Dr Kevan Herold on Living With T1D: “There's Nothing You Do Without Thinking About It”

It's harder for younger children to deal with the complexities of managing type 1 diabetes (T1D), so a delayed diagnosis even by a few years is a big deal, said Kevan Herold, MD, professor of immunobiology and medicine at Yale School of Medicine.

Despite improvements in type 1 diabetes (T1D) care, such as insulin pumps and glucose monitors, the condition still impacts everyday life, so it's important to delay the diagnosis of it, said Kevan Herold, MD, professor of immunobiology and medicine at Yale School of Medicine.


Can you explain the importance of delaying T1D diagnosis?

So the question is, is it better not to have diabetes than have diabetes? The answer is, it's better not to have diabetes. Diabetes is with you 24/7; it disrupts your life, your family's life, everyone who lives with you; it never goes away. The care of the disease has improved, there's absolutely no question about that, but individuals with diabetes basically are on their disease 24/7. There's nothing you do without thinking about it.

If you're a child, and you're 8 years old, and now you're not going to get diabetes until you're 15, that's a big deal. Because younger children are going to have a harder time dealing with all the complexities of managing the disease. It affects diet, it affects activity, it affects sleep, it affects work, it affects school—everything. To be a little bit older, or a lot older, is definitely going to help your ability to manage it. And for the families, it's a blessing not to have the disease.

The question is important. My response is, there are some people—endocrinologists, in particular—who think, "Oh, it's just fine. We have insulin pumps and we have glucose monitors. Who cares if you have diabetes?" That's not true. It matters whether or not you have diabetes.

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