Type 1 diabetes drug to delay onset now available on NHS
A groundbreaking immunotherapy drug that can delay the onset of type 1 diabetes by around three years has been made available on the NHS, marking the first time any treatment has been able to slow the progression of the disease before it takes hold.
Teplizumab, sold under the brand name Tzield, works by targeting the immune system’s T-cells, which in people predisposed to type 1 diabetes mistakenly attack and destroy the insulin-producing cells in the pancreas. By intervening before that process completes, the drug can buy patients — including children as young as eight — significant extra time before they need to begin daily insulin injections.
Who is eligible for the treatment?
The drug is intended for people who have already been identified as being at high risk of developing type 1 diabetes, typically through genetic screening or close family history. Eligible patients must show two or more diabetes-related antibodies in their blood and have already begun to show signs of abnormal blood sugar regulation — what clinicians call the “stage two” phase of the disease.
It’s estimated that around 2,000 people in England could be eligible for teplizumab in the first year alone. The treatment itself is administered as a 14-day course of intravenous infusions, usually in a hospital or clinic setting.
What difference can three years make?
Three years might not sound like much. But for a child diagnosed at eight or nine years old, it can mean completing primary school without the burden of constant blood sugar monitoring, insulin doses, and the anxiety that comes with managing a lifelong condition.
The psychological and practical impact of delaying insulin dependency shouldn’t be underestimated. Families describe the period around a type 1 diabetes diagnosis as genuinely traumatic — sudden hospitalisation, a steep learning curve, and an immediate, permanent change to daily life.
“This is a historic moment for people living with type 1 diabetes and their families,” said a spokesperson for NHS England. “For the first time, we have a treatment that doesn’t just manage the condition but actually delays its progression.”
How teplizumab works
The drug was developed by Provention Bio and later acquired by Sanofi. It received approval from the US Food and Drug Administration in November 2022, making it the first disease-modifying therapy ever approved for type 1 diabetes anywhere in the world. NHS approval in England follows a review by the National Institute for Health and Care Excellence, which concluded the drug offered sufficient clinical benefit to justify its cost.
Clinical trial data showed that patients who received teplizumab went an average of 32.5 months before needing insulin, compared to just under 24 months in those who received a placebo — a meaningful difference by any measure.
What comes next
Researchers are now exploring whether teplizumab could eventually be used even earlier in the disease process, potentially at stage one, before any blood sugar abnormalities appear. If that proves effective, the delay could stretch far beyond three years. And that would change the picture for type 1 diabetes entirely.
