Routine is definitely important for Donald - not only for his dementia, but also to help us manage his diabetes. Donald is on a CGM (continuous glucose monitor) which helps me in managing his blood sugar levels. 

I prepare his smart insulin pen, and his healthcare team has supported me on the doses to make it easier  to manage. 

At the moment, Donald can inject himself. Although he has lived with his diabetes for more than 20 years, injecting is more of a challenge for him now. He forgets as soon as he’s had his insulin dose. 

The smart insulin pen is brilliant, as I can look at it and see that he’s taken his dose and how long ago. Or that he hasn’t remembered to take it. 

But the other day when I came in, Donald didn’t know how to change the cartridge, and he’d just left it. 

Now I'm arranging for a care agency to support me so that I can go out, but paid carers aren't able to administer insulin without training. So we'll have to see how that works out and also if Donald copes OK.

In March 2025, we started the 14-day course of teplizumab at Birmingham Children’s Hospital. My husband and I arranged to take time off work and stay nearer the hospital. And I know there were a lot of things the team in Birmingham had to do to make it all happen.

On the first day of treatment they put in a cannula, which they’d use to give Imogen a daily infusion of teplizumab. The infusion only took about 30 minutes, but we’d stay in the hospital for most of the day so Imogen could be monitored.

Imogen coped brilliantly throughout – she’s so resilient. She didn’t feel sick or tired. Midway through the course, her white blood cells did drop. We’d been told to expect this because teplizumab targets the immune system. It looked like we might need to delay the next day’s dose, but fortunately they came back up again quite quickly.

If anything, boredom was the hardest part. Then we got to day 14 and that was it – all done!

Imogen was advised to wear a mask for a few days afterwards because the drug temporarily lowers immunity. She did catch a cold but bounced back quickly.

Now Imogen has follow–up appointments every six months, with blood tests or an oral glucose tolerance test, to check her blood sugar levels and how her pancreas is working. 

"I’ve seen first-hand the effects of diabetes. My grandfather and my father had type 2 diabetes. Both had significant issues (complications) because of it and died prematurely. I don’t want to end up like that. If my son has grandchildren, I want to be healthy enough to enjoy them.

It was a 26-week online programme. We started off with weekly sessions, then every two weeks, and finally once a month. It helped you shift your mindset around diet and exercise, and what causes the condition, so you understand. And we’d sometimes be put into breakout rooms, and you’d get a chance to chat with other people with similar stories.

Food and weight loss

Because I was doing this with other people on a regular call, and because you were regularly recording your numbers and having monthly blood checks, you felt a responsibility to make changes. And to do well.

I was able to lose 12% of my body weight, which was a target I was set. For me, that was a weight loss of 13kg (two stone). And I managed to get my blood sugar levels back to a normal level (HbA1c 39 mmol/mol) when it was 42 mmol/mol.

"Food is my life. I’m of Greek Cypriot origin, and it’s everything to me. I love eating out." 

Before I went on the course, I was eating a lot, and my diet wasn’t very balanced. To lose weight, I went on a Mediterranean diet, eating fewer cakes, chocolates and biscuits and more fruit and veg.

My wife supported me through the process. She was my backbone, particularly when it came to meals. At the weekend, my diet is more relaxed, and I’ve continued with that.

It hasn’t been an easy journey. 

"Sometimes there’s a voice in your ear that says, ‘eat a second or third doughnut’. But you need to have an image of what you want to be like or look like."

As well as permanent changes to what I eat, I’ve made changes in how much physical activity I do. I was already doing a fair amount of walking, but now I’ve started to increase my steps.

I don’t jog or run as I find it too sore on my joints. But I go to the gym once or twice a week, and I’m weightlifting, so my muscle mass doesn’t deteriorate.

Staying on track 

The only negative thing about the course is that there is no review period. So, although I’ve reversed my prediabetes, I know it’s easy to go back to old habits. 

So I have continued using the My Fitness Pal app on my iPhone, which helps me monitor my steps and my food intake and ensure I get a balanced diet. And I’m going back to my GP every three months for blood tests to check my levels are still normal.

Thomas uses his CGM alongside his hybrid closed loop insulin pump to manage his diabetes. Moving from insulin pens and finger pricks to an insulin pump was great – it gave my son a little more freedom with his diabetes management by taking some of the thinking away from his day. He no longer feels embarrassed injecting insulin in public to eat even the smallest things. He’s also experiencing less hypos than before as the pump recognises downward trends in blood glucose and automatically suspends ‘background’ insulin to help decrease the chance of his blood sugar getting too low, among other features.

That’s when my consultant, Dr Schofield at the Manchester Royal Infirmary, mentioned a treatment called teplizumab. Dr Schofield explained that this treatment could extend the amount of time I had before becoming insulin dependent, by targeting the immune system, stopping it from attacking my insulin-producing cells for a while.

I was really keen to continue living my life as I was doing, without insulin, for as long as possible. I did my own research, and Dr Schofield put me in touch with a professor in Birmingham who’s a leading researcher on early-stage type 1 diabetes. He told me that if his own child were developing type 1, he’d want them to have teplizumab. That really reassured me.

I knew my blood sugars were rising and was told that I would soon be dependent on insulin to manage them. The window to have the treatment was closing fast, so I decided to go ahead.

Starting treatment

I had the treatment at Manchester Royal Infirmary in September 2025. Teplizumab is given as an infusion, ideally over 14 consecutive days. The team looking after me were amazing. I cannot thank them enough. They worked tirelessly, not only to ensure that the whole process ran smoothly and safely, but to get to know me and ensure that I felt comfortable.

This was invaluable as the treatment course wasn’t all plain sailing. On the second day I had a fever, and on day three my blood pressure dropped suddenly, and I fainted. I was diagnosed with cytokine release syndrome, which is a known side effect of treatments like teplizumab. 

It was scary and I remember thinking at the time, “What have I put myself through?” but the team were brilliant and managed it straight away. I felt unwell with a fever and extreme fatigue for a couple more days which meant my treatment had to be paused on day six.

However, after that, the rest of the treatment went much more smoothly. By the final week, I was working remotely from the hospital during the day and feeling completely fine. It really was a rollercoaster, but I’m so glad that I did it.

Within two weeks of finishing the treatment, I started seeing changes in the readings from my continuous glucose monitor. With some small tweaks to my diet, my time in range has jumped from 70% to 95%, and my blood sugars aren’t spiking as frequently or for as long after meals.