Special Report: T1D experts tackle earlier detection and prevention

In this introductory episode of our Special Report: Advancing Type 1 Diabetes Management series, Contemporary Pediatrics convened a peer-to-peer discussion examining how advances in disease understanding are changing the way pediatricians approach type 1 diabetes. Moderated by Herbert Bravo, MD, the conversation frames type 1 diabetes not as an abrupt clinical event, but as a condition with a defined natural history that can be recognized and addressed earlier than ever before.

Bravo opens by emphasizing recent progress in staging classification and early recognition, highlighting how these developments create opportunities to intervene before children present with acute complications such as diabetic ketoacidosis. For general pediatricians, who are often the first clinicians to evaluate at-risk children, this evolving framework has important implications for screening, education, and anticipatory guidance.

The discussion introduces Marian Rewers, MD, PhD, whose career spans pediatric endocrinology and preventive medicine. Rewers describes more than 3 decades of experience caring for children with type 1 diabetes while also approaching the disease through a public health lens. This dual perspective, he explained, informs his focus on identifying type 1 diabetes earlier in its course rather than waiting for symptomatic presentation.

Rewers noted that integrating preventive medicine principles into routine pediatric care raises important considerations beyond individual patient management. Questions surrounding feasibility, health economics, and long-term outcomes of early screening will be central to advancing care on a population level. These themes set the foundation for deeper exploration in subsequent episodes of the special report.

Together, this introductory exchange establishes the framework for a series focused on shifting type 1 diabetes care from reactive treatment to proactive identification and prevention.

Our experts

Herbert Bravo, MD, is a pediatrician and the president and founder of the Society for Innovation in Pediatrics. He is also the co-founder of The Pediatric Lounge Podcast.

Marian Rewers, MD, PhD, is a professor of Pediatrics and Medicine at the University of Colorado School of Medicine and executive director of the Barbara Davis Center for Diabetes.

Editor's note:

Herbert Bravo, MD, reports disclosures for Society For Innovation in Pediatrics, Sanofi, and Barbara Davis Center.