Recent advances in type 1 diabetes

• 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. • Newtechnologies, 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.