Log in with your email address username.


Important notice

doctorportal Learning is on the move as we will be launching a new website very shortly. If you would like to sign up to dp Learning now to register for CPD learning or to use our CPD tracker, please email support@doctorportal.com.au so we can assist you. If you are already signed up to doctorportal Learning, your login will work in the new site so you can continue to enrol for learning, complete an online module, or access your CPD tracker report.

To access and/or sign up for other resources such as Jobs Board, Bookshop or InSight+, please go to www.mja.com.au, or click the relevant menu item and you will be redirected.

All other doctorportal services, such as Find A Doctor, are no longer available.

Recent advances in type 1 diabetes

- Featured Image

Type 1 diabetes (T1D) affects around 120 000 Australians, half of whom are diagnosed in adulthood.1 It is caused by the immune-mediated destruction of pancreatic beta cells, leading to insulin deficiency, hyperglycaemia and the risk of ketoacidosis. Antibodies directed against the beta-cell antigens insulin, glutamic acid decarboxylase 65 (GAD65), insulinoma-associated protein 2 (IA-2) and zinc transporter 8 (ZnT8) are markers of T1D autoimmunity used to confirm the diagnosis of T1D and to identify normoglycaemic people at high risk of progressing to T1D.2 The incidence of T1D has doubled in Australia during the past 20 years,3 leading to speculation that it is caused by environmental or epigenetic factors. Environmental changes that may play a pathogenic role include viral infections, a more hygienic environment, and increased caloric intake with associated weight gain.4

Some individuals with insulin deficiency presenting as T1D do not express the typical beta-cell autoantibodies, and alternative diagnoses, such as early-onset type 2 diabetes or idiopathic (type 1b) diabetes, should be considered. Another possibility is monogenic diabetes, particularly in children with a strong family history and unusual clinical features, such as renal impairment or exocrine pancreatic insufficiency.

General management principles