Series 4 episode 3: Hannah Robinson and Nick Thomas. First steps in delaying adult-onset Type 1 diabetes

Released 5 August 2025

When Hannah Robinson was diagnosed with gestational diabetes and found to have islet auto-antibodies she was recognised as being on the path to future Type 1 diabetes. With help from her diabetes consultant Dr Nick Thomas, she became the first adult in the UK to be given Teplizumab, a new treatment that delays the onset of Type 1 diabetes.

Hannah Robinson explains how she was found to be on the path towards the development of Type 1 diabetes when multiple islet autoantibodies were detected in her blood when she was diagnosed with gestational diabetes in her first pregnancy. She needed insulin treatment in both her pregnancies to tightly control her blood glucose but outside of pregnancy she has not needed treatment for her blood glucose. As she had multiple islet autoantibodies and her glucose was slightly raised it was a question of when rather than if she would develop Type 1 diabetes. In this situation the immunotherapy drug Teplizumab has been shown to delay the onset of Type 1 diabetes. This was published in the New England Journal. https://pubmed.ncbi.nlm.nih.gov/31180194/
In 2023 it was approved for clinical use in America by the FDA see https://www.fda.gov/media/164864/download . Dr Nick Thomas, her diabetes consultant, made it possible for Hannah to receive Teplizumab. Days after this podcast was recorded, she became the first adult in the UK to receive this treatment. A report about this can be found here: https://www.bbc.co.uk/news/articles/cgq74z3701eo

Dr Nick Thomas is a diabetes consultant in Exeter and a talented young diabetes researcher who has done a lot of important work on adult-onset Type 1 diabetes. He is presently working on research into how to identify adults at risk of developing Type 1 diabetes with a view to giving treatment to delay the onset of the disease. Details of his work can be found here:
https://experts.exeter.ac.uk/33420-nicholas-thomas