection as a treatment for diabetes. Tresiba side effects. Growing new beta cells. Ertapenem Injection: learn about side effects, dosage, special precautions, and more on MedlinePlus Ertapenem injection is used to treat certain serious infections, including pneum. Studies found people using semaglutide and making lifestyle changes lost about 333 kilograms) versus 56 kilograms) in those who didn't use the drug. Diabetic hypoglycemia is the result of the blood sugar of an individual with diabetes going too low. Dulaglutide is available as a once‐weekly subcutaneous injection that can be administered at any time of the day,. 5% on these medications. Learn about side effects, cost, and more. The sooner diabetes in dogs is diagnosed and treatment begins, the better chance tyour pet has of a normal life. Your doctor may prescribe a glucagon injection kit in case you have severe hypoglycemia. Taking turmeric may affect people with diabetes, according to MedlinePlus. Pork Mixtard (discontinued in the UK). Nov 1, 2023 · Glyxambi (empagliflozin and linagliptin) was approved in 2015. There are several steps you must learn to be able to correctly inject Ozempic. Basaglar and Toujeo are two new forms of insulin glargine. Although hydrochlorothiazide is a diuretic — a type of medicine that causes the body to make more urine — it can lower urine output for some people with nephrogenic diabetes insipidus.