Early Assessment of Teplizumab Treatment Response Using Continuous Glucose Monitoring.

Source: PubMed, NCBI / U.S. National Library of Medicine

We describe continuous glucose monitoring (CGM) trajectories in five children with stage 2 type 1 diabetes treated with teplizumab in a real-world setting. Participants were followed longitudinally using CGM metrics, including glycemic variability (GV) and time above 140 mg/dL. Over 8-19 months of follow-up, four participants remained in stage 2, while one progressed to stage 3 diabetes within 4 months of treatment. CGM-derived metrics demonstrated heterogeneous trajectories. Most participants showed stabilization or improvement in GV and time above 140 mg/dL within 3-6 months, whereas the progressor exhibited increasing variability and worsening glycemic excursions over time. These changes were detectable early and were not paralleled by substantial changes in glycated hemoglobin. These observations suggest that CGM may capture early directional changes in glycemic dynamics following immunomodulatory therapy and may provide a practical approach for longitudinal monitoring. Findings should be interpreted as hypothesis-generating and require validation in larger cohorts.