{ "schema_version": 1, "kind": "condition", "id": "type-1-diabetes", "name": "Type 1 Diabetes Mellitus", "category": "chronic", "sources": "Egyptian National Drug Formulary - Endocrine, insulin monograph, Dosage Regimen, type 1 diabetes mellitus · Type 1 Diabetes - StatPearls, updated 5 October 2024 - https://www.ncbi.nlm.nih.gov/books/NBK507713/ · Type 1 Diabetes - StatPearls - NCBI Bookshelf - disease-level clinical article (type-1-diabetes-full.txt)", "review_status": "reviewed", "verified_against": "Egyptian National Drug Formulary - Endocrine, insulin monograph, Dosage Regimen, type 1 diabetes mellitus · Type 1 Diabetes - StatPearls, updated 5 October 2024 - https://www.ncbi.nlm.nih.gov/books/NBK507713/ · No dose - referral pathway, no medicine given in primary care · Type 1 Diabetes - StatPearls - NCBI Bookshelf - disease-level clinical article (type-1-diabetes-full.txt)", "verified_date": "2026-08", "treatments": [ { "id": 1764, "generic": "Insulin (basal-bolus regimen)", "line": 1, "is_adjunct": false, "form": "injection", "strength_mg": null, "adult_dose": "Basal insulin is one-third to one-half of the total daily insulin dose; the remainder is given as rapid- or short-acting insulin before meals. The total daily dose is set and titrated by the diabetes service, not from this screen.", "adult_duration": "Lifelong", "dose_source": "Egyptian National Drug Formulary - Endocrine, insulin monograph, Dosage Regimen, type 1 diabetes mellitus", "rationale": "Type 1 diabetes is autoimmune destruction of the insulin-producing cells, so insulin is replacement, not control - it can never be stopped and no oral agent substitutes for it. The split above is the Egyptian formulary's own, quoted verbatim; the total daily dose is deliberately not given here because it is individualised and specialist-set.", "cautions": [ "NEVER STOP INSULIN, including when the patient is not eating. Stopping during an illness is the commonest route into diabetic ketoacidosis - see [Diabetic Ketoacidosis].", "Metformin and the other type 2 agents do NOT treat type 1. The type 2 diabetes entry is a different disease.", "New diagnosis needs same-week specialist referral, and same-day if there are ketones, vomiting or weight loss.", "Hypoglycaemia is the price of tight control: confirm the patient and family can recognise and treat it before intensifying anything.", "Distinguishing type 1 from type 2 in an adult can need autoantibodies (GAD65, IA-2, ZnT8) - StatPearls lists these and adult-onset type 1 is regularly misdiagnosed as type 2.", "Egyptian pharmacies stock human insulins (soluble and isophane, and 70/30 mixes) far more cheaply than the analogues; the regimen has to match what the patient can actually keep buying." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Children are managed by a paediatric diabetes service. Doses change with growth, puberty and activity, and are not reproduced here.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [], "condition_id": "type-1-diabetes" }, { "id": 1765, "generic": "Referral & safety-netting (no drug therapy)", "line": 1, "is_adjunct": false, "form": null, "strength_mg": null, "adult_dose": null, "adult_duration": null, "dose_source": "No dose - referral pathway, no medicine given in primary care", "rationale": "Carries the referral criteria and warning signs for this condition, which apply whichever treatment is chosen.", "cautions": [ "RED FLAG - Most patients in DKA require ICU-level admission and monitoring.", "Repeated hypoglycaemic episodes, especially in someone who has had the disease a long time, blunt the warning symptoms until they appear only at dangerously low glucose levels.", "A blood glucose below 54 mg/dL is a distinct, more severe level of hypoglycaemia and is usually accompanied by impaired thinking and reduced consciousness.", "Treat a glucose below 70 mg/dL with 15 to 20 grams of oral glucose, recheck after 15 minutes, and follow with a snack once the level has normalised.", "Screen for coexisting autoimmune disease - autoimmune thyroid disease, coeliac disease, primary adrenal insufficiency and rheumatoid arthritis are all commoner in this group.", "Ask about disordered eating and insulin omission at review, particularly in young women, in whom eating disorders are common.", "Examine the feet for early neuropathy, deformity, pre-ulcerative lesions, ulceration, calluses and fungal nail disease.", "Inspect the injection and infusion sites at every review; if lipodystrophy has developed, rotation of sites has to be retaught.", "First- and second-degree relatives of a patient with type 1 diabetes should be offered screening with autoantibody testing." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": null, "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [], "condition_id": "type-1-diabetes" }, { "id": 1766, "generic": "Glucagon", "line": 1, "is_adjunct": true, "form": "injection", "strength_mg": 1.0, "adult_dose": "IM, SC, IV: 1 mg; may repeat in 15 minutes as needed", "adult_duration": null, "dose_source": "Egyptian National Drug Formulary - Endocrine", "rationale": "Emergency rescue medication for severe hypoglycemia when the patient cannot take oral carbohydrate; prescribed for home use so carers can administer it before emergency services arrive.", "cautions": [ "Hypersensitivity reactions including generalized rash and anaphylactic shock have been reported.", "There is a lack of efficacy in patients with decreased hepatic glycogen such as starvation, adrenal insufficiency, or chronic hypoglycemia." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Pediatric weighing <20 kg: IM, SC, IV: 0.5 mg; may repeat in 15 minutes as needed", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [ { "trade_name": "GLUCAGEN 1MG/ML VIAL", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "NOVO NORDISK > EGYPTIAN PHARMACEUTICAL TRADING COMPANY", "price_egp": 323.0, "pack_count": null, "unit_price": null, "strength_mg": 1.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "type-1-diabetes" } ] }