New treatment to delay onset of type 1 diabetes approved for NHS use

A new first-of-its-kind treatment which has been found to delay the onset of type 1 diabetes for up to three years has been approved for use in the NHS in England and Wales.

Teplizumab (also known as Tzield and made by Sanofi) has been recommended in final draft guidance issued by NICE today for children aged eight and over and adults who have type 1 diabetes in its early, pre-symptomatic stage (stage 2).

It will be made available on the NHS in England and Wales within the coming months.

It is estimated that around 1,100 people could be eligible to use the therapy in the first year, decreasing to approximately 820 eligible patients annually from year three onwards.

And specialist nurses have welcomed the news as a ‘significant step forward’ in the care and management of type 1 diabetes.

Following a clinical trial reviewed by an independent NICE committee, teplizumab was found to delay the early stages of symptomatic type 1 diabetes (stage 3) by an average of nearly three years.

By delaying the onset of symptomatic type 1 diabetes, NICE said the treatment would allow people to benefit from ‘precious extra time’ before having to manage the ‘full demands’ of lifelong diabetes management.

It added that children and young people in particular will have ‘more time’ to reach key developmental milestones.

Clinical nursing advisor at NICE Lucy Common said: ‘Early, pre-symptomatic diagnosis can have a significant impact on individuals and their families.

‘This recommendation matters enormously for patients and their loved ones.

‘Having time before the onset of stage 3 diabetes is not just a clinical benefit; it can make a meaningful difference to people’s lives, their mental wellbeing, and the wellbeing of the families and carers who support them.

‘It is encouraging to see a treatment that has the potential to be made available across the NHS.’

Clinical lead diabetes specialist and co-chair of the Diabetes Specialist Nurse Forum UK Bethany Kelly said this was an ‘exciting development’ and marked a ‘significant step forward’ in the care and prevention of stage 3 type 1 diabetes.

‘As a clinical lead diabetes specialist nurse, the ability to delay the onset of symptomatic type 1 diabetes by such a meaningful period is incredibly important, not only in reducing the immediate burden of diagnosis, but also in potentially lowering the risk of diabetic ketoacidosis at presentation, as it allows time for appropriate education and support to be provided in advance,’ she said.

‘This type of intervention marks a shift from reactive management to proactive prevention, which is a major milestone in diabetes care.’

She added that, although this brings ‘new opportunities and challenges’, there must be ‘appropriate education and support systems’ in place.

Ms Kelly highlighted that while there are screening studies underway, a national screening programme for type 1 diabetes is not currently in place. She suggested this ‘may raise questions about how we effectively identify individuals who could benefit’.

‘We also need to consider how individuals diagnosed at stage 1 and 2 type 1 diabetes will be managed – where their care will sit, and what psychological, nursing, and educational support will be available to them,’ she added.

‘In some areas, there are already gaps in support for people living with type 1 diabetes, and this development may place additional demands on services.

‘It is therefore important that all nurses working in diabetes care develop a clear understanding of the stages of type 1 diabetes and how this evolving approach to prevention and early intervention will work in practice.’

Charity Diabetes UK has described the news as a ‘landmark approval’ which should be celebrated.

Director of research and clinical at Diabetes UK Dr Elizabeth Robertson 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.

‘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.’

Teplizumab will be available to NHS patients in England within 90 days of publication of NICE final guidance.

Patients in Wales will be able to access it 60 days from Tuesday 23 June 2026.

Recently, a campaign to reduce missed diagnoses of type 1 diabetes in children was backed by the former health secretary Wes Streeting.