Glycaemic control deteriorated in diabetes patients following the floods but was almost exclusively confined to patients taking insulin and was worst at 6-9 months following the event. Insulin-treated patients may need specific targeting in the event of a natural disaster.
Based on these findings, we recommend that all women diagnosed with GDM should be assessed post-partum by an OGTT if we are to detect all the women who have abnormal glucose tolerance at this time. Those women with normal glucose tolerance also need counselling regarding the implications of the diagnosisofGDMandshouldreceiveadviceonrecommendations for lifestyle modification and follow-up, if we are to reduce their subsequent progression to Type 2 diabetes.In this large, multi-ethnic Australian group of women with gestational diabetes, relying on fasting glucose alone at 6-week post partum assessment would have missed 33% of mothers shown to have ongoing Type 2 diabetes and 76% of those with impaired glucose tolerance.
The multistep model of carcinogenesis in the breast suggests a transition from normal epithelium to invasive carcinoma via non-atypical and atypical hyperplasia and in situ carcinoma. The introduction of mammographic screening has led to the increased detection of preinvasive disease, and this has highlighted deficiencies in the biology and classification of such lesions. The excitement surrounding the development of DNA microarray analysis and proteomics has raised expectations about the role of these techniques in understanding the biology and translating these data to clinical practice. Only a few years ago, scientists studied disease initiation and progression in a linear fashion, identifying and examining one cancer-related molecule at a time. The recent development of technologies that allow a large number of genes and gene products to be analysed simultaneously has brought renewed interest to breast cancer research, with the hope of identifying a unique 'fingerprint' for each tumour and hence individualised treatment. To date, histopathological assessment has been at the heart of clinical management-does the new technology herald the end? Hormone replacement therapy (HRT): indications and side effects
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