Type 1 diabetes (T1D) is defined when the immune system mistakenly destroys insulin-producing beta cells in the pancreas. It affects millions worldwide and for many years treatment has relied on daily insulin injections or pumps. But new advances in biotechnology are paving the way to something once thought impossible: reinstalling the body’s ability to produce its own insulin.
Recently, three separate studies have reported remarkable progress: stem cell therapy, gene-edited donor cells, and engineered islets using hypoimmune technology. While still experimental, each approach could transform how T1D is treated in the future.
Timeline of Key Breakthroughs
| Year | Breakthrough | Key Outcome |
|---|---|---|
| 2024 (July) | Wang et al., Cell | 25-year-old woman with T1D achieved insulin independence after autologous iPSC-derived islet-like cell transplant |
| 2025 (Jan) | Breakthrough T1D / Sana Biotechnology | Engineered hypoimmune islets implanted into T1D patient; insulin production confirmed without immunosuppressive drugs |
| 2025 (Aug) | NEJM CRISPR study | Gene-edited donor islet cells transplanted without immunosuppression; patient produced insulin |
Breaking Down the Three Approaches
For those new to the science, here’s a simple explanation of the three cutting-edge strategies being tested.
1. Stem Cell Therapy (iPSCs) – Growing New Islets From Scratch
What it is:
Stem cells are “master cells” that can turn into many different types of cells. Scientists can take a patient’s own cells (like skin cells), reprogram them into induced pluripotent stem cells (iPSCs), and guide them to become insulin-producing islet-like cells.
Why it matters:
The risk of immune rejection is very low. This is because the cells come from the patient’s own body, meaning people with T1D could potentially grow back their own beta cells.
2. CRISPR Gene Editing – Rewriting Donor Cells to Avoid Attack
What it is:
CRISPR (Clustered Regularly Interspaced Short Palindromic Repeats) is a powerful genetic tool that works like molecular scissors. Scientists can use CRISPR to remove or alter parts of DNA in donor cells so that the immune system doesn’t recognise them as alien.
Why it matters:
Normally, donor islets are quickly destroyed unless patients take strong immune-suppressing drugs. With CRISPR, donor cells can be modified to “hide” from immune attack, meaning no drugs are needed.
Example:
In August 2025, The New England Journal of Medicine reported a man who received CRISPR-edited donor islets into his forearm. The cells had three key edits: two to reduce immune visibility and one to increase protection (CD47). He began producing insulin without any immunosuppressive medication (Carlsson et al., 2025).
3. Hypoimmune Technology – Making Donor Islets Invisible
What it is:
Hypoimmune engineering changes donor islets so that the immune system doesn’t “see” them at all. Unlike CRISPR, which edits specific genes, hypoimmune technology reprograms the cell surface more broadly to avoid triggering immune attacks.
Why it matters:
This could allow donor or lab-grown islets to survive in the body without immune suppression — a critical step toward a scalable, safe therapy.
Example:
In 2025, Sana Biotechnology, with support from Breakthrough T1D, implanted hypoimmune-engineered donor islets into a T1D patient. Within four weeks, the cells were alive, making insulin, and not rejected — all without immunosuppressive drugs (Breakthrough T1D, 2025).
Side-by-Side Comparison
| Feature | Stem Cell Therapy (iPSCs) | Gene-Edited Donor Cells (CRISPR) | Engineered Islets (Hypoimmune) |
|---|---|---|---|
| Source of cells | Patient’s own reprogrammed cells | Donor pancreatic islet cells | Donor islets (future: stem cell–derived) |
| Immune rejection risk | Low (autologous) | Reduced through gene editing | Avoided through hypoimmune engineering |
| Key advantage | Personalised therapy, insulin independence | Off-the-shelf potential, no immunosuppression | First immune-evasive insulin production without drugs |
| Status | One patient, insulin-free | One patient, partial insulin independence | Early trial, insulin production confirmed |
| Main challenge | Cost, scalability, long-term safety | Long-term survival, replication | Donor scarcity, need for stem cell-derived scalability |
What This Means for the Future of Diabetes Care
Together, these breakthroughs represent a paradigm shift in type 1 diabetes research. Instead of managing blood sugar with external insulin, science is moving toward restoring or replacing insulin-producing cells inside the body.
- Stem cells could allow patients to generate their own beta cells.
- Gene editing could make donor cells immune-evasive.
- Hypoimmune engineered islets could combine both approaches, offering scalable, off-the-shelf insulin-producing cells.
Key Takeaway
Gene-Edited Donor Cells (CRISPR) and Engineered Islets (Hypoimmune) both function without immunosuppressive drugs, which is revolutionary. But Engineered Islets (Hypoimmune) is being pitched as more future-proof because it could be combined with stem cell–derived islets (solving donor shortage).
Type 1 diabetes has long been considered incurable, but recent progress shows real potential for change. Stem cell therapies, gene-edited donor cells, and engineered islets are three different , yet complementary , strategies. While more research, funding, and clinical trials are needed, these breakthroughs bring us closer to a future where people with T1D may no longer rely on daily insulin.
References
- Breakthrough T1D, 2025. Clinical trial shows engineered islets survive and function without immunosuppressive drugs. Available at: https://www.breakthrought1d.org [Accessed 6 September 2025].
- Carlsson, P.-O., Hu, X., Scholz, H., et al., 2025. Survival of transplanted allogeneic beta cells with no immunosuppression. New England Journal of Medicine, 393(9), pp.887–894. doi:10.1056/NEJMoa2503822.
- Kumar, D., Tanwar, R. & Gupta, V., 2025. First-ever stem cell therapy restores insulin independence in type 1 diabetes: A medical milestone. World Journal of Stem Cells, 17(7), p.106856. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12305139/ [Accessed 6 September 2025].
- Wang, S., Du, Y., Zhang, B., et al., 2024. Transplantation of chemically induced pluripotent stem-cell-derived islets under abdominal anterior rectus sheath in a type 1 diabetes patient. Cell, 187, pp.6152–6164.e18. doi:10.1016/j.cell.2024.09.004.
