Back-to-school season is one of the busiest times of the year for health care providers (HCPs). Doctors’ offices are full of young patients and families preparing for the year ahead, checking off physical exams, immunization forms, and age-based screenings. These visits are more than just routine; they are critical opportunities to talk about risk factors and catch early signs of health issues. Yet too often, one disease slips through the cracks: type 1 diabetes (T1D).
As a pediatric endocrinologist, I see young patients and families all the time during this period, many who tell me the same story: When they were first diagnosed, they did not know anything about T1D, and they even never knew they might be at risk before experiencing complications. Unfortunately, with an estimated 27,000 new pediatric T1D cases in the U.S. each year; and as many as sixty-two percent of newly diagnosed individuals experiencing life-threatening events requiring hospitalization. These stories are not isolated cases. They are a call to action.
For HCPs, back-to-school checkups offer a powerful opportunity to change the narrative around T1D by making these visits a starting point for education, awareness, and action. Here is how we can make T1D a simple, yet effective part of routine care.
Eliminate the stigma around screening.
As doctors, it is not uncommon to encounter parents who may feel apprehensive about proactive health screenings for their children, which can be especially true for diseases like T1D. It can be scary to consider that your child may have a chronic autoimmune disease that they will have to live with for the rest of their life. As a parent (and someone who has T1D myself) it is a feeling I know all too well.
In truth, I was hesitant to get my own children screened for the disease. I ultimately chose to get them checked for autoantibodies (and was thankful that I did), but for a long time, I struggled with feelings of guilt that my children may have to experience the same health challenges that I have lived with since I was a child; and that it would be my fault if they did.
The irony is that today, I work hard to ensure my patients never experience the same feelings of hesitation or self-doubt that I did. As HCPs, we have the power to create a safe space for these candid conversations, and back to school provides the perfect opportunity to do so. By leveraging this moment-in-time to help parents make informed decisions around early T1D risk detection, we can eliminate stigma around screening and embed preparation into the T1D conversation.
Empower patients through open dialogue.
In daily practice, I recognize that there is a tendency to focus our efforts in T1D on those most perceivably at risk and rule out those who may not check certain boxes. That said, anyone (no matter their age, family history, or lifestyle choices) can develop T1D. In fact, while having just one family member with T1D increases your likelihood of developing the disease by up to fifteen times, roughly ninety percent of people who are diagnosed have no family history at all.
That means we need to reframe how we talk to all patients about T1D, not just those with certain risk factors. This starts with communication. When there are so many misconceptions about T1D, such as believing it is a binary diagnosis when really it is a progressive disease, education is necessary to overcome outdated beliefs and ensure patients have the information needed to take their health into their own hands.
Here again, back-to-school offers a critical touchpoint for open dialogue. Listen for potential risk factors, educate about the value (and ease) of knowing sooner, and make clear that autoantibody screening should be part of any parent’s broader health plan for their kids. Put simply: Patients do not know what they do not know, and if we, as their HCPs, are not educating them, then who will?
One last word before the bell
For so many families, back-to-school appointments represent one of the only moments throughout the year with their doctors, which is why it is critical that we as HCPs are as thorough as possible in educating, advocating, and empowering our patients to make informed decisions about their health.
New state laws have started to take effect around the country encouraging education on T1D through school systems for parents and caregivers, so it is possible you may get more questions as the year begins. Be ready to answer their call. Speaking from my own experiences, personally and professionally, I cannot reiterate enough just how important these conversations surrounding T1D are. Because when the school year begins, so too does our opportunity to make sure T1D does not get left off the syllabus.
Shara Bialo is a pediatric endocrinologist.
