Hannah’s story: I’m hopeful teplizumab will give me extra years free from type 1 diabetes

During my first pregnancy in 2020, I had routine screening for gestational diabetes which caught high blood sugar levels. My doctors decided to investigate further and tested me for type 1 diabetes autoantibodies.

What are type 1 diabetes autoantibodies?

Autoantibodies are proteins used by the immune system to attack insulin-producing cells. A blood test can detect if someone has autoantibodies, and how many. When there are two or more autoantibodies, the immune system’s destruction of beta cells has already started, and it’s almost certain someone will fully develop type 1 diabetes in their lifetime. This hidden phase – before symptoms appear or insulin treatment is needed – is called early-stage type 1 diabetes.

The results showed I had two autoantibodies. The doctors explained this meant I was very likely to progress to a full type 1 diabetes diagnosis at some point. But they couldn’t tell me whether that would happen in six months or 10 years.

It was a huge shock – I hadn’t expected anything to come from that test.

The uncertainty was the part I found most stressful. I didn’t know what was happening underneath the surface. I’m still trying to get my head around the fact that type 1 diabetes will eventually happen.

Although I had early-stage type 1 diabetes, during my pregnancy I needed to start insulin injections and monitor my blood sugars regularly. This is because pregnancy hormones increase the body’s insulin needs, and my pancreas couldn’t keep up. The same happened during my second pregnancy too. But after each birth, I was able to come off insulin.

I became quite obsessive with my blood sugar numbers during my pregnancies. So, I’ve had this taste of what life managing type 1 diabetes is like.

After finding out about my early-stage type 1 diabetes, I’d previously asked my doctors if there were any treatments or research trials I could be on. And at the time there was nothing.

But in early 2025, my consultant in Exeter told me, “There’s a possibility we may be able to get hold of a drug that could push back your full type 1 diagnosis.” And then it clicked that this drug – teplizumab – was something I’d read about before on Diabetes UK’s website and in the news.

I knew it was being used in the US and knew the data that was out there showing it could delay type 1 diabetes by two or three years. So, I wasn’t concerned that it was ‘new’ and I didn’t really hesitate. Because I had that insight from my pregnancies of what it’s like dealing with the daily grind of insulin injections, blood sugar checks and carb counting – the idea of pushing type 1 back that bit further was an opportunity I didn’t want to miss.

Some people might say, “oh two extra years without type 1, that doesn’t sound a lot”. But for someone living with type 1 diabetes, they’d probably do anything to have even an extra week without it. And hopefully two years is the minimum, and then researchers can develop something that means five years, or 10 years, or ultimately forever, without type 1.

Everything happened quickly after that. But I know the team at Exeter worked incredibly hard to get me access to the drug and get everything ready to treat me with it. I felt very lucky because I just had to say “yes” and then turn up. I wasn’t feeling particularly apprehensive, just excited.

I’d need to go into hospital every day for 14-days to receive the course of teplizumab. I decided to book that time off work. I spent around three or four hours each day in the hospital. They started me on a very low dose of teplizumab, gradually increasing it until day five.

The doctors had talked to me about possible side effects. They explained that my white blood cell count would drop and that I might feel unwell mid-way through the course. They were right – around day five I had nausea and some vomiting and did feel rough for a couple of days.

But I was monitored closely the whole time and apart from that everything went fine. It was actually quite nice having this new daily routine and spending time with the lovely nurses.

A lot of people have asked me “how do you know if the treatment worked”. And it's hard to say. The doctors told me their best guess was that it might have been about a year until I fully developed type 1 diabetes, based on where my blood sugars were at. That’s only a rough guide, but any extra time I have beyond that will feel like a win.

Now, I go for an HbA1c test every six months to track the progression of my early-stage type 1 diabetes. But I try not think too much about type 1 diabetes until I know I’ll have to. I feel incredibly lucky and grateful that teplizumab was made available for me, because I know there are so many others who would love the same chance. 

I hope my experience helps open the door for more people to access teplizumab and to get it offered on the NHS. It has filled me with a lot of hope for the future – for myself and others in my situation.

You can follow more of Hannah’s story on the One in Six Billion podcast. In one episode, she discusses early-stage type 1 diabetes and the lead up to her teplizumab treatment. In a later episode, Hannah talks about what it was like to have teplizumab.