Labs notes

Diabetes

Type 1 diabetes: how close is a cure?

A cure would need a new supply of insulin-making cells and a way to stop the immune system destroying them again. Both are moving forward, as is a drug that delays the disease, but none of them is a cure yet. The few people who have come off insulin after cell transplants must keep taking anti-rejection drugs to keep the cells working. This note sets out how far each approach has come.

By attnomSources read on 18 sources4 min read

What type 1 diabetes is

In type 1 diabetes the immune system attacks the cells in the pancreas that make insulin, the hormone that moves sugar from the blood into the body’s cells. Without those cells, people need insulin every day to survive.[1] WHO puts the number of people with type 1 diabetes at about 9.5 million in 2025, with more than 500,000 new cases that year.[2]

Replacing the lost cells

Donor islet transplants

Islets are the clusters of cells that hold the insulin makers. In 2000, a Canadian team gave seven patients islets from donor pancreases, with anti-rejection drugs, and all seven stopped taking insulin over about a year of follow-up. Each needed islets from at least two donors.[3] In 2023 the US Food and Drug Administration approved Lantidra, the first donor islet therapy, for adults with repeated severe low blood sugar. In its studies, 21 of 30 people went a year or more without insulin, but most had at least one serious side effect from the procedure or the anti-rejection drugs.[4]

Islet cells grown from stem cells

Stem cells can be grown into islet cells in a lab. In a 2025 report on zimislecel, made by Vertex, 10 of the 12 people given the full dose needed no insulin a year later. All of them took anti-rejection drugs. Two of the 14 people in the analysis died, one of a fungal brain infection and one of dementia that had begun before the study. The authors call it a small, short-term study.[5] In November 2026 Vertex said it would focus instead on a newer version, VX-017, which it says could reach more patients. VX-017 is in an early trial, and Vertex hopes to start a larger one in 2027.[6]

Protecting the cells without lifelong drugs

Anti-rejection drugs can cause serious side effects, so they limit who can be offered new cells.[4]

Gene-edited cells that hide from the immune system

One idea is to edit the cells’ genes so the immune system does not see them. In a 2025 report from Sweden, one man with long-standing type 1 diabetes received edited donor islet cells in his forearm muscle with no anti-rejection drugs. Twelve weeks later the cells were still making insulin and his immune system had not attacked them.[7] The company behind the cells, Sana Biotechnology, reported in November 2026 that the cells were still working at 14 months, and that it had not yet started a trial of a stem-cell version.[8] The dose was only about 7 percent of what would usually be needed to come off insulin, so the study was never meant to free him from it.[9]

Slowing the disease down

Teplizumab, a drug that delays onset

Type 1 diabetes often shows up in blood tests years before symptoms. In a trial of 76 relatives of people with the disease who were at high risk, a single two-week course of teplizumab pushed back the median time to diagnosis from 24 months to 48 months.[10] The US approved it in 2022 for people aged 8 and over at this early stage, and the regulator says plainly that it does not prevent or cure the disease, only delays it.[11] The US has since widened that to age 1 and over.[12] The UK approved it in August 2025[13] and the European Union in January 2026.[14] In June 2026 the US also gave a faster, conditional approval for children aged 8 to 17 who were recently diagnosed, to slow the loss of their own insulin. A further study must confirm the benefit.[12]

The bridge: automated insulin delivery

Hybrid closed loop systems

For now, the biggest everyday help for many people is a system that links a glucose sensor, an insulin pump and software that adjusts the dose on its own. In a six month trial of 168 people aged 14 to 71, those given such a system raised the time their blood sugar stayed in the healthy range from 61 to 71 percent, while the others stayed at about 59 percent.[15] In a 16 week trial of 101 children aged 6 to 13, it rose from 53 to 67 percent in those using the system.[16] NICE recommended these systems for many people with type 1 diabetes in England in December 2023, while noting that people still need to dose by hand at times, such as around meals.[17]

What is still unknown

  • Whether stem-cell islets work safely in large numbers of people and for many years. The 2025 results were early and short.[5]
  • Whether gene-edited cells keep hiding from the immune system for years, and whether a full dose can free someone from insulin.[8]
  • Whether the autoimmune attack, which destroyed the original cells, will in time find new cells that are not shielded.
  • How much the June 2026 teplizumab approval for newly diagnosed children helps in daily life. The trial behind it slowed the loss of their own insulin, but did not show clear gains in insulin dose or blood sugar control.[18]

This note summarises published research. It is not medical advice. For any question about your own health, or someone in your care, see a doctor.

Sources

Numbered in the order the note first cites them. Each was opened and read on 15 November 2026.

  1. [1]Type 1 diabetesInternational Diabetes Federation, 14 June 2023.Read 15 November 2026. Cited once. idf.org
  2. [2]Diabetes (fact sheet)World Health Organization, 11 November 2026.Read 15 November 2026. Cited once. www.who.int
  3. [3]Islet transplantation in seven patients with type 1 diabetes mellitus using a glucocorticoid-free immunosuppressive regimenNew England Journal of Medicine, 27 July 2000.Read 15 November 2026. Cited once. doi.org
  4. [4]FDA Approves First Cellular Therapy to Treat Patients with Type 1 DiabetesUS Food and Drug Administration, 28 June 2023.Read 15 November 2026. Cited 2 times. www.fda.gov
  5. [5]Stem Cell-Derived, Fully Differentiated Islets for Type 1 DiabetesNew England Journal of Medicine, 20 June 2025.Read 15 November 2026. Cited 2 times. doi.org
  6. [6]Vertex Reports Third Quarter 2026 Financial Results (company press release)Vertex Pharmaceuticals, filed with the US SEC, 2 November 2026.Read 15 November 2026. Cited once. www.sec.gov
  7. [7]Survival of Transplanted Allogeneic Beta Cells with No ImmunosuppressionNew England Journal of Medicine, 4 August 2025.Read 15 November 2026. Cited once. doi.org
  8. [8]Sana Biotechnology Reports Third Quarter 2026 Financial Results and Business Updates (company press release)Sana Biotechnology, filed with the US SEC, 5 November 2026.Read 15 November 2026. Cited 2 times. www.sec.gov
  9. [9]Form 10-K, annual report for 2025 (company filing)Sana Biotechnology, filed with the US SEC, 3 March 2026.Read 15 November 2026. Cited once. www.sec.gov
  10. [10]An Anti-CD3 Antibody, Teplizumab, in Relatives at Risk for Type 1 DiabetesNew England Journal of Medicine, 9 June 2019.Read 15 November 2026. Cited once. doi.org
  11. [11]FDA approves first drug that can delay onset of type 1 diabetes (FDA Update, AAP News)US Food and Drug Administration, in AAP News, 1 January 2023.Read 15 November 2026. Cited once. www.fda.gov
  12. [12]FDA Approves New Indication for Tzield (teplizumab) for Certain Pediatric Patients with Recently Diagnosed Stage 3 Type 1 DiabetesUS Food and Drug Administration, 15 June 2026.Read 15 November 2026. Cited 2 times. www.fda.gov
  13. [13]MHRA approves teplizumab to delay progression of type 1 diabetesMedicines and Healthcare products Regulatory Agency, UK, 14 August 2025.Read 15 November 2026. Cited once. www.gov.uk
  14. [14]Teizeild (teplizumab): EPAREuropean Medicines Agency, 8 January 2026.Read 15 November 2026. Cited once. www.ema.europa.eu
  15. [15]Six-Month Randomized, Multicenter Trial of Closed-Loop Control in Type 1 DiabetesNew England Journal of Medicine, 16 October 2019.Read 15 November 2026. Cited once. doi.org
  16. [16]A Randomized Trial of Closed-Loop Control in Children with Type 1 DiabetesNew England Journal of Medicine, 27 August 2020.Read 15 November 2026. Cited once. doi.org
  17. [17]Hybrid closed loop systems for managing blood glucose levels in type 1 diabetes (TA943)National Institute for Health and Care Excellence, 19 December 2023.Read 15 November 2026. Cited once. www.nice.org.uk
  18. [18]Teplizumab and β-Cell Function in Newly Diagnosed Type 1 DiabetesNew England Journal of Medicine, 18 October 2023.Read 15 November 2026. Cited once. doi.org