Advances in type 1 diabetes (T1D) care have improved glucose management, but significant challenges remain. Automated insulin delivery (AID) systems still require daily input, access to diabetes technology remains unequal, and many people continue to experience the mental burden of managing the condition. At the same time, researchers are exploring new approaches that could reduce the need for constant decision-making, delay the onset of T1D, and potentially move treatment beyond insulin. These topics were central to Breakthrough T1D’s inaugural Clinical and Research Congress, which brought together clinicians, researchers, and industry leaders to discuss the future of T1D care.

This week, Dr. Brynn Marks, a pediatric endocrinologist and Senior Director of Medical Affairs at Breakthrough T1D, joins us on the podcast to discuss the latest developments and the barriers that remain. One area of focus is the development of fully closed-loop systems that could reduce or eliminate the need to announce meals and make frequent treatment decisions. Breakthrough T1D has helped establish proposed benchmarks for these systems, including targets for time in range, time in tight range, reducing hypoglycemia, and improving quality of life. The goal is not simply better glucose numbers, but also less diabetes distress and more freedom for people living with T1D.

Marks also discusses gaps in access to care, the shortage of endocrinologists and diabetes care professionals, and the need to identify T1D earlier. Broader screening could help identify people in earlier stages of the disease, reduce diabetic ketoacidosis (DKA) at diagnosis, and connect eligible individuals with disease-modifying treatments. Breakthrough T1D is also working to prepare clinicians for emerging therapies through initiatives such as its Interventional Diabetes program.

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