# Type 1 Diabetes Mellitus - Category: chronic - Review status: reviewed (every claim checked against a document named on this page) - 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) - Verified date: 2026-08 ## 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) ## Treatment metadata - Insulin (basal-bolus regimen) — injection - Referral & safety-netting (no drug therapy) - Glucagon — 1 mg — injection ## Complete treatment card ```text TYPE 1 DIABETES MELLITUS 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 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) (2026-08) IS IT THIS? - reference only, to read alongside your own examination SYMPTOMS - what the patient reports (4) - Classic opening picture: passing lots of urine, heavy thirst, tiredness and weight coming off [fatigue] - Some arrive acutely in ketoacidosis rather than with a gradual build-up - Sudden visual disturbance or perineal thrush can be the presenting complaint - In adults the first label given is sometimes type 2 before the true type is recognised SIGNS - what you find (4) - Foot check may reveal early neuropathy, deformity, pre-ulcer skin change, frank ulcers, callus or fungal nails [visible deformity] - A failed 10-g monofilament test marks a raised chance of foot ulceration - Fat change at injection or pump sites means the patient needs to rotate where insulin goes in - Vibration and protective sensation both need testing at the foot check TESTS (11) - Fasting plasma glucose reaching 126 mg/dL, seen on more than a single occasion - Random plasma glucose from 200 mg/dL upwards together with typical hyperglycaemic symptoms - Two hours after a 75-g glucose load, a value of 200 mg/dL or more - HbA1c of 6.5% or above meets the threshold - Where hyperglycaemia is not clear-cut, two abnormal results are needed to confirm - Pancreatic autoantibodies and stimulated C-peptide separate this from other forms; C-peptide reflects beta-cell function - Most have at least one positive antibody when first diagnosed - Repeat HbA1c three-monthly at follow-up to judge control - If not done in the last year: lipids, creatinine, urine albumin-to-creatinine ratio, liver tests, TSH, full blood count and potassium - Potassium matters especially when an ACE inhibitor, ARB or diuretic is being taken - Consider looking for coexisting autoimmune disease: thyroid, coeliac, adrenal failure, rheumatoid arthritis IF NOT THIS - what else fits (7) - Type 2 diabetes - Monogenic diabetes - Cystic fibrosis-related diabetes - Chronic pancreatitis - Diabetes after transplantation - Steroid-induced diabetes - Psychogenic polydipsia Source StatPearls "Type 1 Diabetes" - disease-level clinical article Status traced to the source above 1. INSULIN (BASAL-BOLUS REGIMEN) [1st line] Adult 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. - Lifelong Peds Children are managed by a paediatric diabetes service. Doses change with growth, puberty and activity, and are not reproduced here. Source Egyptian National Drug Formulary - Endocrine, insulin monograph, Dosage Regimen, type 1 diabetes mellitus Why 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. Caution 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. Egypt no Egyptian brand matched - prescribe by generic name 2. REFERRAL & SAFETY-NETTING (NO DRUG THERAPY) [1st line] Adult Source No dose - referral pathway, no medicine given in primary care Why Carries the referral criteria and warning signs for this condition, which apply whichever treatment is chosen. Caution 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. 3. GLUCAGON [add-on - not a substitute] Adult IM, SC, IV: 1 mg; may repeat in 15 minutes as needed Peds Pediatric weighing <20 kg: IM, SC, IV: 0.5 mg; may repeat in 15 minutes as needed Source Egyptian National Drug Formulary - Endocrine Why 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. Caution 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. Egypt GLUCAGEN 1MG/ML VIAL NOVO NORDISK ... 323.00 EGP Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy. ``` --- Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement. [Privacy policy](/privacy)