How Searching For Answers Changed One Man’s T1D Journey

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At a routine annual checkup, John’s bloodwork showed that his blood sugar and hemoglobin A1C were outside of normal range. Without considering T1D or screening for T1D-related autoantibodies, John’s doctor diagnosed him with T2D and urged him to eat better and exercise more. However, abnormal blood sugar is a symptom that appears in both T1D and T2D, and they have important differences. Knowing which is which can help ensure the right diagnosis and treatment plan. 

Below, learn more about John’s journey and the differences between T1D and T2D. 

When nothing seems to work  

For John, his T2D diagnosis was shocking. “I’m a very active person, fitness has always been an important part of my life, and I’ve maintained a healthy weight. While I was apprehensive about my T2D diagnosis, I didn’t question it. Instead, I doubled down on my exercise, adjusted my diet, and closely monitored my blood glucose numbers,” John said. 

Despite John’s best efforts, it was impossible to ignore his high blood sugar. “I was doing everything in my power to manage my numbers, and nothing seemed to work; it was really disheartening,” John recalled. 

After a few months of this, John decided it was time to talk to another doctor about the challenges he was facing and ask if there might be something else going on. In the back of his mind, he wondered: Could I have T1D?

Understanding the differences between T1D and T2D 

T1D is a chronic autoimmune disease that attacks insulin-producing beta cells in the pancreas; it is not preventable and cannot be cured through diet and exercise. On the other hand, T2D is a metabolic disease indicative of insulin resistance that may be preventable and can be managed through lifestyle changes. 

Interestingly, findings from a new global study, RECLASS-T1D, found that roughly 1 in 46 individuals initially diagnosed with prediabetes or T2D were later reclassified as T1D, and experienced a greater number of diabetes-related hospital visits during the follow-up period. Overlooking adult-onset T1D can have real consequences for individuals and families. 

Closing awareness gaps between T1D and T2D matters, as misunderstandings can delay diagnosis and patient care. 

Seeking answers  

When John sought a second opinion to discuss his experience, he asked about T1D and inquired about autoantibody screening, which can detect the disease before visible symptoms develop.  

Initially, John’s doctor wasn’t convinced that he needed to be screened due to his age. Unfortunately, it’s a common misconception that T1D affects mostly children, but the truth is that anyone at any age can develop T1D. Interestingly, up to 60% of new T1D diagnoses occur after the age of 20. 

John insisted that they explore what else might be going on. As John described it, “I needed more answers to explain my dysglycemia. I needed to find answers.” 

Navigating a Stage 2 T1D diagnosis 

A few weeks after his appointment, John got a call from his doctor. Screening and additional blood tests revealed that John had Stage 2 T1D. This meant that the autoimmune attack on his beta cells had begun and his blood sugar levels were being affected, but symptoms were not present, and he didn’t yet require daily insulin management.

While John’s diagnosis brought clarity, it didn’t bring comfort. “I was grateful to know what was going on in my body after months of struggling, and it better explained my experience. Still, my Stage 2 T1D diagnosis was devastating,” John shared. 

John immediately started researching T1D in an effort to learn everything he could about the disease and what options he might have. “I’m a proactive person, so I wanted to learn as much as I could about the disease before I had my first meeting with my endocrinologist, so I knew what to ask about.” 

Through this process, John learned about TZIELD® (teplizumab-mzwv) injection 2mg/2mL – a prescription medication used to delay the onset of Stage 3 type 1 diabetes, which is when your body can’t make enough insulin on its own and may require insulin injections. TZIELD is for adults and children 1 year of age and older who have Stage 2 type 1 diabetes. This means that they have tested positive for 2 or more type 1 diabetes-related autoantibodies, have abnormal blood sugar levels, and do not have type 2 diabetes or other forms of diabetes. It is not known if TZIELD is safe and effective in children under 1 year of age.

TZIELD may cause serious side effects, including potentially life-threatening cases of viral reactivation including Epstein-Barr virus (EBV) and cytomegalovirus (CMV), Cytokine Release Syndrome and a decrease in white blood cell counts, which can affect your body's ability to fight infections. The most common side effects with TZIELD include rash, leukopenia, decrease in white blood cell, rash, vomiting, diarrhea, and headache. These are not all of the possible side effects you can experience with TZIELD.

At his first meeting with his endocrinologist, John asked about TZIELD, which his doctor thought might be a good fit for John. After working with his healthcare team to determine that he was an eligible candidate, John decided to move forward with the infusion process. 

 “I was so excited about the opportunity to delay insulin-dependent T1D with TZIELD,” John shared. “At the time, I had a lot on my plate; my wife and I were growing our family, and it was a busy time at work. Introducing daily insulin at that time would have felt overwhelming.”

John’s advice to others  

For John, the opportunity to delay insulin-dependent Stage 3 T1D gave him more time to learn about the disease and how to prepare for eventual daily insulin management when he progressed to Stage 3. 

“If I were to go back in time and talk to myself before starting my TZIELD journey, I would make the same decision,” John shared. “I want others to feel empowered to advocate for themselves and make sure they find a doctor who listens to them. A Stage 2 T1D diagnosis can be scary, so it’s worth the extra effort to find someone who can educate you about the disease and help you understand your options.”

John’s story is a reminder of the importance of speaking up when something doesn’t feel right. His experience shows that T1D can happen to anyone, no matter their age or lifestyle factors. 

For individuals with Stage 2 T1D, TZIELD could mean more time before insulin-dependent T1D, more time to learn about eventual symptoms and risks, and more time to get ready for daily insulin management, like it did for John. 

Learn more at TZIELD.com.

John is a TZIELD Brand Ambassador. 

What is TZIELD? 

TZIELD is a prescription medicine used to delay the onset of Stage 3 type 1 diabetes, which is when your body can’t make enough insulin on its own and may require insulin injections. TZIELD is for adults and children 1 year of age and older who have Stage 2 type 1 diabetes. This means that they have tested positive for 2 or more type 1 diabetes-related autoantibodies, have abnormal blood sugar levels, and do not have type 2 diabetes or other forms of diabetes. 

It is not known if TZIELD is safe and effective in children under 1 years of age. 

IMPORTANT SAFETY INFORMATION 

What is the most important information I should know about TZIELD? TZIELD may cause serious side effects, including: 

• Viral Reactivation. Epstein-Barr virus (EBV) and cytomegalovirus (CMV) are common viruses that may stay inactive in your body after an initial infection. TZIELD may cause these viruses to become active again which, especially in patients with a weakened immune system, can become serious and potentially life-threatening. These viral reactivations can happen during treatment with TZIELD and up to 2 months after your last dose. Your healthcare provider will test you for active EBV and CMV infections before treatment with TZIELD. Contact your healthcare provider right away if you develop symptoms of an infection during or after treatment with TZIELD (such as fever, swollen glands, or fatigue). 

• Cytokine release syndrome (CRS). Signs and symptoms may start during the first 5 days of TZIELD treatment and could include fever, nausea (with or without vomiting), feeling tired (fatigue), headache, muscle and joint pain, or increased liver enzymes in your blood. Tell your healthcare provider right away if you develop any signs and symptoms of CRS during treatment with TZIELD. 

• Decrease in white blood cells. TZIELD may cause a decrease in a type of white blood cell called lymphocytes. A decrease in white blood cells is a serious, but common side effect that can affect your body’s ability to fight infections. A decrease in white blood cell counts can happen after your first dose. Your white blood cell counts will start to go back to normal after your fifth dose of TZIELD. Some people may develop longer and more severe decreases in lymphocytes. 

Your healthcare provider will do blood tests to check for active infections, verify your liver function and your complete blood counts before you start treatment and during treatment with TZIELD. During and after your treatment with TZIELD, your healthcare provider will check for serious side effects, as well as other side effects, and treat you as needed. Your healthcare provider may temporarily or completely stop your treatment with TZIELD, if you develop liver problems, have a serious infection, or if your blood counts stay too low. 

What should I tell my healthcare provider before receiving TZIELD? 

Before or after receiving TZIELD, tell your healthcare provider about all your medical conditions, including if you: 

• have any of the conditions or symptoms listed in the section “What is the most important information I should know about TZIELD?”

• have a weakened immune system, including if you have Down syndrome.

• have a serious infection or an infection that does not go away or keeps coming back. 

• have recently received or are scheduled to receive an immunization (vaccine). TZIELD may affect how well a vaccine works. Tell your doctor that you are receiving TZIELD before receiving a vaccine. 

• are pregnant or plan to become pregnant. TZIELD may harm your unborn baby. Do not receive TZIELD during pregnancy and at least 30 days before a planned pregnancy. If you become pregnant while taking TZIELD, you are encouraged to report your pregnancy to us at our Adverse Event reporting line at 1-800-633-1610 or visit https://ae.reporting.sanofi. 

• are breastfeeding or plan to breastfeed. It is not known if TZIELD passes into your breast milk and if it can harm your baby. Talk to your healthcare provider about the best way to feed your baby if you receive TZIELD. 

Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. 

The most common side effects of TZIELD include: 

• decrease in white blood cell counts

• vomiting 

• rash 

• diarrhea

• headache 

These are not all of the possible side effects of TZIELD. Talk to your healthcare provider for more information, and tell them about any side effects you notice. You may report side effects to the FDA at www.fda.gov/medwatch or 1-800-FDA-1088. You may also report side effects to us at 1-800-633-1610 or visit https://ae.reporting.sanofi.

Please see full Prescribing Information, including Risk of SERIOUS SIDE EFFECTS and Medication Guide.

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