The future of beta cell therapies according to the experts

We make faster progress when we look old problems through fresh lenses. Beta cell therapy is one of the most promising routes toward improving, and one day potentially curing type 1 diabetes. But today, only a small number of people can access existing treatments. At the same time, scientific advances are moving quickly.  

In a new Type 1 Diabetes Grand Challenge-funded perspective, Professor Shareen Forbes brings together leading UK experts to examine the current challenges and how the field could evolve to transform the future of type 1 treatment. 

Why today’s beta cell therapies reach so few 

Islet transplants – an existing form of beta cell replacement therapy – have been available in the UK since 2008.  

These involve transplanting clusters of cells, called islets, from a donor pancreas into the liver of someone with type 1 diabetes. They are offered only to a small group of adults who have hypo unawareness and experience severe hypos, or some undergoing kidney transplantation.  

Islet transplants can restore a person’s own insulin production often for several years. However, donor islets are limited, their quality varies, and people often need more than one transplant as the benefits fade over time.  

Another major barrier is the use of strong medications known as immunosuppressants. These medicines are needed to stop the immune system from attacking the transplanted cells, but they increase infection risk whilst also putting strain on the kidneys. This makes them unsuitable for children and many adults with other health conditions.  

Together, these pressures mean today’s beta cell therapies reach only a small fraction of those who could benefit. Who gets them is limited by how few donor pancreases there are and by the side effects of the drugs needed to protect cells.  

What the next generation of beta cell therapies could unlock 

In a recent publication, Professor Forbes and the other experts highlight the hopeful solutions being developed to tackle these challenges, particularly the use of stem cells. 

Stem cell-derived islets are lab-grown insulin-producing cells. Instead of relying on organ donors, scientists are able to manufacture new beta cells from stem cells. A reliable supply of high‑quality stem cell-derived islets could help move beta cell therapies from being dependent on rare donor organs to becoming far more scalable.  

Early clinical trials have already shown encouraging signs. Some participants have been able to come off insulin completely, providing early but meaningful evidence of what may be possible in the future. 

Right now, stem cell-derived islets being tested in clinical trials still require powerful immunosuppressing drugs. A clear message from the experts is the need to reduce or remove the need for this, to make sure therapies reach many more people living with type 1 diabetes. 

Researchers – including teams funded by the Type 1 Diabetes Grand Challenge are working on three main approaches: 

• Gene‑edited stem cells that are less visible to the immune system. 

• Encapsulation, which protects cells inside a protective device that allows insulin to leave but keeps immune cells out. 

• Local immunomodulation, which delivers immune‑calming signals directly to the transplant site, rather than suppressing the immune system throughout the whole body. 

All of these approaches aim to protect transplanted cells while making treatment safer and in turn more accessible. 

Preparing for what’s coming 

With Type 1 Diabetes Grand Challenge researchers and others driving rapid progress, the experts looked at what would be needed once beta cell therapies are no longer limited by the scarcity of organ donors or immunosuppression.  

Greater access would bring up new responsibilities. Health services would need to plan for scheduled ‘top‑up’ treatments, as transplanted cells may naturally lose function over time. It will also be important to ensure that expanding access does not unintentionally create new inequalities.  

Why this perspective matters 

Professor Forbes’ work captures a field that is rapidly evolving.  Her analysis connects the realities of today’s system with the innovations that could define the next decade. This is exactly where the Type 1 Diabetes Grand Challenge is focused. We are investing in the science needed to move beta cell therapy into a new era. This includes improving how cells are grown, developing safer ways to protect transplanted cells, testing new delivery sites, and exploring approaches that could eventually help the body rebuild its own beta cells. 

This perspective also shows that the Grand Challenge community is not just shaping the science but also leading the thinking on how the next generation of beta cell therapies could be delivered widely and equitably – to help many more people make their own insulin again.