Type 1 Diabetes: Are We Closer to a Functional Cure?

Medical research into type 1 diabetes is shifting toward the possibility of a functional cure through a combination of stem cell therapies and immune-modulating drugs. While the prospect of a cure has long been discussed in the medical community, recent developments in monoclonal antibodies and cellular engineering are providing new pathways to restore insulin production and protect the body from autoimmune attacks.

Current strategies are focusing on two primary goals: delaying the onset of the disease in high-risk individuals and restoring insulin-producing beta cells in those already diagnosed.

Delaying Disease Progression

One significant advancement is the use of teplizumab, a monoclonal antibody approved in late 2022. The drug is designed to slow or potentially halt the progression of type 1 diabetes in individuals at stage 2 of the disease.

Stage 2 is characterized by the presence of at least two types of antibodies that attack insulin-producing beta cells in the pancreas, though the patient does not yet require insulin for treatment. Typically, stage 2 progresses to stage 3, where blood sugar levels become dysregulated and insulin dependency begins.

In one clinical case reported by Yale University endocrinologist Kevan Herold, a girl who began taking the drug in 2011 delayed the progression to stage 3 for nearly a decade, remaining free of diabetes for eight to nine years.

Engineering Immune Protections

For those who have already progressed to insulin dependency, researchers at the Medical University of South Carolina (MUSC) are developing a therapy to rebuild insulin cells while training the immune system to tolerate them.

Led by Leonardo Ferreira, Ph.D., the team is pairing stem cell-derived insulin-producing cells with custom-engineered immune cells that act as bodyguards. This approach aims to prevent the immune system from destroying the transplanted cells without the need for lifelong immunosuppressive drugs.

The project is supported by $1 million in funding from Breakthrough T1D. The goal is to create a treatment that is ready for use even for individuals who have lived with diabetes for several years.

These awards support the most promising work that can significantly advance the path to cures for type 1 diabetes.

Leonardo Ferreira, Ph.D.

Experimental Success in Animal Models

Separate research from Stanford Medicine has demonstrated a potential immune system reset in animal models. In a study published online November 18, 2025, in the Journal of Clinical Investigation, researchers successfully prevented or cured type 1 diabetes in mice.

The researchers used a combination of blood stem cell and pancreatic islet cell transplants from an immunologically mismatched donor. This process created a hybrid immune system containing cells from both the donor and the recipient.

The results of the six-month experiment included:

• The animals did not require insulin for the duration of the study.
• The animals did not require immune suppressive drugs.
• No animals developed graft-versus-host disease, a condition where donor immune cells attack the recipient’s healthy tissue.

Seung K. Kim, MD, PhD, a professor at Stanford Medicine and senior author of the study, noted that the key steps used to create the hybrid immune system are already being applied in clinical settings for other medical conditions.

The Path Toward a Functional Cure

The current focus on cell therapy builds on a long history of research. The first successful transplants of insulin-producing cells in humans with type 1 diabetes occurred approximately 25 years ago, as noted in reports from February 17, 2026.

The primary challenge has remained the immune system’s tendency to destroy both native and transplanted beta cells. By combining stem cell science with immunology, researchers are attempting to move beyond symptom management toward a functional cure that eliminates the need for daily insulin injections.

While the Stanford findings are currently limited to mice and the MUSC therapy is still in development, the combination of disease-delaying drugs like teplizumab and new cellular engineering techniques suggests a multi-pronged approach to ending insulin dependency.