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Early Assessment of Teplizumab Treatment Response Using Continuous Glucose Monitoring

Sari Krepel-Volsky1,2, Merav Gil-Margolis1,2, Keren Smuel-Zilberberg1,2

  • 1The Jesse Z and Sara Lea Shafer Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children's Medical Center of Israel, Petah Tikva, Israel.

Diabetes Technology & Therapeutics
|June 10, 2026
PubMed

Insights

Continuous glucose monitoring (CGM) reveals varied responses to teplizumab in children with type 1 diabetes. Early CGM data may predict glycemic changes, offering insights into treatment effectiveness.

Area of Science:

  • Immunology
  • Endocrinology
  • Pediatrics

Background:

  • Type 1 diabetes (T1D) management requires continuous monitoring of glycemic control.
  • Teplizumab is an immunomodulatory agent investigated for its potential impact on T1D progression.
  • Understanding treatment effects in real-world settings is crucial for optimizing T1D care.

Purpose of the Study:

  • To describe continuous glucose monitoring (CGM) trajectories in children with stage 2 T1D treated with teplizumab.
  • To evaluate the utility of CGM metrics in assessing glycemic dynamics during immunomodulatory therapy.
  • To explore early indicators of treatment response or disease progression.

Main Methods:

  • Longitudinal follow-up of five children with stage 2 T1D receiving teplizumab.
  • Utilized continuous glucose monitoring (CGM) to collect data on glycemic variability (GV) and time above 140 mg/dL.
  • Analyzed CGM metrics over 8-19 months, correlating with T1D stage and glycated hemoglobin levels.

Main Results:

  • Four of five participants maintained stage 2 T1D, showing stabilized or improved GV and reduced time above 140 mg/dL within 3-6 months.
  • One participant progressed to stage 3 T1D within 4 months, exhibiting increasing glycemic variability and worsening excursions.
  • CGM changes were detectable early and not mirrored by significant glycated hemoglobin shifts.

Conclusions:

  • CGM may detect early glycemic dynamics following teplizumab therapy in T1D.
  • CGM offers a practical approach for longitudinal monitoring of treatment effects.
  • These hypothesis-generating findings require validation in larger pediatric cohorts.

Keywords:
continuous glucose monitoringearly-stage T1Dglycemic variabilitymonitoringteplizumabtime in rangetreatment response

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