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For most of the last century, Type 1 Diabetes announced itself with an acute crisis. A child gets sick, sometimes critically sick, and the diagnosis arrives in the emergency department. The standard clinical response is therefore reactive: wait for symptoms to appear, manage the acute crisis – often Diabetic Ketoacidosis (DKA) – and then initiate lifelong insulin therapy. And here is the uncomfortable part: the autoantibody tests that can identify T1D years before symptoms have been broadly available for more than 15 years. Yet 85–90% of patients are still diagnosed at stage 3, in clinical distress.
The science of finding T1D early is settled. What is not settled is how to get it done.
At our recent webinar, clinical leaders Dr. Michael J. Haller (Professor and Chief of Pediatric Endocrinology, University of Florida; Chair of TrialNet), Dr. Monica Bianco (Pediatric Endocrinologist, Lurie Children’s Hospital), and Dr. Melissa Putman (Adult & Pediatric Endocrinologist, Mass General Hospital) joined us to outline how new screening technologies, virtual clinical models, and disease-modifying therapies are transforming T1D from an inevitable acute diagnosis into a manageable, delayable, and ultimately preventable condition.
As Dr. Monica Bianco put it:
“It’s not a question of whether or not we should screen people. It’s how we’re going to do it, and whether our healthcare systems can reliably support the number of people identified through screening.”
Here are the key takeaways and actionable strategies from their discussion on how we can operationalize general population screening and build a proactive care model: