If you have high blood pressure, treating it can delay or prevent damage that could lead to heart disease. That’s the idea behind delaying the development of stage 3 T1D, which can:1
The longer you have T1D the greater your risk for complications, including heart and kidney disease, nerve damage, and vision problems. Delaying progression can help reduce the risk and severity of these complications.
It is easier to manage T1D in the earlier stages when your body is still making some insulin; this, in turn, lets you live a more normal life without intensive medical treatments.
As you recall, specialized cells in the pancreas called beta cells make insulin. In the early stages of T1D, some of those cells are still working. Delaying progression may preserve their function, improving blood sugar control and reducing the need for insulin therapy.
Healthcare is expensive, especially for a complex chronic condition like T1D. Delaying progression means fewer drugs, doctor visits, hospitalizations, and tests, all of which can help reduce your out-of-pocket costs.
There are numerous clinical trials testing new drugs designed to delay, reverse, or even prevent the development of T1D. Remaining in the early stages of T1D makes you eligible for these studies. In addition, you will be able to try those drugs that are approved.
Managing a chronic condition like diabetes can take a toll on mental health. Delaying progression can ease some of the stress and anxiety associated with the disease.
In 2022, the Food and Drug Administration approved the first drug to delay progression to stage 3 of T1D in people 8 years old and older who are already in stage 2. You are in stage 2 T1D if you tested positive for 2 or more T1D-related autoantibodies, have abnormal blood sugar levels, and no symptoms.2
Of course, the only way to know if you are in stage 2 is by getting screened.
The drug is called teplizumab. It’s an antibody, which is a type of protein that can recognize and attach to a specific receptor on the surface of immune cells called T cells. Think of it as inserting a key into a lock. This helps “calm” those cells, so they back off from destroying pancreatic beta cells. In turn, those beta cells maintain the ability to produce insulin, delaying the development of full-blown T1D.3
The FDA approved teplizumab based on a study called AT-Risk. The study enrolled relatives of patients with T1D at high risk of developing the disease. After 6 years, more than half (55%) of the people receiving teplizumab were diabetes free vs about 22% of the people receiving a placebo. Teplizumab delayed the onset of stage 3 by more than 2 years (32.5 months) compared with placebo, with delays being longer in certain individuals.4, 5
Side effects of teplizumab are mild to moderate. The most common side effects seen in the studies were rash, headache, and low white blood cell counts.4,5 Very rarely, a condition called cytokine release syndrome (CRS) may occur. In CRS, your immune system responds to the drug more aggressively than it should. Symptoms include fever, nausea, fatigue, and body aches. Tell your doctor immediately if you experience any of these symptoms while taking teplizumab.6
You receive teplizumab in an infusion center every day for 14 days. The infusion nurse will insert an IV into your arm, allowing the medication to flow directly into your veins. It takes about 30 minutes for each infusion.2
You’ll have bloodwork done before you start on teplizumab and during treatment to check for any signs of liver damage or changes to your white blood cells and to monitor for infections.2
Clinical trials testing numerous other treatments that work on the immune system are underway. These include drugs to stem immune cell attacks on beta cells, reduce inflammation, and protect beta cell function.
You can find links to those trials in the Resources section of this web site.
