PHARMAMINT
TYPE 1 DIABETES MELLITUS
(T1DM)
THE ULTIMATE PHARMACY STUDY GUIDE & CLINICAL CHEAT SHEET
Reflecting NICE Guideline NG17 & February 2026 Medicines Update
High-Yield Study Notes for Pharmacy Students BY a Pharmacy Student
For personal use only. Commercial redistribution of this file as-is is prohibited.
, Type 1 Diabetes Mellitus (T1DM) | Pharmacy Revision Notes
Contents
1. Pathophysiology & Cellular Biology .................................................................................................................. 4
Autoimmune β-cell Destruction ....................................................................................................................... 4
Insulin Biosynthesis & Storage Chemistry......................................................................................................... 4
Glucose-Stimulated Insulin Secretion (GSIS) .................................................................................................... 6
Metabolic Consequences of Absolute Deficiency............................................................................................. 7
2. Diagnosis, Profiling & Clinical Red Flags............................................................................................................ 8
NICE NG17 Diagnostic Criteria .......................................................................................................................... 8
Immunological Profiling (Autoantibody Testing) .............................................................................................. 8
The Diagnostic Role of C-Peptide...................................................................................................................... 8
Pancreatic Cancer Red Flag ............................................................................................................................... 8
3. Support, Care Planning & Education............................................................................................................... 10
The Early Care Plan & MDT Support ............................................................................................................... 10
Structured Patient Education: DAFNE ............................................................................................................ 10
4. Dietary & Physical Activity Management........................................................................................................ 11
Dietary Management & Carbohydrate Counting............................................................................................ 11
Physical Activity: Metabolic Physiology & Adjustments ................................................................................. 11
Alcohol & Driving Precautions ........................................................................................................................ 11
5. Glycaemic Targets & Monitoring Technologies .............................................................................................. 12
HbA1c Measurement & Clinical Targets ......................................................................................................... 12
Capillary Blood Glucose Self-Monitoring Targets ........................................................................................... 12
Continuous Glucose Monitoring (CGM).......................................................................................................... 13
6. Pharmacotherapy & Formulation Chemistry .................................................................................................. 14
The Regimen of Choice: Basal-Bolus MDI ....................................................................................................... 14
Insulin Delivery & Injection Technique ........................................................................................................... 14
Advanced Technology: Pumps & Hybrid Closed-Loop (HCL) .......................................................................... 14
Pharmacological Adjuncts in Type 1 Diabetes ................................................................................................ 14
7. High-Yield Updates & Clinical Safety............................................................................................................... 15
⚠️ Live Supply Update: Global Levemir Discontinuation .............................................................................. 15
Pre-Discontinuation Basal Analogue Hierarchy .............................................................................................. 15
Prescribing and Dispensing Safety Rules ........................................................................................................ 15
8. Acute Complications & Inpatient Protocols .................................................................................................... 17
Page 2
, Type 1 Diabetes Mellitus (T1DM) | Pharmacy Revision Notes
Hypoglycaemia: Awareness & Gold/Clarke Scores ......................................................................................... 17
Acute Hypoglycaemia Treatment Protocol ..................................................................................................... 17
Inpatient Diabetic Ketoacidosis (DKA) Management Protocol ....................................................................... 17
9. Chronic Complications & Long-Term Care ...................................................................................................... 19
Microvascular & Microvascular Screening...................................................................................................... 19
Periodontitis & Oral Health............................................................................................................................. 19
Diabetic Kidney Disease (Nephropathy) ......................................................................................................... 19
Ophthalmology & Eye Screening .................................................................................................................... 19
Diabetic Neuropathies: Autonomic, Gastroparesis & Painful ......................................................................... 19
Eating Disorders & Diabulimia ........................................................................................................................ 20
10. Hospital Inpatient Care & Summaries........................................................................................................... 21
Inpatient Glycaemic Targets & Insulin Management ..................................................................................... 21
Advanced Referrals & Clinical Summary ......................................................................................................... 21
High-Yield Cardiovascular Risk & Hypertension Summary ............................................................................. 21
11. Appendix: Insulin Formulations .................................................................................................................... 22
Key Clinical References ................................................................................................................................... 22
Page 3
TYPE 1 DIABETES MELLITUS
(T1DM)
THE ULTIMATE PHARMACY STUDY GUIDE & CLINICAL CHEAT SHEET
Reflecting NICE Guideline NG17 & February 2026 Medicines Update
High-Yield Study Notes for Pharmacy Students BY a Pharmacy Student
For personal use only. Commercial redistribution of this file as-is is prohibited.
, Type 1 Diabetes Mellitus (T1DM) | Pharmacy Revision Notes
Contents
1. Pathophysiology & Cellular Biology .................................................................................................................. 4
Autoimmune β-cell Destruction ....................................................................................................................... 4
Insulin Biosynthesis & Storage Chemistry......................................................................................................... 4
Glucose-Stimulated Insulin Secretion (GSIS) .................................................................................................... 6
Metabolic Consequences of Absolute Deficiency............................................................................................. 7
2. Diagnosis, Profiling & Clinical Red Flags............................................................................................................ 8
NICE NG17 Diagnostic Criteria .......................................................................................................................... 8
Immunological Profiling (Autoantibody Testing) .............................................................................................. 8
The Diagnostic Role of C-Peptide...................................................................................................................... 8
Pancreatic Cancer Red Flag ............................................................................................................................... 8
3. Support, Care Planning & Education............................................................................................................... 10
The Early Care Plan & MDT Support ............................................................................................................... 10
Structured Patient Education: DAFNE ............................................................................................................ 10
4. Dietary & Physical Activity Management........................................................................................................ 11
Dietary Management & Carbohydrate Counting............................................................................................ 11
Physical Activity: Metabolic Physiology & Adjustments ................................................................................. 11
Alcohol & Driving Precautions ........................................................................................................................ 11
5. Glycaemic Targets & Monitoring Technologies .............................................................................................. 12
HbA1c Measurement & Clinical Targets ......................................................................................................... 12
Capillary Blood Glucose Self-Monitoring Targets ........................................................................................... 12
Continuous Glucose Monitoring (CGM).......................................................................................................... 13
6. Pharmacotherapy & Formulation Chemistry .................................................................................................. 14
The Regimen of Choice: Basal-Bolus MDI ....................................................................................................... 14
Insulin Delivery & Injection Technique ........................................................................................................... 14
Advanced Technology: Pumps & Hybrid Closed-Loop (HCL) .......................................................................... 14
Pharmacological Adjuncts in Type 1 Diabetes ................................................................................................ 14
7. High-Yield Updates & Clinical Safety............................................................................................................... 15
⚠️ Live Supply Update: Global Levemir Discontinuation .............................................................................. 15
Pre-Discontinuation Basal Analogue Hierarchy .............................................................................................. 15
Prescribing and Dispensing Safety Rules ........................................................................................................ 15
8. Acute Complications & Inpatient Protocols .................................................................................................... 17
Page 2
, Type 1 Diabetes Mellitus (T1DM) | Pharmacy Revision Notes
Hypoglycaemia: Awareness & Gold/Clarke Scores ......................................................................................... 17
Acute Hypoglycaemia Treatment Protocol ..................................................................................................... 17
Inpatient Diabetic Ketoacidosis (DKA) Management Protocol ....................................................................... 17
9. Chronic Complications & Long-Term Care ...................................................................................................... 19
Microvascular & Microvascular Screening...................................................................................................... 19
Periodontitis & Oral Health............................................................................................................................. 19
Diabetic Kidney Disease (Nephropathy) ......................................................................................................... 19
Ophthalmology & Eye Screening .................................................................................................................... 19
Diabetic Neuropathies: Autonomic, Gastroparesis & Painful ......................................................................... 19
Eating Disorders & Diabulimia ........................................................................................................................ 20
10. Hospital Inpatient Care & Summaries........................................................................................................... 21
Inpatient Glycaemic Targets & Insulin Management ..................................................................................... 21
Advanced Referrals & Clinical Summary ......................................................................................................... 21
High-Yield Cardiovascular Risk & Hypertension Summary ............................................................................. 21
11. Appendix: Insulin Formulations .................................................................................................................... 22
Key Clinical References ................................................................................................................................... 22
Page 3
