A Health System in the Middle of a Research Shift
The UK has around 4.2 million people living with type 2 diabetes, with type 1 affecting well over 400,000 people across the country. NHS England reports that nearly one million people have already started its Healthier You Programme, one of the world's first diabetes prevention schemes when it launched. What's striking is how fast the landscape is moving now.
In 2026, NICE approved teplizumab, the first treatment that delays the onset of type 1 diabetes rather than simply managing symptoms once it appears. A single 14-day course, given in hospital, was shown in clinical trials to roughly halve the rate of progression to symptomatic type 1 diabetes in people identified at an early stage. Around 1,100 patients are expected to be eligible in the first year, with access depending on early detection through screening for type 1 diabetes autoantibodies.
Alongside this, NICE also gave the green light to insulin efsitora alfa, sold as Onswik, a once-weekly injection for type 2 diabetes. Clinical trials found it matches the blood glucose control of existing daily treatments, and over a million people could potentially switch. For people who struggle to stick to a daily routine, or who find daily injections hard to manage, that is a meaningful change in daily life.
The common thread across all of this progress is clinical research. Every new treatment, every new screening method, every new technology reaching NHS clinics started as a trial.
How Trials Actually Work in the UK
The typical journey looks like this. A study is designed by a university, a hospital trust, or a pharmaceutical company. It must be approved by a research ethics committee and registered on a public database such as the ISRCTN registry. Recruitment happens through NHS clinics, diabetes charities, and online finders. Participants are given clear information about what is involved, and consent can be withdrawn at any time without affecting their normal care.
Some trials are observational, asking people to fill in questionnaires about how they manage their condition. Others test new medications, devices, or care models. Still others explore the psychological side of living with diabetes, such as a Cardiff Metropolitan University study recruiting adults in Wales to talk about how confidence shapes type 2 self-management.
A useful example of a live medication trial: a study run through sites in Nuneaton and Norwich is evaluating a new mealtime insulin for people with type 2 diabetes who are already on basal insulin and at least 1000mg of metformin daily. Participants in that study receive two payments totalling £180 over the course of the research, with travel expenses and overnight accommodation reimbursed. This is typical of how many commercially sponsored trials acknowledge the time and effort participants give.
What Different Trial Types Offer
| Trial Type | Example | What It Involves | Best For | Advantages | Considerations |
|---|
| Drug delay trial | Teplizumab for stage 2 type 1 | 14-day hospital infusion course | People identified early via screening | Can delay onset, potentially for years | Infusion logistics and travel to hospital |
| Weekly insulin | Efsitora alfa (Onswik) | One injection per week | Type 2 on daily insulin | Fewer daily injections, better adherence | Not suitable for type 1 |
| Remission programme | NHS soups and shakes | 12-month weight management diet | Recent type 2 diagnosis | 1 in 3 completers reached remission | Requires strong commitment to diet change |
| Digital health study | Dexcom CGM in primary care | Wearing continuous glucose sensors | Type 2 on insulin in primary care | Real-time glucose data, fewer finger pricks | Device wear for several weeks |
| Survey study | Diabetes UK panel research | Questionnaires, often online | Anyone with diabetes | Low commitment, can join from home | No direct medical benefit |
The Remission Revolution
One of the most compelling developments in UK diabetes care is the NHS Type 2 Diabetes Path to Remission Programme, often called the soups and shakes diet. A major study published by NHS England found that of those who completed the programme and were measured twice, around one in three, 32 percent, had put their type 2 diabetes into remission. In the last recorded year, over 13,000 people enrolled.
The programme replaces meals with low-calorie soups, shakes, and bars for a period, followed by gradual food reintroduction and long-term weight management support. It is a 12-month intervention, not a quick fix. The evidence base draws on randomised controlled trials that changed how clinicians think about type 2 diabetes, which was once considered a lifelong progressive condition.
This matters because it shows that trials don't just produce new pills. They produce new care pathways that can change the very definition of what living with diabetes means.
How to Find and Join a Trial
Taking part in research is entirely voluntary, and there are several routes in.
Start with the NHS. Ask your GP or diabetes specialist team whether they are recruiting for any local studies. Many hospital trusts run research departments that keep lists of open trials. If you live in Scotland and are registered for NHS healthcare there, you can join the Scottish register for type 1 diabetes research and be contacted when relevant opportunities arise.
Use the charity finders. Diabetes UK runs a clinical trials page that lists open studies, searchable by location, age group, and topic. Breakthrough T1D UK offers a type 1 diabetes trial finder built with the digital health company Antidote, which asks a few questions about your health to match you with suitable studies. Both are free, and registering does not commit you to anything.
Consider the research panels. The British Research Panel matches people with diabetes to researchers across the UK, and Research for the Future in north-west England does similar work through Manchester University NHS Foundation Trust. These are particularly good for people who want to contribute without travelling, since many opportunities are online surveys or focus groups.
Keep an eye on screening programmes. The ELSA study, co-funded by Diabetes UK and Breakthrough T1D, has screened children aged 2 to 17 for type 1 diabetes risk. Its second phase, ELSA 2, launched with £1.5 million in funding and aims to recruit a further 30,000 children across the UK. For adults, the T1DRA study covers ages 18 to 70. Being identified early through such screening is what makes treatments like teplizumab possible in the first place.
What to Consider Before You Sign Up
Trials come with trade-offs, and being honest about them helps you make the right decision.
Check the time commitment. Some studies need regular clinic visits, as the mealtime insulin trial demonstrates. Others, like the Dexcom continuous glucose monitoring study, run for about 24 weeks and include in-person visits at the start followed by wearing a sensor in daily life.
Understand the reimbursement. Commercial studies often cover travel and sometimes offer payment, but this is not guaranteed and should never be the reason you join. NHS and university studies usually offer no payment, only the satisfaction of contributing to science.
Ask about your normal care. A well-run trial ensures your routine diabetes care continues alongside the research. You can withdraw at any point, and your decision will not affect your treatment.
Think about what type of study suits your life. If you hate needles, a device study may not be for you. If you cannot travel, look for online surveys or remote studies. The University of Birmingham, for example, has run workshops to understand how young people newly diagnosed with type 1 feel about potential treatments, entirely online.
Why Participation Matters
Every person who joins a trial helps answer a question that affects thousands of others. Daisy, diagnosed with type 1 in 2020, took part in an immune therapy trial with her mum Kathy. As Kathy put it, people like Daisy taking part in trials now will make living with type 1 easier for themselves and others in the future.
The UK's position in diabetes research is not accidental. It comes from a network of NHS trusts, universities, and charities that actively recruit patients into studies. The approval of teplizumab, the arrival of weekly insulin, and the proven remission rates of the soups and shakes programme all trace back to people who agreed to take part.
If you are thinking about joining, the best first step is simple. Talk to your diabetes team about what is recruiting locally, or register with one of the free research finders run by Diabetes UK or Breakthrough T1D. You do not need to be an expert, and you do not need to commit to anything by asking questions. A conversation with your clinician can tell you whether a study fits your situation and your goals.
The research is happening now, across every region of the UK. The only question is whether you want to be part of it.
研究の知恵