Podcast Summary

Podcast: Diabetes Connections | Type 1 Diabetes
Episode: Rethinking Type 1 Screening with Adam Schefter & Dr. Shara Bialo
Host: Stacey Simms
Guests: Adam Schefter (ESPN Senior NFL Insider), Dr. Shara Bialo (Pediatric Endocrinologist, T1D advocate)
Date: November 25, 2025

Episode Overview

This episode focuses on the current landscape and emotional impact of screening for Type 1 diabetes (T1D), especially in families with or without a known history of the disease. Host Stacey Simms is joined by Adam Schefter, whose wife lives with T1D, and Dr. Shara Bialo, a pediatric endocrinologist who also lives with T1D. They discuss why screening is recommended, how it's evolving, their personal experiences, and the associated emotional complexities. The conversation provides insight for families at risk for T1D and those curious about preventive advances.

Key Discussion Points & Insights

1. Current Landscape of Type 1 Diabetes Screening

[06:43–09:02]

• Dr. Shara Bialo explains the evolving recommendations:
  • Screening used to be focused on those with a family history or other autoimmune diseases.
  • Guidelines now recommend screening anyone with a family history, but conversation is expanding to consider general population screening.
  • Key insight: "We should start to plant the seeds for general population screening, because we know that 85 to 90% of people who pop up with T1D each year don’t have that family history..." – Dr. Bialo (07:35)

2. Personal Experiences & Motivations for Screening

[08:07–11:59]

• Adam Schefter shares his family’s perspective:

  • His wife, Shari, was diagnosed with gestational diabetes during pregnancy, then with T1D after a traumatic event (9/11).
  • Emphasizes that screening gives families time to prepare and make informed decisions.
  • Memorable quote: "You can’t prevent type 1, but you can prepare for it. And screening gives you the time you need to prepare." – Adam Schefter (08:28)

• Dr. Bialo highlights insights from TrialNet and other programs:

  • T1D's progression is slow and happens over four stages, with the first two stages showing no symptoms but being detectable via autoantibody testing.

3. The Value of Screening for “T1D-Aware” Families

[11:59–14:57]

• Both guests respond to the idea that T1D families might notice symptoms early enough without screening.
  • Adam stresses the importance of not being blindsided and wanting "information in advance." (12:45)
  • Dr. Bialo addresses the fallacy that being vigilant alone is enough:
    • Even in families familiar with T1D, up to 20–30% of new diagnoses present in diabetic ketoacidosis (DKA).
    • T1D "can mimic other things," meaning progression can be easy to miss even for experienced parents.

4. Personal Family Screening Stories: The Emotions Involved

[14:57–18:32]

• Adam Schefter: Despite disliking needles, has screened himself and his children, describing the process as "more purposeful than anything else."

  • "You just want to make sure you’re doing the right thing for the sake of your family." – Adam Schefter (15:38)
  • He admits to feeling nervous while awaiting results.

• Dr. Bialo: Candid about emotional difficulty, especially as someone living with T1D and a parent.

  • Felt guilt and anxiety over possibly passing on T1D.

  • Relieved when results were negative for her kids but highlights that it is not a permanent safeguard, so periodic retesting is important.

  • Quote: "I was a mess of emotion… and there was this added, like, guilt factor that if it was positive, that would somehow stem from me." – Dr. Bialo (16:34)

5. Retesting Protocols and Rationale

[19:42–20:59]

• Dr. Bialo explains that:
  • Autoantibodies can appear early, but sometimes not until later in childhood.
  • Screening at intervals (around ages 2–4, 4–6, and 10–15) catches ~80% of future cases.
  • Multiple screenings over time increase chances of detection.

6. Marriage & CGM Data Sharing Dynamics

[20:59–23:34]

• Different approaches:
  • Dr. Bialo: Manages her own data, husband is supportive but not a live follower.
    • "What matters most is that the person living with type 1 feels supported and not necessarily surveilled." (21:40)
  • Adam: His wife does not allow him to access her data, citing personality differences and boundaries.
    • Quote: "Not only does she not ask me to follow. She would never want me to follow, never. That would be a violation of HIPAA laws in my mind." – Adam Schefter (22:15)

7. Balancing Busy Lives with Type 1 in the Family

[24:29–25:33]

• Adam and Dr. Bialo both describe busy professional and family lives.
  • Adam: "I've learned over the years to multitask fairly well. I could be doing TV and tweeting and doing this podcast at the same time." (24:45)
  • Dr. Bialo: Stresses adaptability; "Perfection is a total myth. It’s not attainable." (25:13)

8. Spreading Awareness & Hope for the Future

[27:14–29:16]

• Adam: Discusses the uncertainty of impact but remains committed to spreading awareness.

  • "I just try to stay on point and deliver something that I feel matters..." (27:38)

• Dr. Bialo: Notes increasing awareness and optimism in both the medical community and families, but stresses "awareness translating into action" remains a challenge.

  • Quote: "...the topic [of screening] is truly taking off academically. We know it can take a while... but it’s happening." – Dr. Bialo (28:46)

Notable Quotes & Memorable Moments

• On the need for broader screening:
  "85 to 90% of people who pop up with T1D each year don’t have that family history..."
  — Dr. Shara Bialo (07:35)

• On screening’s purpose:
  "You can’t prevent type 1, but you can prepare for it. And screening gives you the time you need to prepare."
  — Adam Schefter (08:28)

• On parental guilt and emotions:
  "I was a mess of emotion… and there was this added, like, guilt factor that if it was positive, that would somehow stem from me."
  — Dr. Shara Bialo (16:34)

• On CGM data sharing:
  "She would never want me to follow, never. That would be a violation of HIPAA laws in my mind."
  — Adam Schefter (22:15)

Segment Timestamps

| Topic | Timestamp | |------------------------------------------------------------|-------------| | Screening landscape & population screening | 06:43–09:02 | | Adam & Stacey on personal/family diagnoses | 09:02–11:59 | | Why screen even for T1D-aware families? | 11:59–14:57 | | Personal stories/emotions about screening families | 14:57–18:32 | | Retesting rationale | 19:42–20:59 | | Marriage/CGM info-sharing | 20:59–23:34 | | Balancing T1D/family/career | 24:29–25:33 | | Spreading the word & hope for the future | 27:14–29:16 |

Overall Tone & Takeaway

The tone is candid, supportive, and encouraging, with openness about the complex mix of pragmatism and emotion that comes with family T1D screening. Both guests emphasize preparation and knowledge as powerful tools, while sharing the emotional realities of making those choices—especially for those with lived experience. The conversation is rich with insight for newly diagnosed families and offers reassurance that T1D research and advocacy are making tangible progress.

For more resources and information about T1D screening, visit screen4type1.com, as recommended by the guests, or consult with your healthcare provider.