Delaying the onset of type 1 diabetes and highlighting the importance of TEST and early recognition of symptoms

In the last weeks of 2022, Teplizumab, the world’s first type 1 diabetes disease-modifying drug, has been approved for use by the USA’s Food and Drug Administration (FDA).  It is an immunotherapy drug proven to delay the onset of type 1 diabetes by up to three years in high-risk individuals. It effectively tackles the root cause of the condition for the first time. The drug also has the potential to slow progression of type 1 diabetes in the long-term.


Professor Kevan Herold, a researcher who has been developing teplizumab for nearly 30 years, said: “This decision represents a turning point in the field. First, it identifies a way in which an immune therapy to stop the disease process might be combined with cell replacements in those with type 1 diabetes. It also suggests that it is time to more broadly screen to identify those at risk of type 1 diabetes since now there is a therapy that can change its course.”


In Ireland, general screening for type 1 diabetes is not yet well-established, but in other countries such as Germany, Israel and the USA family members are often screened for type 1 diabetes. The approval for teplizumab is of great importance, as finally those with high risk of developing diabetes, have a drug to prevent its onset.


For children at risk of type 1 who are approaching adolescence, delaying type 1 diabetes would enable the pancreas to grow to adult size, giving better disease outcomes. Teplizumab can also help prevent traumatic and potentially fatal diabetic ketoacidosis (DKA) in individuals at risk of type 1 diabetes.


Preventing Diabetic Ketoacidosis


Preventing DKA is extremely important for anyone at risk. DKA is a severe lack of insulin which leaves the body unable to use glucose for energy. As a result, body starts to use and burn fat instead, releasing chemicals called ketones which turn the blood acidic. It is a life-threatening condition. In Ireland, an average of 25 children are diagnosed with type 1 diabetes each month, and typically, 4 in every 10 children with new onset type 1 diabetes in Ireland have DKA at the time of their diagnosis.


Therefore, it is essential to promote early recognition of symptoms of diabetes. We all need to know them, so we can recognise them early and take action. The symptoms (Thirst, Exhaustion, Sudden weight loss and Toilet Trips) are the key indicators that you or your child might have type 1 diabetes. TEST which is easy to remember as an acronym represents the symptoms of Type 1 diabetes. See more HERE


Take a TEST –  ask for a simple finger prick blood glucose test (or bring a urine sample) which will greatly help make the diagnosis of Type 1 diabetes in a person feeling unwell. Contact your GP or local pharmacist.

Think of TEST and do not delay!



Diabetes Ireland continues to work with Edna Roche, Professor in Paediatrics at the University of Dublin, Trinity College Dublin, and Consultant Paediatrician and Paediatric Endocrinologist at CHI Tallaght University Hospital, who leads the Irish Childhood Diabetes National Register (ICDNR) to promote the TEST campaign. It aims to help people recognise the symptoms of type 1 diabetes and with no screening currently available, everyone should know what the symptoms of diabetes are.


How does teplizumab work?


The drug helps to protect insulin-producing beta cells in the pancreas, by attaching markers to the cells in the immune system that go awry, and attack and destroy beta cells in type 1 diabetes. These markers neutralise the rogue cells, enabling beta cells to live and produce insulin. Research is showing that teplizumab can also slow disease progression among newly diagnosed people with type 1 diabetes.


JDRF (Juvenile Diabetes Research Foundation), a partner of Diabetes Ireland Research Alliance, have been instrumental in the development of teplizumab by funding the initial exploratory research, trial recruitment networks, and the clinical trials themselves.


Karen Addington, CEO of JDRF UK, said: “This landmark approval is tremendously important and we, JDRF, are proud to have funded the research into teplizumab from its start nearly thirty years ago. The world now has a drug which is proven to effectively tackle the root causes of type 1 diabetes, delaying the onset of the condition and slowing down disease progression. We will also be leading further research into the future potential of teplizumab to entirely prevent type 1, helping to eradicate this condition from everyone’s lives.”


Kieran O’Leary, CEO of Diabetes Ireland said “we would hope to see the HSE make teplizumab available here in Ireland as soon as possible and to see a screening programme for Type 1 diabetes developed to identify high risk individuals early which in turn would reduce the levels of DKA we are currently seeing in Ireland which is way too high.”