Pharmacological Approach to Type 1 Diabetes in Adults

▪️ Treat most adults with type 1 diabetes with multiple daily doses of prandial and basal insulin         

Strong recommendation, High-Quality Evidence (systematic review of cross-sectional studies with a consistent reference standard) ^{3- 5}

▪️  For most adults with type 1 diabetes, insulin analogs are preferred over injectable human insulins to 2minimize hypoglycemia risk. 

Conditional recommendation, High-Quality Evidence (systematic review of cross-sectional studies with a consistent reference standard) ^{6 - 10}

▪️  Automated Insulin delivery systems (insulin pens) and insulin analogues could be considered for all adults with type 1 diabetes.

Conditional recommendation, High-Quality Evidence (systematic review of cross-sectional studies with a consistent reference standard) ^{11, 12}

^▪️  To improve glycemic outcomes and quality of life and minimize hypoglycemia risk, most adults with type 1 diabetes could receive education on how to match mealtime insulin doses to carbohydrate intake and, additionally, to fat and protein intake. They should also be taught how to modify the insulin dose (correction dose) based on concurrent glycemia, glycemic trends (if available), sick-day management, and anticipated physical activity.

 Conditional Recommendation, Moderate Quality Evidence (based on observational studies) ^{13, 14}

▪️  Insulin treatment plan and insulin-taking behavior should be reevaluated at regular intervals (e.g., every 3–6 months) and adjusted to incorporate specific factors that impact choice of treatment and ensure achievement of individualized glycemic goals 

Conditional Recommendation, Moderate Quality Evidence (based on observational studies) ^{1, 14, 15}