Hey readers! This week brought a number worth sitting with: for a specific group of kids, a two-injection therapy pushed back the day insulin became a daily requirement by more than five years. It doesn't stop type 1 diabetes, but buying years of childhood before the shots start is meaningful. Let's dig into that, plus a new kidney drug, screening momentum, and a few insulin approvals worth knowing.
⏳ Retogatein and the five-year delay
Diamyd's retogatein delays insulin requiring Type-1 Diabetes for more than 5 years — Long-term follow-up from the randomized, placebo-controlled DiAPREV-IT study shows two subcutaneous GAD-alum injections significantly delayed progression to Stage 3 (insulin-requiring) type 1 diabetes in a genetically defined subgroup of children.
– Diamyd Medical AB, via Inderes
The details matter here. This was a study of 50 children (ages 4 to under 18) who were GAD autoantibody positive with at least one additional islet autoantibody, so kids already on the path to type 1. In the responder subgroup (those with the HLA DR3-DQ2 profile), the estimated median time to Stage 3 was 9.0 years with retogatein versus 3.4 years with placebo (p=0.018). The median follow-up ran 12.9 years, which is unusually long for this kind of data.
The published data confirming the delay landed on September 29, 2026, with Diamyd putting the responder-group figure at 5.6 years. The company is candid about the limits:
"While we do not yet prevent type 1 diabetes, the published data show that retogatein delayed the need for insulin by 5.6 years in the treatment responder group."
Why this is worth your attention: retogatein is described as an antigen-specific, immune tolerance approach rather than broad immunosuppression, with a reported safety record across more than 1,000 patients and administration that's just two injections. Two caveats to hold onto, though. The benefit was seen only in a genetically defined responder subgroup, which means genetic screening would gate who's likely to respond. And this is a delay, not prevention, so families would still be preparing for type 1, just later. The full results are set to appear in Diabetologia.
🔬 The bigger question: can immunotherapy stop the clock?
Can immunotherapy stop the clock on type 1 diabetes? — A useful companion read on treating the autoimmune cause of type 1 rather than only its consequences, centered on teplizumab.
– The Pharmaceutical Journal
Retogatein isn't operating in isolation. Teplizumab is the reference point: NICE approved it in June 2026 for people in the early stages of developing type 1, and it delays symptoms and the need for insulin by an average of three years. Retogatein's reported delay sits alongside that as another antigen-specific angle on the same problem.
"Teplizumab completely flips the approach by targeting the underlying root cause of type 1 diabetes, rather than just dealing with the problem of not being able to make insulin."
The recurring obstacle in both stories is finding eligible people in time. In the UK, teplizumab is cleared only for stage 2, yet the NHS doesn't routinely screen for it. Opt-in studies like ELSA (a Diabetes UK and Breakthrough T1D initiative) and T1DRA are framed as the practical route to catch people early enough for any of these therapies to matter.
🩺 Screening: the piece that makes early therapy work
Consensus recommends early screening for type 1 diabetes — A new international consensus statement lays out how to screen children for early-stage type 1, but insists the follow-up infrastructure comes first.
– Medscape
This connects directly to retogatein and teplizumab: a delay-the-onset therapy is only useful if you can identify who to treat. The statement proposes universal pediatric screening at ages 2 to 4 (with a recheck at 6 to 8 if antibody-negative) and again at 10 to 15, with catch-up possible any time. Its first principle is worth quoting:
The first step isn't screening but making sure that you have the infrastructure in place for the follow-up monitoring.
There's real disagreement here, which is healthy. The ADA still recommends targeted screening based on family history or genetic risk, and the AAP says it has no early screening policy yet. But one point cuts through: roughly 85% of people who develop T1D have no first-degree relative with the disease, so family-history-only screening misses most future patients.
💊 A kidney drug, and insulin news
FDA approves Kerendia for CKD associated with type 1 diabetes — Finerenone (Kerendia, Bayer) was approved to lower urinary albumin-to-creatinine ratio in adults with chronic kidney disease tied to type 1 diabetes.
– Daily Diabetes News
This one is easy to overlook but genuinely relevant to anyone managing type 1 long-term. In the phase 3 FINE-ONE trial, finerenone produced a 34% decrease in urinary albumin-to-creatinine ratio at 6 months versus a 12% reduction with placebo (P = .0001), with safety similar to prior type 2 studies. Bayer notes it's the first CKD drug approval for the type 1 population in more than 30 years.
"For more than 3 decades, people with CKD and type 1 diabetes have had limited options to address the risk of kidney disease progression," said Janet McGill, MD, co-chair of the trial's executive committee.
The honest asterisk: the trial was small and short, and albuminuria is a surrogate marker. Whether this translates to long-term protection against hard kidney outcomes in type 1 isn't yet known.
A few more approvals and studies worth a quick scan:
FDA approves Eli Lilly's Onswik once-weekly basal insulin — Insulin efsitora alfa-gobe was cleared for adults with type 2 diabetes, with Lilly saying it could cut injections by more than 300 per year versus once-daily basal insulin. Important note for this audience: Lilly states it should not be used in type 1 diabetes due to increased risk of severe hypoglycemia.
FDA clears the MODI insulin dosing app for type 2 diabetes — DreaMed's algorithm uses CGM and insulin data to suggest dose adjustments without a clinician configuring settings; it's being evaluated in the 13-week MODIUS trial, with completion expected in January. It's a type 2 clearance for now, but the direction (turning CGM data into timely dosing guidance) is one to watch.
Eating only 8 hours a day may help control type 1 diabetes — A small six-month UIC trial in 32 obese adults with type 1 found time-restricted eating (noon to 8 p.m., no calorie counting) lowered average HbA1c by about 0.5%, with no increased risk of dangerous highs, lows, or DKA. Preliminary, and researchers stress any dietary change should happen with your care team.
🧬 Why the attack lasts for years
Stem-like immune cells in pancreatic lymph nodes may explain persistent T1D attacks — University of Florida researchers found a population of stem-like T cells in pancreatic lymph nodes that appear to self-renew and keep supplying the T cells that destroy beta cells.
– Medical Daily
This is laboratory research, not a treatment, and worth reading as such. It offers a plausible answer to a long-standing question: why the immune attack in type 1 can continue for years instead of burning out.
"These T cells likely persist and continue to drive the autoimmune attack for years or even decades," said Todd Brusko.
The study used single-cell gene sequencing on donated human pancreatic tissue and nearby lymph nodes, captured at a single time point, so it shows which cells are present rather than how they behave over time. No therapy was tested. Still, the researchers point to markers they think could eventually be targeted with antibodies, which is the kind of upstream work that feeds future immune-based approaches like the ones above.
That's the throughline this week: therapies that delay type 1, drugs that protect against its complications, and screening plus basic science that make early action possible. None of it replaces insulin today, but the trend toward earlier, more targeted intervention is real. Take care of yourselves, and talk to your care team before changing anything.