Three New Paths Forward: How Scientists Are Working to Restore Beta-Cell Function in Type 1 Diabetes

For over a century, insulin therapy has been the cornerstone of Type 1 diabetes treatment since its discovery in 1921. Today, closed-loop insulin delivery systems represent the cutting edge of technology-based management. But scientists are pursuing a parallel path: restoring the body's own insulin-producing beta cells.

This biological approach takes three main forms: preserving the beta cells a person still has, regenerating new ones, or replacing damaged cells through transplantation. Recent breakthroughs in all three areas suggest these strategies are moving from laboratory studies into clinical practice.

One of the most significant recent advances is teplizumab, an anti-CD3 monoclonal antibody that received FDA approval in 2022 and European Medicines Agency approval in 2025. Unlike approaches that aim to grow new beta cells, teplizumab works by protecting the insulin-producing cells a person still has.

In clinical trials, teplizumab delayed the onset of Type 1 diabetes in people with stage 2 disease—those who show signs of beta-cell attack but haven't yet developed symptoms. This preservation strategy represents a new category of treatment that intervenes earlier in the disease process than traditional insulin therapy.

Scientists are also working to generate new insulin-producing cells through multiple pathways: differentiating stem cells into beta cells, encouraging existing beta cells to multiply, converting other pancreatic cells into beta cells, and transforming cells from outside the pancreas into insulin producers.

A major 2025 breakthrough involved transplanting insulin-producing cells derived from human embryonic stem cells directly into the liver. At one year, 83% of patients achieved insulin independence—meaning their transplanted cells produced enough insulin to meet their body's needs without injections. However, this success came with a requirement: patients needed to take immunosuppressive medications to prevent their immune system from rejecting the new cells.

This represents significant progress, but the need for lifelong immunosuppression remains a consideration for patients and doctors weighing the benefits and risks of the approach.

Islet transplantation—moving insulin-producing cells from deceased donors into people with Type 1 diabetes—has moved from experimental to mainstream in some countries. Since 2021, France's national health insurance system has covered islet transplantation, reflecting confidence in its potential.

However, this approach faces real-world limitations. Isolating usable islets from donor pancreases is complex and resource-intensive. There's often not enough viable islet mass available from a single donor to meet a recipient's full insulin needs. And like stem cell transplants, islet transplantation requires lifelong immunosuppression to prevent rejection. These factors mean the procedure remains available to a limited number of patients.

The field is rapidly evolving. Teplizumab offers a way to slow or delay diabetes onset in people at risk. Stem cell-derived islet transplantation shows promise for achieving insulin independence, though the requirement for immunosuppression needs further study. Islet transplantation from donors is becoming more accessible in some healthcare systems.

Each approach has different benefits and challenges. Together, they represent a fundamental shift in how scientists think about Type 1 diabetes—not just as a condition to manage with insulin, but as one where restoring the body's natural insulin production is increasingly possible.

Source: Annales d'endocrinologie. Evidence type: PubMed indexed literature. Type1Cure is an information and intelligence hub, not a medical advice service. This article summarizes published research and does not provide diagnosis, treatment, or personal medical guidance. Always talk to your own care team before changing anything about your Type 1 diabetes management.