Strategies for durable β cell replacement in type 1 diabetes

Technological advancements in blood glucose monitoring and therapeutic insulin administration have improved the quality of life for people with type 1 diabetes. However, these efforts fall short of replicating the exquisite metabolic control provided by native islets. We examine the integrated advancements in islet cell replacement and immunomodulatory therapies that are coalescing to enable the restoration of endogenous glucose regulation. We highlight advances in stem cell biology and graft site design, which offer innovative sources of cellular material and improved engraftment. We also cover cutting-edge approaches for preventing allograft rejection and recurrent autoimmunity. These insights reflect a growing understanding of type 1 diabetes etiology, beta cell biology, and biomaterial design, together highlighting therapeutic opportunities to durably replace the beta cells destroyed in type 1 diabetes.

Automated summary

Advancements in blood glucose monitoring and therapeutic insulin administration have improved the quality of life for individuals with type 1 diabetes, but still fall short of the metabolic control provided by native islets. Integrated advancements in islet cell replacement and immunomodulatory therapies are offering hope for the restoration of endogenous glucose regulation. Progress in stem cell biology and graft site design are providing innovative sources for cellular material and improved engraftment.