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Recent advances in type 1 diabetes

Mervyn Kyi, John M Wentworth, Alison J Nankervis, Spiros Fourlanos and Peter G Colman
Med J Aust 2015; 203 (7): 290-293. || doi: 10.5694/mja14.01691

Summary

  • Type 1 diabetes (T1D) is caused by an autoimmune attack on pancreatic beta cells that leads to insulin deficiency.
  • The incidence of T1D in Australia has doubled over the past 20 years.
  • T1D treatment focuses on physiological insulin replacement, aiming for near-normal blood glucose levels.
  • Hypoglycaemia is a significant cause of morbidity and mortality in T1D.
  • Optimal T1D management is complex, and is enhanced by empowering individuals in all aspects of managing diabetes.
  • New technologies, including insulin pumps, continuous glucose monitors and sensor-augmented pumps, can assist people achieve better glycaemic control and reduce the risk of severe hypoglycaemia.
  • Women with T1D can achieve significantly better outcomes during pregnancy and for their infants by planning for their pregnancy and by intensive glycaemic control.
  • Several trials are underway that seek to identify the determinants of autoimmunity and to develop therapies that prevent T1D in at-risk individuals.
  • Pancreatic and islet cell transplants are proven therapies, but are only offered to individuals with diabetes and renal failure (pancreas) or severe hypoglycaemia unawareness (islet cell transplants).
  • Although T1D is still associated with considerable premature mortality, recent findings show that a significant improvement in life expectancy has occurred.

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  • Mervyn Kyi
  • John M Wentworth
  • Alison J Nankervis
  • Spiros Fourlanos
  • Peter G Colman

  • Royal Melbourne Hospital, Melbourne, VIC

Correspondence: peter.colman@mh.org.au

Competing interests:

No relevant disclosures.

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