Thanks to early screening tests, Grayson Visco was able to avoid hospitalization from diabetic ketoacidosis, a life-threatening crisis that about 50% of people with type 1 diabetes endure before they’re diagnosed with the autoimmune disease.
Now, the eighth grader at Baldwin Street Middle School in Hudsonville hopes to stave off the progression of type 1 diabetes and delay the need for insulin injections for several more years. That’s possible because of a new treatment called teplizumab, a monoclonal antibody infusion approved in 2022 by the U.S. Food and Drug Administration for people with the early stages of type 1 diabetes.
“This is the first time we can actually delay the progression of type 1 diabetes and alter its course, which is a really big deal,” said Dr. Nader Kasim, an endocrinologist and diabetes specialist at Corewell Health Helen DeVos Children’s Hospital in Grand Rapids.
The drug, which is sold under the brand name TZield, has been shown in clinical trials to delay the need for insulin by a median of 2.7 years in people with early-stage type 1 diabetes, a genetic disorder that causes the immune system to attack the beta cells in the pancreas that produce insulin, he said. This leads to high levels of glucose in the blood and can cause dangerous complications.
TZield got wider regulatory clearance in April and now can be used in adults and children as young as age 1.
But the timing of when people qualify for therapy is key, Kasim said.
Patients must be in the “sweet spot” of disease progression — caught after at least two autoantibodies have begun to attack pancreatic beta cells, but before there are symptoms of diabetes — to qualify for treatment.
Recognizing type 1 diabetes before there are symptoms can be done only if people get screened, Kasim said. It is now recommended for:
“You’ve got to look at yourself and your family as a whole,” Kasim said. “This is what I communicate to families: If you’ve got autoimmune [disease], then it’s probably a good idea to get screened for type 1 because it’s an urgent medical problem that can be prevented.”
Grayson, who is 14, was at high risk because his father, Matthew Visco, was diagnosed with type 1 diabetes when he was a child.
“We always knew there was a possibility for our kids to inherit some of those genetics,” said Grayson’s mother, Liz Visco.
But it wasn’t until 2022, when the family saw a TV commercial advertising free screening through a clinical trial, that they discovered a simple blood test could act a bit like a crystal ball when it came to Grayson’s type 1 diabetes risk.
“We thought that was pretty amazing just so we could be prepared and aware,” Liz Visco said. The test was offered through Type 1 Diabetes TrialNet, an international group of scientists, researchers and doctors working to understand the causes of the disease and how to prevent it.
“At that time, it was just to pay it back to the science community,” she said, and better understand whether Grayson and his younger sister, Avery, had any of the five autoantibodies in their blood samples linked to type 1 diabetes.
“Little did we know after a few years of screenings, it was going to come back and help Grayson.”
Avery had none of the autoantibodies, but Grayson’s first blood test identified one. That’s enough to suggest his risk was elevated. However, it was not high enough to diagnose type 1 diabetes, Kasim said. The family was urged to have him rechecked each year.
“You can develop autoantibodies later in life,” Kasim said. “So, if there’s a higher risk, it’s recommended that you screen.” He added that one of the biggest misconceptions that persists about type 1 diabetes is it begins in childhood, and only in childhood. Actually, Kasim said, “half, if not more, are diagnosed as an adult.”
In September 2025, a re-test showed Grayson had developed a second autoantibody associated with the disease. That meant he was in the early stages of type 1 diabetes.
“Screening someone for type 1 diabetes actually reduces the risk of hospitalization tremendously,” Kasim said, reducing the likelihood of hospitalization with diabetic ketoacidosis to about 3%. “But the other benefit of screening is that if you’re able to identify someone in the early stage, which would be called Stage 1, you can actually monitor the blood sugars and determine when they enter Stage 2.”
Stage 2 begins when a person’s blood glucose levels fluctuate abnormally, often swinging too high and, occasionally, too low.
Grayson and his family worked with Kasim at DeVos Children’s Hospital pediatric endocrinology clinic, and were able to identify when he slipped from Stage 1 to Stage 2, a progression that made him eligible for treatment with TZield.
In January, Grayson became the first person at Helen DeVos Children’s Hospital to get TZield, undergoing a series of infusions over the span of 14 days. The hope is that the treatment will slow the advance of his disease and help him manage his blood sugar without insulin for a far longer time.
TZield targets the immune system’s T-cells, calming them down, Kasim said.
“It effectively dampens the autoimmune response that’s already been set … into motion with the intention of slowing down the destruction of beta cells that make insulin,” he said. “The intention is to have as much functional insulin-making capacity as possible … to preserve their function over time.
“Grayson is a great example because he was able to detect that he was in Stage 1, but was able to identify relatively quickly that he was entering Stage 2. … We were able to leverage tools like a continuous glucose monitor to really pick up on those abnormalities in his blood sugar.”
The small, circular white disc implanted in the back of Grayson’s right arm — a FreeStyle Libre 3 continuous glucose monitor — now tracks how his blood sugar reacts to what he eats, so he can clearly measure which foods have the most dramatic effects and how exercise factors in.
“That was really cool,” Grayson said. “I actually got to see my actual glucose numbers. And it’s kind of like a game to me now, to, like, keep my line level. I’m trying my best right now to, like, keep good glucose bubbles.”
An app on Grayson’s phone links to the monitor in his arm and relays data to his parents and to his doctor.
Grayson said he’s grateful to have more time to understand the disease, and learn how to take care of himself.
“I actually have to learn how to use an insulin pen, just in case for emergencies,” he said. “So, it gives me a lot more time to prepare.”
And Kasim said they’re already seeing Grayson’s body successfully respond to TZield.
“When he got the infusion, we saw a drastic change in his blood sugars as he was getting the infusion, which is a very remarkable thing as a pediatric endocrinologist to see,” Kasim said. “The hope is that he will have insulin-making capacity for years that he otherwise wouldn’t have had.”
It’s an exciting time in type 1 diabetes research, Kasim said, as there are now at least 15 other treatments in the development pipeline.
“I think the future is hopeful that people who are screened early for type 1 will have different therapeutic options, depending on where they are at in their journey. Depending on how they want to get treated and what their goals are, they’ll have options,” Kasim said.
“Just having this particular drug as an FDA-approved option really paves the path for even more treatments down the road.”
Contact Kristen Shamus: kshamus@freepress.com. Subscribe to the Detroit Free Press.
This article originally appeared on Detroit Free Press: Michigan teen gets type 1 diabetes therapy to delay need for insulin
Reporting by Kristen Jordan Shamus, Detroit Free Press / Detroit Free Press
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