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Diabetes experts in Birmingham have welcomed news that a drug that can delay the progression to insulin requiring type 1 diabetes in individuals with early-stage disease has been approved for use on the NHS, following an announcement by the National Institute for Health and Care Excellence (NICE).

Teplizumab is an immunotherapy drug that can delay the progression to symptomatic type 1 diabetes in people who are in stage 2 of the condition and will now be available through the NHS for children over 8 years and adults with Stage 2 Type 1 Diabetes.

The NICE announcement follows work by academics and clinicians to improve the support available for children and young people who go onto develop type 1 diabetes. At University Hospitals Birmingham, the University of Birmingham, and Birmingham Women's and Children's NHS Foundation Trust, ongoing research is looking at how a screening programme can help to identify young people at risk of the condition.

The ELSA (Early Surveillance for Autoimmune diabetes) study, led by Professor Parth Narendran, has seen thousands of young people screened for antibodies that act as markers for whether type 1 diabetes will develop in later life (as evidenced in a publication in The Lancet Diabetes & Endocrinology).

Today’s announcement recognises the crucial role that screening programmes, including ELSA, will have for identifying young people who will benefit from Teplizumab.

ELSA has also enabled patients to have early access to Teplizumab, with the first young person in the UK, 14-year-old Sam from Kings Norton, receiving the drug at Birmingham Children’s Hospital under the care of Dr Renuka Dias and her specialist team at the Clinical Research Facility.

Now, with the approval for funded use on the NHS it is estimated that around 1,100 people could be eligible for teplizumab in the first year-based data provided from the ELSA study.

Professor Parth Narendran, Honorary Consultant Physician at University Hospitals Birmingham, said: “Today's NICE recommendation for teplizumab marks a significant milestone in the UK for people at the very earliest stages of type 1 diabetes.

“As the first disease-modifying therapy shown to delay progression to clinical, insulin-requiring type 1 diabetes, teplizumab has the potential to transform the treatment paradigm from reacting to disease onset to intervening earlier in the disease process. This means that patients identified early, for example through the ELSA study, will have benefit from treatment that can give valuable additional years free from the daily burden of managing type 1 diabetes.

“This decision will go a long way to help the development of screening, monitoring and prevention pathways that will underpin the future of type 1 diabetes care.”

Type 1 diabetes is an autoimmune condition that causes the body to attack and destroy insulin-producing cells in the pancreas. Without insulin, blood glucose levels rise dangerously, and, without treatment, death.

Diagnosis often comes suddenly and in crisis - one in four children in the UK are diagnosed in diabetic ketoacidosis (DKA), a life-threatening emergency caused by extremely high blood glucose levels and requires emergency care support.

Teplizumab is designed to target the immune system’s attack on insulin-producing beta cells in the pancreas. By modulating the immune response, it can delay the onset of clinical type 1 diabetes in people who are in stage 2.

Clinical trials showed that a single course of teplizumab, which is administered in hospital daily for 14 days, can halve the progression rates to symptomatic type 1 diabetes.

The approval of teplizumab represents an important step forward in type 1 diabetes care, offering young people and adults more time to prepare for living with the disease.