The National Institute for Health and Care Excellence (NICE) has approved teplizumab for use on the NHS for people with early-stage type 1 diabetes, marking the start of a new era in how we treat the condition.
Teplizumab, also known as Tzield, is the world’s first immunotherapy treatment that targets the root cause of type 1 diabetes and can slow its progression.
It can give people in the early stages of type 1 diabetes extra years before they need insulin or develop symptoms.
We want a future where everyone with early-stage type 1 diabetes can access immunotherapies. That’s why we’re calling for national services to detect and treat type 1 early, with fair access for all. Help us get there by supporting our Type 1 Tipping Point campaign and spreading the word about our ELSA early detection study.
Who can have teplizumab for type 1 diabetes?
Teplizumab hasn’t been approved for everyone with type 1 diabetes. It’s for people in its symptomless, early stage.
At this point, the immune system is already attacking insulin-producing beta cells, but many of these cells are still alive. Teplizumab works by resetting the immune system, helping to protect beta cells so the body can keep making more of its own insulin for longer.
We can spot people who are at this stage by looking for signs in the blood called type 1 diabetes autoantibodies.
You may be eligible for teplizumab if you have these autoantibodies, are aged 8 or over, and your blood sugar levels have started to rise slightly – but you don’t yet need insulin.
How does teplizumab change type 1 diabetes treatment?
Teplizumab is the start of a completely new way of treating type 1 diabetes.
Until now, we’ve had to wait for symptoms to appear and then act fast to manage high blood sugar levels with insulin. But instead of reacting after damage is done, teplizumab allows us to step in earlier and slow that damage down.
This can extend the time someone spends in the symptomless phase, delaying the need for insulin and the relentless, daily demands that come with it. And when insulin treatment is eventually needed, the transition can be planned and managed safely – helping to avoid diabetic ketoacidosis (DKA), a life-threating medical emergency.
In a landmark trial, teplizumab delayed progression to the insulin-treated stage of type 1 diabetes by an average of two to three years.
This won’t be exactly the same for everyone. Some people may get more time, others less. Researchers are continuing to study how long the effects could last, and why some people benefit more than others.
Imogen, aged 12, was diagnosed with early-stage type 1 diabetes in 2023 after taking part in our ELSA screening study. She received teplizumab through an early access programme last year. Her mum, Amy, said:
“Imogen was always going to develop type 1 diabetes, but thanks to research, we’ve been able to slow down the process and prepare.
“I’ve told Imogen that having diabetes won’t stop her living the life she wants to. But it does take that extra care and effort to manage life with diabetes. If we can give her a childhood where she doesn’t need to think about that yet, that will mean everything.
“For us, teplizumab has been incredible, and we’re so pleased that more children like Imogen will now get the chance to enjoy a normal childhood before facing the realities of type 1 diabetes.”
When will teplizumab be available on the NHS?
NICE has approved teplizumab for use on the NHS in England and Wales. Now, the NHS in England has 90 days to set up services so eligible people can start receiving the treatment. In Wales, the NHS has 60 days to make teplizumab available.
In Scotland and Northern Ireland access is decided separately.
In Northern Ireland, there is a process for reviewing and adopting NICE guidance, and we’re working with local systems to understand what happens next.
In Scotland, decisions about new treatments are made by the Scottish Medicines Consortium (SMC). Teplizumab is not currently being assessed by the SMC, but we’re working to find out more about when this might happen.
We’ll push for fair access across the UK, so that everyone who could benefit has the same opportunity.
How can I find out if I’m eligible for teplizumab?
The key to unlocking treatments like teplizumab is early detection. That means testing for type 1 diabetes autoantibodies. These are proteins used by the immune system to target beta cells.
You can find out if you or your child has autoantibodies by taking part in screening studies.
We’re co-funding the ELSA study that’s screening children aged 2-17 across the UK, and the T1DRA study screens adults aged 18-70. Taking part involves a simple finger-prick blood test that can be done at home.
You may also be able to get an autoantibody test through your GP or in hospital. This will need a retest in a specialist lab to confirm it's positive before you are considered for treatment.
Anyone with a positive autoantibody test is encouraged to join the UK Islet Autoantibody Registry, so they can get their free follow-up test, ongoing support from specialist nurses, and hear about new research and treatment opportunities.
A tipping point in type 1 diabetes treatment
We’re continuing to fund ground-breaking research into detecting and treating early-stage type 1 diabetes, and we’ve spent decades investing in science that has brought us to this tipping point in type 1 diabetes. Our scientists have:
- Shown that the immune attack happens gradually, creating a window to intervene early.
- Discovered that autoantibodies are an early warning sign that type 1 diabetes has begun.
- Shown that national screening is effective to identify children at risk or with early-stage type 1.
- Sped up the development and testing of immunotherapies in trials.
Now, we’re determined to move further and faster into this new era. We’re paving the way for a future where everyone at risk of type 1 diabetes can be diagnosed early, offered life-changing treatments, and where one day, the condition could be prevented completely.
Through our Type 1 Tipping Point campaign, we’re calling on UK governments to act now. We need the UK to be ready to quickly adopt new advances like screening and immunotherapies, and to invest in research that keeps moving us closer to a cure.
We’re taking our campaign to Parliament. You can help by inviting your MP and making sure they know how important this is to you.
Dr Elizabeth Robertson, Director of Research and Clinical at Diabetes UK, said:
“Today’s landmark approval of teplizumab marks the start of a new age of type 1 diabetes treatment. For the first time in 100 years, we are moving beyond insulin, with a medicine that targets the root cause of the condition. This is an extraordinary moment for celebration in the type 1 diabetes community, and towards a future where type 1 diabetes can be prevented altogether.
“Teplizumab offers those in the early stages of type 1 diabetes years free from the relentless demands of managing the condition with insulin as well as valuable time to prepare. 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.
"We want a future where everyone with early-stage type 1 diabetes can benefit from immunotherapies. Through our long-term investment in world-class research, and partnership with the NHS and industry, we are working to make a national type 1 diabetes screening programme a reality."
