Clinical reference

Type 1 Diabetes Mellitus

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources3 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 against4 documents

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 date2026-08

Presentation reference

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

SourceStatPearls "Type 1 Diabetes" - disease-level clinical article

Presentation findings are traced to the source above.

INSULIN (BASAL-BOLUS REGIMEN)

1st line

Forminjection

Adult dose and duration

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

Paediatric dose

Children are managed by a paediatric diabetes service. Doses change with growth, puberty and activity, and are not reproduced here.

Dose 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.

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.

Egyptian brands

No Egyptian brand matched — prescribe by generic name.

REFERRAL & SAFETY-NETTING (NO DRUG THERAPY)

1st line

Dose 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.

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.

GLUCAGON

add-on - not a substitute

Strength1 mg

Forminjection

Adult dose and duration

IM, SC, IV: 1 mg; may repeat in 15 minutes as needed

Paediatric dose

Dose by age
Pediatric weighing <20 kg:	IM, SC, IV: 0.5 mg; may repeat in 15 minutes as needed

Dose 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.

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.

Egyptian brands

Egyptian brand	Manufacturer	Indicative price
GLUCAGEN 1MG/ML VIAL	NOVO NORDISK > EGYPTIAN PHARMACEUTICAL TRADING COMPANY	323.00 EGP

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.