Ep 104: Decoding T1D: Beta Cells, Autoantibodies, and Early Detection
In this episode:
- Dr. Shara Bialo’s personal journey living with type 1 diabetes
- Why type 1 diabetes is an autoimmune disease, not simply a blood sugar problem
- The role of genetics, viral infections, and the immune system
- Understanding the three stages of type 1 diabetes
- Why most people diagnosed with type 1 diabetes have no family history
- Adult-onset type 1 diabetes and why it is often mistaken for type 2 diabetes
- What diabetes autoantibodies are and how screening works
- Who should consider screening for type 1 diabetes
- Available screening options, including blood tests and home screening kits
- The emotional challenges families face when considering screening
- The importance of preventing diabetic ketoacidosis through early detection
- Why preserving beta cell function can improve long-term outcomes
- Italy’s national screening program and the future of population-wide screening
- Resources available through screenfortype1.com
In this episode, Dr. Steve Edelman and Dr. Jeremy Pettus are joined by Dr. Shara Bialo, Senior Medical Director of Type 1 Diabetes Immunology at Sanofi, pediatric endocrinologist, and person living with type 1 diabetes, for an in-depth discussion about what happens before type 1 diabetes is diagnosed. Together, they explore the autoimmune process that begins months or even years before symptoms appear, why early detection matters, and how screening is changing the future of type 1 diabetes care.
Dr. Bialo shares her personal diagnosis story, discusses common misconceptions about what causes type 1 diabetes, and explains the three stages of the disease. The conversation also covers who should be screened, how diabetes autoantibody testing works, the benefits of preserving beta cell function, and why identifying people before they develop symptoms can lead to better long-term outcomes and fewer cases of diabetic ketoacidosis (DKA). Whether you have type 1 diabetes, have a family member at risk, or simply want to better understand the latest advances in prevention and early detection, this episode provides valuable insights into one of the fastest-moving areas of diabetes research.
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Supported by an unrestricted educational grant from MannKind Corporation.
That Type 1 Diabetes does not really run in families.
Believe it or not, people who do have a first-degree relative with type 1 diabetes have an increased risk (up to 15x) of developing it also.
I’m remember stage 1 or definitely 2 … but as said no one doing anything about the Lows that we didn’t know were lows or thought they were faint spells I’d get dizzy and slip down the wall or the even at school and my mom would say let your sister rest … I’d pass out like you do after a bad low or possibly it was a high and I’d wake up starving… or go to the nurses office at school… I was so embarrassed… I was a very quiet child and parents Well that’s another story after it progressed to the thirst and sleepless nights restless legs and wake to exhaustion… monthly menstrual was horrific… I could go on and on … small framed never gained weight Then the High Coma approximately 5-6 years later… I started my period very early at 11 years of age or younger.:.: I was a mess
Thank you for sharing your story…hope things are better for you now.
T1D LADA onset age 52. Now age 71. It’s genetic. I am 5’4” weigh 110 lbs. Hospitalized 5 days blood sugars over 500. Ketones 3. Endocrinologist #1 in the state did a genetic test. It came from my late father’s side. He was youngest of 9. Several siblings had it. Very thin. Took pills. I had the misfortune of getting type 1. Shocked. Had hypoglycemia age 25. Now they know it flips to Type 1 diabetes. It’s an autoimmune disease. Genetic. It’s manageable. Very tough. Worked with dietician/ diabetes educator, read books, keep logbook. Am on top of it. This support group helps me. It’s not from a virus. Everything is Genetic.
I agree. It is genetic. It’s not as strongly passed on as type 2 diabetes, but your thoughts are right on. You can have a genetic susceptibility.
You can DO this!I know-T1for 68 years and I’ve accomplished every goal I’ve ever set for myself! I’ve earned 4 college degrees; I’ve given birth to 5 incredible children; I worked a 37 year HS teaching career with several years of perfect attendance; My husband and I traveled the world after he completed Law School! I met him in college and Law School and we went on to enjoy a 53 year marriage until he died of a stroke in 2022! He could simply look at me and announce that I had Low BS! We married in 1969, completed college and law school and we went on to live the most wonderful life! Our children and 7 grandchildren have been my greatest joy! Imagine, the T1 outlived her nondiabetic husband! I may regret saying this but T1 made me a stronger,more conscientious person!
Wow, love your enthusiasm! You could be the poster child on how to live a full life with type 1 diabetes! And you are so right…even though it may not seem like it, there are gifts that can be found in life with type 1. It sure sounds like you and your husband had a wonderful life together…thank you for sharing your story, and your spirit!
I may regret saying this but living with T1 for 68 years, while never easy, it made me a stronger, kinder, more determined person! Has it been easy-absolutely NOT! Has it been doable-absolutely YES! I continue to live an incredible life with my 5 children and 7 grandchildren! My attorney husband, who I met in college, was my steadfast partner through all of my ups and downs! He died 4 years ago after our marriage of 54 years! We traveled the world and he was my devoted partner and father to our children. Three years ago, I retired from my 36 year HS teaching career! Imagine, one of my daughters was the principal of the HS! The students always asked me if it was “Legal”! I would always respond that they were, in my eyes, my legal advisors!
Thanks for the kind words! T1 has never held me back from living an incredible life! “It’s NOT the problems of today that TRY men’s but the Regrets of yesterday and the Fears of tomorrow!
Thank you for your kind words! I certainly don’t want people to think I’ve enjoyed the T1 journey! Fortunately, I try to face life with perseverance and hard work! I came down with T1 at age 10 and my mother made sure I never pitied myself or blamed others! Surprisingly, I may regret saying this, but T1 made me a stronger more determined person! My parents never showed me any pity, and pushed me to accomplish every task I set out for myself! “It’s Not the problems of today that try men’s souls but the regrets of yesterday and the fears of tomorrow! I’ve lived an incredibly full life with few regrets!
You’re awesome, and have a great outlook on life! 🙂
Truly, facing T1 and life, in general, has been my “Raison d’etre”! Has it been easy-absolutely Not! Has it been doable-absolutely YES! Despite T1 and my nondiabetic’s husband’s sudden death, I’ve lived an incredible life with 3 college degrees, a 36 year HS teaching career, a marriage of 53 years and 5 children and 7 grandchildren! When I look in the mirror, I’m so happy with the person who returns the smile!
That’s so great! 😊💪💛