A new therapy can delay type 1 diabetes in children

What the research found

A randomised, placebo-controlled trial published in 2019 tested a single 14-day course of teplizumab in 76 relatives of people with type 1 diabetes. All were at high risk but did not yet have the disease. Most (55) were 18 or younger.

Australian regulator data on that trial show that 20 of 44 people (45%) given teplizumab went on to stage 3 diabetes, compared with 23 of 32 (72%) given placebo. A follow-up study found the average time to stage 3 was 50 months with teplizumab and 25 months with placebo.

Australian regulators approved teplizumab (Tzield) in 2026 for people aged 8 and over with stage 2 type 1 diabetes. NICE in England reviewed the trial evidence and said it can delay symptomatic diabetes by nearly 3 years on average. International paediatric diabetes guidelines from 2024 also discuss its approval as a way to delay progression.

What it doesn’t mean

• This is not a cure or prevention. It buys time before insulin injections are needed. It is only approved for children aged 8 and over who are already at stage 2, before symptomatic (stage 3) disease.
• The main trial was small, and the strongest results come from high-risk relatives of people with type 1 diabetes. Teplizumab is not approved for children who have not reached stage 2.
• If your child has a close relative with type 1 diabetes, ask your GP about screening. If your child has been unusually thirsty and weeing more for over a week, or is losing weight suddenly, see your GP. Diabetic ketoacidosis is a life-threatening medical emergency, so go to the nearest hospital emergency department if you are worried.