Key Takeaway:
- NICE has approved teplizumab, the first treatment that can slow the progression of type 1 diabetes by targeting its underlying immune cause.
- The therapy is available for eligible people age 8 and older with early-stage, symptomless type 1 diabetes and can delay the need for insulin by an average of two to three years.
- NHS England and Wales will begin rolling out the treatment in the coming months, with early screening playing a key role in identifying eligible patients.
The National Institute for Health and Care Excellence has approved teplizumab for use on the National Health Service in England and Wales, making the first treatment that can slow the progression of type 1 diabetes available to eligible patients with early-stage disease.
NICE clears first treatment to target disease cause
The approval marks a major shift in type 1 diabetes care. Teplizumab, marketed as Tzield, is the first immunotherapy shown to delay the progression of the disease by targeting the immune attack that destroys insulin-producing beta cells.
The treatment is intended for people age 8 and older who have early-stage, symptomless type 1 diabetes. Eligible patients must have type 1 diabetes autoantibodies and rising blood sugar levels but not yet require insulin therapy.
Unlike traditional treatment, which begins after symptoms develop, teplizumab aims to slow damage before significant loss of insulin-producing cells occurs. Clinical trial results showed the drug delayed progression to insulin-dependent type 1 diabetes by an average of two to three years.
“Today’s landmark approval of teplizumab marks the start of a new age of type 1 diabetes treatment,” said Dr. Elizabeth Robertson, director of research and clinical at Diabetes UK. “For the first time in 100 years, we are moving beyond insulin, with a medicine that targets the root cause of the condition.”
NHS prepares services for eligible patients
Following the approval, NHS England has 90 days to establish services so eligible patients can begin receiving the treatment. NHS Wales has 60 days to make the drug available.
Access in Scotland and Northern Ireland will be determined through separate review processes. The Scottish Medicines Consortium has not yet begun assessing teplizumab, while Northern Ireland officials are reviewing NICE guidance.
Health experts said early detection will be critical to identifying patients who may benefit from the therapy. Screening relies on detecting type 1 diabetes autoantibodies through blood tests before symptoms appear.
Children can be screened through the ELSA study, while adults may participate in the T1DRA study. Some patients may also obtain testing through their general practitioner or hospital services.
Robertson said the next challenge is ensuring equal access. “Detecting type 1 diabetes early, before symptoms appear, is key to unlocking these benefits, and our focus now is ensuring fair and equitable access for everyone who is eligible,” she said.
Families welcome new option for children
For families affected by type 1 diabetes, the approval offers hope for delaying the daily burden of managing the disease.
Imogen, now 12, was diagnosed with early-stage type 1 diabetes in 2023 through a screening study and received teplizumab through an early-access program. Her mother, Amy, said the treatment has provided valuable time before insulin becomes necessary.
“Imogen was always going to develop type 1 diabetes, but thanks to research, we’ve been able to slow down the process and prepare,” Amy said.
She added that delaying the condition’s progression allows her daughter to enjoy more of her childhood without the constant demands of diabetes management.
Researchers continue studying how long the treatment’s effects last and why some patients benefit more than others. Diabetes UK said the UK’s approval of Teplizumab reflects decades of research into early detection, immune-system interventions and disease prevention strategies.
Advocates are also calling for broader screening programs across the United Kingdom, arguing that identifying people at risk before symptoms emerge is essential to maximizing the benefits of new therapies.
