Episode 14: From Diagnosis to Hope: The Changing Landscape of Type 1 Diabetes Treatment

Dr. Rinku Mehra hosts the Endo Kids Podcast and interviews pediatrician Dr. Herb Bravo, who works with Sanofi’s type 1 diabetes clinical research programs, about advances in type 1 diabetes care, early detection, and emerging therapies. Dr. Bravo describes the trauma and dangers of diabetic ketoacidosis (DKA), emphasizing that many children present in DKA without parents knowing the warning signs. The episode explains that type 1 diabetes is an autoimmune disease with a long asymptomatic period and discusses screening with commercially available autoantibody tests (e.g., through LabCorp/Quest), TrialNet, and the Barbara Davis Center’s ASK study, including risk implications of having one versus two confirmed autoantibodies and the potential to prevent most DKA cases through earlier identification. They discuss who might be screened (especially those with first-degree relatives with type 1 diabetes or family/self-history of autoimmune disease), the idea of broader population screening, and the current gap in clinician education and infrastructure. Treatment updates include diabetes technology (pumps, CGMs, hybrid closed loops), inhaled insulin, and disease-modifying therapy that can delay insulin dependence by about three years and preserve beta-cell function, with additional therapies under investigation to support beta-cell preservation and immune modulation. Dr. Bravo outlines stages of disease (autoimmunity with normal glucose, dysglycemia without symptoms, and symptomatic diabetes) and notes a key intervention window before overt hyperglycemia, comparing this approach to preventive care for hypertension and high cholesterol. The conversation highlights the burden, costs, hospital impact, and reduced life expectancy associated with early diagnosis, and closes with encouragement that many people with type 1 diabetes thrive and that the future of care is improving, along with resources including the Barbara Davis Center ASK study, TrialNet, and organizations such as Breakthrough T1D.00:00 Welcome to the Endo Kids Podcast (What We Cover + Disclaimer)00:55 Meet Dr. Herb Bravo: Why Type 1 Diabetes Research Matters02:02 The Trauma of DKA: Why Early Detection Is So Critical04:03 From Primary Care to Sanofi: Dr. Bravo’s Turning Point07:43 Type 1 Diabetes 101 + Recognizing Early Symptoms10:00 Screening for Autoantibodies: How Testing Works (LabCorp, TrialNet, ASK)13:16 Who Should Get Screened? Family History, Autoimmune Risk & Population Screening17:04 “Do I Want to Know?” Counseling Families on Risk & Follow-Up Plans20:21 New Therapies & Beta-Cell Preservation: Delaying Onset and Reducing Burden26:27 Stages of Type 1 Diabetes: The Window Where Treatment Can Help Most29:45 The Future of Type 1 Care: Remission Hopes, Costs, and Big-Picture Impact33:21 Key Message for Parents + Resources, Links, and Final Wrap-UpMedical Disclaimer: The information shared on The Endo Kids Podcast is for educational purposes only and does not constitute medical advice. Listening to this podcast does not establish a doctor-patient relationship. Please consult your child’s healthcare provider for personalized medical guidance.