Teplizumab on the NHS: who can get the type 1 'delay' drug, and how
NICE has recommended teplizumab for NHS patients in England and Wales aged 8+ with stage 2 type 1 diabetes. Here is who qualifies and what happens next.
There is now an NHS route in England and Wales to a medicine that can delay type 1 diabetes. On 23 June 2026, NICE (the body that decides which treatments the NHS in England and Wales pays for) recommended teplizumab for eligible people. It is not a cure, and it is not for anyone who already has type 1. It is for a smaller group found early, before insulin is needed, usually through a screening blood test in families where type 1 already runs.
- Teplizumab is an immunotherapy: it calms the immune attack that causes type 1, rather than replacing insulin.
- It is recommended for people aged 8 and over in stage 2, meaning immune markers are present and glucose is starting to drift, but insulin is not needed yet.
- In trials it delayed the start of insulin-dependent type 1 by around two to three years on average, which is an average across a group, not a promise for any one person.
- Most people only learn they are stage 2 through screening, offered most often to close relatives of someone who already has type 1.
- A recommendation is a real step forward, but being found eligible in the first place is the part that takes time for most families.
The funding step, not the first approval
A medicine reaches NHS patients in two stages. First a regulator judges it safe and effective enough to be used at all, which is what the UK licence for teplizumab covered. Then a separate body decides whether the NHS should actually pay for it, and for whom. In England and Wales that body is NICE, the National Institute for Health and Care Excellence. Its recommendation on 23 June 2026 is that second stage: the NHS in England and Wales is now expected to fund teplizumab for people who fit the criteria.
Scotland and Northern Ireland make these funding calls through their own routes, so if you live outside England and Wales, your team can tell you where things stand where you are. A recommendation also does not flip a switch overnight. Services still need to be set up to find and treat the small group it is meant for.
Stage 2, and why screening is the key
Type 1 develops in stages. In stage 1, the immune markers (autoantibodies, proteins that show the immune system is attacking the insulin-making cells) are present but glucose is still normal. In stage 2, those markers are there and glucose has started to wobble, yet the person feels well and needs no insulin. Stage 3 is what most people picture as diagnosis: symptoms, high glucose, and the start of insulin. Teplizumab is for stage 2, and only stage 2.
The catch is that most people have no idea they are in it, because stage 2 has no obvious symptoms. You usually find out only through a screening blood test that looks for those autoantibodies, and the people most likely to be offered one are close relatives of someone who already has type 1, whose risk is higher. Routine screening for everyone is not in place, so for now this mainly reaches families already looking because type 1 runs among them.