September 22, 2026 — Type 1 Diabetes TrialNet (TrialNet), the world’s leading international research network dedicated to type 1 diabetes prevention, has launched the ASCEND T1D Study. This clinical trial is directly comparing low-dose anti-thymocyte globulin (ATG), a treatment proven to preserve insulin production in people newly diagnosed, to teplizumab, the first and only FDA-approved treatment for delaying progression in people at high risk.

“We are in a new era of type 1 diabetes prevention research,” said David Baidal, MD, ASCEND T1D Study Chair and TrialNet Center Director at the Diabetes Research Institute-University of Miami. “Having an approved treatment to delay disease progression in people at high risk opens the door for testing additional therapies to slow and eventually stop type 1 diabetes.”

Delaying the progression of type 1 diabetes offers many benefits for high-risk individuals, including extending the time spent living without the need for daily insulin injections.

ASCEND T1D builds on 25 years of TrialNet research

Previous TrialNet research discovered that teplizumab can delay clinical diagnosis by an average of two or more years in high-risk individuals, leading to its historic FDA approval. Teplizumab protects insulin-producing cells by calming down the immune system’s attack on the pancreas.

A separate TrialNet study found that ATG preserved insulin production and improved blood sugar levels for two years in newly diagnosed individuals. ATG works by temporarily reducing multiple types of aggressive immune cells, paving the way for long-term immune regulation. ASCEND T1D will now test this same treatment at an earlier stage of the disease, before clinical diagnosis.

The study will enroll 60 participants ages 4 to 34 with Stage 2 T1D. Stage 2 is defined as being positive for multiple diabetes-related autoantibodies and having abnormal glucose levels, indicating a high risk of progressing to Stage 3, clinical diagnosis.

“ASCEND T1D is an active control study, meaning there is no placebo group. Every participant will receive one of the two active treatments,” explains Vandana Raman, MD, Study Associate Chair and TrialNet Principal Investigator at the University of Utah.

Beyond gaining access to therapies with the potential to delay disease progression, participants will benefit from intensive diabetes management and close monitoring by leading type 1 diabetes experts. People taking part in type 1 diabetes research are about ten times less likely to experience life-threatening diabetic ketoacidosis (DKA) at the time of diagnosis. Additionally, if ATG proves to be comparable to teplizumab, participants may have the opportunity to transition to an extension study.

For more information about the ASCEND T1D Study, eligibility criteria, and participating sites, visit trialnet.org/ascend-t1d. To learn more about free TrialNet risk screening for relatives of people with type 1 diabetes, visit trialnet.org/participate.

About TrialNet

TrialNet (NCT00097292), the largest clinical trial network ever assembled to change the course of type 1 diabetes, is funded by the National Institutes of Health (NIH), primarily through the Special Statutory Funding Program for Type 1 Diabetes. TrialNet data collected from more than 250,000 relatives of people with type 1 diabetes over 25 years led to the development of the stages of type 1 diabetes, making it possible to identify who will develop the disease and advancing prevention research. Learn more at www.trialnet.org.