OBJECTIVE -Our aim was to evaluate the predictive value of gestational diabetes mellitus (GDM), diabetes-associated autoantibodies, and other factors for development of clinical diabetes later in life.RESEARCH DESIGN AND METHODS -In this case-control study the presence of autoantibodies was studied in 435 women with GDM and in healthy matched control subjects. The need for exogenous insulin during GDM was recorded. In the GDM group, the mean follow-up period was 5.7 years and in the control group 6.1 years.RESULTS -Among the subjects with GDM, 20 (4.6%) developed type 1 diabetes and 23 (5.3%) developed type 2 diabetes, whereas none of the control subjects became diabetic. Twothirds of those who developed type 1 diabetes tested positive initially for islet cell antibodies (ICAs), whereas 56% of them had autoantibodies to GAD (GADAs) and 38% to the protein tyrosine phosphatase-related IA-2 molecule. Only 2 of the 23 women who presented later with type 2 diabetes tested positive for autoantibodies. According to multivariate analysis, initial age Յ30 years, the need for insulin treatment for GDM, and antibody positivity for ICAs and GADAs were associated with increased risk for clinical type 1 diabetes.CONCLUSIONS -Pregnancy seems to identify women who are at risk of developing diabetes later in life. About 10% of Finnish women with GDM will develop diabetes over the next 6 years; nearly half of them develop type 1 diabetes and the other half type 2 diabetes. Age Յ30 years, the need for insulin treatment during pregnancy, and positivity for ICAs and GADAs confer a high risk of subsequent progression to type 1 diabetes in women affected by GDM. Diabetes Care 29:607-612, 2006N ormal pregnancy induces insulin resistance (1), which may unmask diabetes or reduced insulin secretory capacity. The incidence of gestational diabetes mellitus (GDM) has been reported to be 2-5% during pregnancy (1). The condition is associated with both impaired insulin action and secretion, defects that are also characteristic of type 2 diabetes (2). Women with GDM have a considerable risk of developing type 2 diabetes later in life, but the risk of developing type 1 diabetes is also increased (3-5).The presence of circulating autoantibodies to various islet cell proteins is one of the most thoroughly characterized immune phenomena associated with type 1 diabetes (6). These autoantibodies are the detectable markers of an ongoing destructive process in the islets and thus provide a potential tool to identify individuals at risk of developing the disease in the future. Diabetesassociated autoantibodies have a high positive predictive value (PPV) for clinical type 1 diabetes among relatives of affected patients. The results of recent studies have implied that the PPV of autoantibodies associated with type 1 diabetes is also high in women with GDM (7). Although the antibody status of women with GDM may vary, depending on the phase of pregnancy and treatment mode for GDM, as well as on the methods used for antibody detection, most investigators hav...
In our study sample of first-episode schizophrenia spectrum drug-naïve adolescents, overweight was shown to be prevalent in all diagnostic groups other than first-episode schizophrenia spectrum psychotic girls. To the best of our knowledge, this is the first study in which overweight was analyzed and verified among drug-naïve adolescent boys, suffering from first-episode schizophrenia spectrum disorder. To what extent our results are applicable to other regions and study groups, remains to be seen.
This article presents a study in which we began with a question "how to teach theoretical reflectivity in teacher education, and ended with a sentence "there is theoretical diffraction in teacher education". The research presented in this paper took place in the context of a university course in which we have been involved for the past two years. During the course we simultaneously pursued to teach theoretical reflection and to analyse what was happening as we taught theoretical reflection. For two years we asked, 'What are students doing while we are trying to engage them in theoretical reflection?' We noted that students are engaged in theory, but not in ways easily readable to the educators, and that the process could rather be called theoretical diffraction than reflection. Theoretical diffraction during the course was patterned by existing discursive practices: 1) disciplining emotions and focusing on control and answers, 2) personalising school as the teacher and personally defending it, 3) prioritising practice over theory and seeing both as dogma.
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