Engineering islets from stem cells for advanced therapies of diabetes

Diabetes mellitus is a metabolic disorder that affects more than 460 million people worldwide. Type 1 diabetes (T1D) is caused by autoimmune destruction of beta-cells, whereas type 2 diabetes (T2D) is caused by a hostile metabolic environment that leads to beta-cell exhaustion and dysfunction. Currently, first-line medications treat the symptomatic insulin resistance and hyperglycaemia, but do not prevent the progressive decline of beta-cell mass and function. Thus, advanced therapies need to be developed that either protect or regenerate endogenous beta-cell mass early in disease progression or replace lost beta-cells with stem cell-derived beta-like cells or engineered islet-like clusters. In this Review, we discuss the state of the art of stem cell differentiation and islet engineering, reflect on current and future challenges in the area and highlight the potential for cell replacement therapies, disease modelling and drug development using these cells. These efforts in stem cell and regenerative medicine will lay the foundations for future biomedical breakthroughs and potentially curative treatments for diabetes. Diabetes is a substantial and increasing health concern. In this Review, Lickert and colleagues discuss the progress made in developing insulin-producing islets using in vitro methods, including which aspects need to be improved in order to use these islets as transplants. Using these islets in laboratory settings could further our understanding of pancreatic function and the mechanisms underlying diabetes.

Automated summary

Diabetes is a significant global health concern affecting millions of people, and advanced therapies utilizing stem cell differentiation and islet engineering may offer potential breakthroughs in treatment. Research in these areas could lead to improved understanding of pancreatic function and provide new insights into diabetes mechanisms.