Seattle Children’s Offers New Drug to Delay Type 1 Diabetes

Seattle Children’s Endocrinology and Diabetes Program is now offering a new medication that can delay the progression of type 1 diabetes mellitus. The drug Teplizumab-mzwv, also known as TZIELD, is the first FDA-approved disease-modifying therapy for type 1 diabetes mellitus.

TZIELD is a CD3-directed monoclonal antibody that can delay the progression from stage 2 type 1 diabetes mellitus to stage 3 (clinical) type 1 diabetes mellitus. Teplizumab-mzwv is given via infusion over 14 days to patients who are age 8 and older, deemed eligible via type 1 diabetes mellitus autoantibody screening (two or more positive), and evidence of dysglycemia defined as:

• FPG (Fasting plasma glucose) of 100-125 mg/dL
• 2-h PG (2-hour plasma glucose) of 100-125 mg/dL
• Intervening plasma glucose level at 30, 60 or 90 minutes of FPG (Fasting plasma glucose) of 100-125 mg/dL ≥200 mg/dL during an OGTT

We recommend screening by checking type 1 diabetes mellitus autoantibodies (GAD65, IA-2, insulin and ZnT8 autoantibodies) in individuals with first- or second-degree relatives with type 1 diabetes mellitus.  Screening can also be considered for individuals with personal or family history of other autoimmune diseases. For individuals with two or more positive autoantibodies, an oral glucose tolerance test should be performed to determine eligibility.

Patients with positive screenings should be referred to Endocrinology. See the new algorithm for Screening for Risk of Type 1 Diabetes.