A Doctor’s First Possible Case of Prevented Type 1 Diabetes — and What It Means for the Future of Care
- Rebecca Guldberg
- 3 days ago
- 3 min read
What if type 1 diabetes could be delayed — or even prevented — before symptoms ever appear? In a powerful and hopeful podcast conversation, registered dietitian and diabetes educator Madi Cheever speaks with pediatric endocrinologist Dr. Larry Deeb, who has spent more than four decades on the front lines of diabetes care. He explains how far diabetes treatment has come — and where it may be headed next.
From Urine Tests to Smart Pumps: 40 Years of Progress
Dr. Deeb began practicing at a time when diabetes management for children relied on urine glucose testing. Since then, he has personally helped bring nearly every major insulin innovation to pediatric patients.
Today, many children are placed on automated insulin pumps just weeks after diagnosis, dramatically reducing the daily burden of diabetes management. As Dr. Deeb puts it, the goal is no longer perfection — it’s helping patients live with diabetes, not for it.
A Possible First: Delaying Type 1 Diabetes Before Diagnosis
One of the most emotional moments in the episode comes when Dr. Deeb shares what may be the first documented case in his career where type 1 diabetes was delayed.
Through TrialNet, a global research program that screens relatives of people with type 1 diabetes, a young child was found to have multiple autoantibodies — a strong warning sign for future diabetes. When early blood sugar changes appeared and the child's A1C got to 6.6, Dr. Deeb intervened by giving the child an infusion of anti thymocyte globulin, an immunosuppressant medication, and 18 months later, the child's A1C was 5.4.
While he’s careful not to overuse the word prevented, he says the results are remarkable — and they point toward a future where early screening and intervention could fundamentally change the course of type 1 diabetes.
Why Antibody Screening Matters for Families
A major takeaway from the episode is the importance of early screening, especially for siblings or children of people with type 1 diabetes. Most people with antibodies will not develop diabetes — but identifying those who do allows doctors to monitor closely and intervene sooner, potentially avoiding emergency diagnoses or ICU admissions.
This approach emphasizes watching trends, not reacting to crises.
Type 1 vs. Type 2 Diabetes in Children: A Critical Distinction
The conversation also tackles a growing concern: the rise of type 2 diabetes in youth. Dr. Deeb explains that early-onset type 2 diabetes can be more aggressive than type 1, with higher risks for heart disease, kidney complications, and pregnancy issues later in life.
Early warning signs — including rising A1C levels, obesity, and family history — should prompt action well before a diagnosis is made. Prevention, monitoring, and addressing social determinants of health are all essential parts of care.
The Future of Diabetes Care: Set It and Forget It?
Looking ahead 5–10 years, Dr. Deeb is optimistic. He envisions diabetes technology moving toward systems that require fewer daily decisions — allowing people to live more freely while staying safe.
The ultimate gift? Not just better blood sugars — but better sleep, especially for parents.
As he reminds listeners: diabetes doesn’t have to be perfect to be well-managed. He says time-in-range, not flawless numbers, is what protects long-term health.
Where to Watch or Listen to This Episode
This episode is packed with insight, reassurance, and genuine hope for anyone affected by diabetes — whether you’re newly diagnosed, a parent, a caregiver, or a healthcare professional.
You can watch or listen to the full episode on:
And anywhere you get your podcasts
About Direct Diabetes
Direct Diabetes has been helping people with diabetes for nearly 30 years by mailing the supplies they need directly to their home, and helping them avoid the hassle of having to go to a pharmacy. From Continuous Glucose Monitors (CGMs) to insulin pumps and testing supplies, our goal is to take the stress out of managing diabetes so patients can focus on living healthier, fuller lives. We work directly with doctors and insurance companies to make the process simple and affordable.
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This content is for informational purposes only and should not be taken as medical advice. Always consult a qualified healthcare provider about any questions or concerns regarding your health or treatment options.
