In June 2026, a new drug called teplizumab, the first to demonstrate the delay of Type 1 Diabetes (T1D), was recommended for use in the NHS in children over eight years of age, and adults. For Professor Colin Dayan, who has spent his career trying to spare patients a lifetime of insulin dependency, this moment has been decades in the making.
Professor Dayan, a clinician and immunologist by training, has spent his career steering multiple clinical trials of immunotherapies for T1D. These approaches build on the ability of the immune system to support glucose regulation, as compared with insulin treatment that simply replaces the insulin that the pancreas cannot synthesise.
“Insulin is not a safe drug,” Dayan says categorically. Patients have died from blood sugar swings even while carefully managing the condition. By contrast, immunotherapies are a well-known treatment for existing conditions such as psoriasis and rheumatoid arthritis, with well-established safety profiles.
Professor Colin Dayan has spent his career trying to spare patients a lifetime of insulin dependency.
However until 2022, none had ever been licensed for T1D. “The idea of insulin-dependent diabetes not needing insulin is pretty mind-blowing,” he says. “It completely converts it into a different kind of disease altogether.” Teplizumab specifically targets the destructive autoimmune activity on the insulin-producing beta cells of the pancreas, modulating the response and delaying onset of the condition.
Dayan leads the UK Type 1 Diabetes Immunotherapy Consortium (UKT1D), a network of 30 clinical trial sites spanning all four UK nations. The Consortium exists to solve a challenge in conducting trials with this patient population. Once a person’s insulin-producing cells are destroyed, usually within around five years of diagnosis, there is nothing left to ‘treat’. Trials therefore have to recruit participants early and tightly coordinate the trials process to ensure sufficient numbers for robust research findings.
The Consortium is marketed commercially as T1D-Connect (UK), a University of Birmingham Enterprise Operating Division. It offers pharmaceutical and biotech companies site identification, trial set-up, recruitment support and a public patient portal. At this scale, T1D-Connect is establishing itself as the country’s clear leader. The T1D-Connect’s near-instant contracting is exactly the kind of case study that can re-establish the UK’s global reputation for clinical research.
T1D-Connect is now running trials for four companies to test whether immunotherapies can delay onset or slow progress of T1D.
Dayan had previously faced obstacles in establishing such a network and credits the speed of the Operating Division model. “Almost the minute we got to Birmingham, we were introduced to University of Birmingham Enterprise and it was absolutely transformational,” he says. A contract his team had been trying to arrange for two years was signed almost immediately. T1D-Connect is now running trials for four companies to test whether immunotherapies can delay onset or slow progress of T1D.
Dayan says the OD model works because it does not require the University to become a pharmaceutical company. “This is a kind of fee for service for something we’re already doing. It wouldn’t have made sense to set up a whole company.”
Thanks to the efficiency and agility of the University in convening this Consortium, antibody blood tests can now identify years in advance which children and adults will go on to need insulin. Combined with Birmingham’s ELSA screening programme, led by Professor Parth Narendran and now expanding UK-wide with £1.5 million in new funding, that predictive power means immunotherapies like teplizumab can be offered before symptoms even appear.
Dayan’s team is also expanding clinician training and exploring a longer-term ambition to repurpose decades-old, inexpensive drugs for T1D, where current licensing rules offer no financial incentive for anyone to try.
Dayan imagines that in the future, “going onto insulin will be a failure of treatment, because you just didn’t do enough.”
Professor Clinical Diabetes and Metabolism
Professor Colin Dayan, Professor Clinical Diabetes and Metabolism in the Department of Immunology and Immunotherapy. Professor Dayan was appointed as a 125 Anniversary Chair at the University of Birmingham, UK in 2026.
Professor of Diabetes Medicine
Staff Profile of Professor Parth Narendran of the Department of Immunology and Immunotherapy at the University of Birmingham.
