Future Directions and Clinical Trial Considerations for Novel Islet β-Cell Replacement Therapies for Type 1 Diabetes.

Marinac, Marjana; Rickels, Michael R; Gaglia, Jason L; O'Connell, Philip J; Johnson, Paul R; Piemonti, Lorenzo; Schneider, Bruce S; Greenstein, Julia L et al. · Diabetes · 2025

review · Level V

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Abstract

Current research and development are ushering in a new era of novel islet β-cell replacement therapies that can no longer be considered solely a rescue treatment for those with unstable glucose management. Clinical trial design must ensure that the application of islet β-cell replacement is broadened beyond the indication of severe hypoglycemia given the potential for establishing insulin-independent normoglycemia. It is imperative that people with type 1 diabetes and their clinicians are at the center of the risk-benefit equipoise as evidence for the safety of cellular products, transplant sites, and immune protection strategies accumulates and an increasing number of options for intervention become available.

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