For the first time, a drug that can delay the onset of type 1 diabetes is being made available on the NHS in England and Wales – giving children and adults an extra three years before they need lifelong insulin treatment. Teplizumab, a form of immunotherapy, targets the immune system’s attack on insulin-producing cells in the pancreas, and the NHS medicines body described its decision as “genuinely exciting”, with hundreds of children and young people likely to benefit each year.
The drug is for people whose blood tests show their immune system has already started attacking the pancreas but who have not yet developed symptoms. It is given by infusion, and can be used from age eight. Italy is the only other country in the world to offer it.
“Teplizumab, the first drug to delay type 1 diabetes by three years, is available on the NHS in England and Wales.”
Type 1 diabetes most commonly appears in early teenage years, though it can develop at any age. Unlike type 2, it is not linked to being overweight. Patients must constantly monitor blood glucose and inject or pump insulin to replace what their bodies can no longer produce.
Among those who might have benefited is eight-year-old Theo Sebastian-Jenkin. He was diagnosed at four after his parents took him to A&E with extreme fatigue, constant thirst and weight loss – but he was too young for teplizumab at the time. Now his diet must be carefully weighed and his blood sugar checked regularly; low levels can be a medical emergency, while persistently high levels damage blood vessels and nerves.
“It’s something which you can never switch off from,” says his mum, Vicky. “When you make breakfast, you’ve got to weigh everything, counting how many carbohydrates are in it, so that you know the right amount of insulin to give.”
Theo’s parents say any medicine that could delay the onset could make a real difference. “It would be huge for any family to have those three years of childhood back without the worry and the things he’s had to deal with,” says his dad, Ben.
Karen Addington, chief executive of the charity Breakthrough T1D, called the potential impact “momentous” after decades of work. “If it were your child or someone you love, you would want to do everything possible to give them more years without the daily burden of managing this relentless condition. We now have a treatment that can help make that possible.”