Synopsis
Deliver safe lifelong insulin replacement, technology-supported self-management and complication prevention while recognising hypoglycaemia, ketosis and changing insulin needs early.
- Type 1 diabetes is autoimmune beta-cell failure requiring insulin replacement; clinical suspicion and metabolic safety take precedence over awaiting classification tests.
- Offer diabetes-specific autoantibodies near diagnosis; use paired non-fasting C-peptide later when uncertainty persists because its discrimination improves with time from diagnosis.
- A basal-bolus regimen with rapid-acting mealtime insulin and long-acting basal insulin is usual first-line adult therapy, integrated with carbohydrate estimation and dose adjustment.
Investigation priorities
Support autoimmune classification near presentation using the locally available antibody panel.
Management branches
Type 1 diabetes is newly diagnosed or strongly suspected without established DKA.
- Involve the specialist diabetes team promptly, begin an individualised basal-bolus insulin regimen and teach injection, storage and glucose-monitoring safety.
- Provide structured carbohydrate-counting and dose-adjustment education, hypoglycaemia treatment, ketone testing and written sick-day rules from the outset.
Key medicines
Rapid-acting insulin analogueCalculate each subcutaneous mealtime and correction dose from the person's specialist-agreed insulin-to-carbohydrate ratio, glucose target, sensitivity factor, active insulin and planned activity; pump settings require equivalent individualisation.
Long-acting basal insulin analogueGive the individually titrated subcutaneous daily or twice-daily regimen at consistent times according to preparation and specialist plan; continue during fasting and illness unless explicitly adjusted by the team.