Therapies for Type 1 Diabetes: Current Scenario and Future Perspectives

Abstract

Type 1 diabetes (T1D) is caused by autoimmune destruction of insulin-producing β cells located in the endocrine pancreas in areas known as islets of Langerhans. The current standard-of-care for T1D is exogenous insulin replacement therapy. Recent developments in this field include the hybrid closed-loop system for regulated insulin delivery and long-acting insulins. Clinical studies on prediction and prevention of diabetes-associated complications have demonstrated the importance of early treatment and glucose control for reducing the risk of developing diabetic complications. Transplantation of primary islets offers an effective approach for treating patients with T1D. However, this strategy is hampered by challenges such as the limited availability of islets, extensive death of islet cells, and poor vascular engraftment of islets post-transplantation. Accordingly, there are considerable efforts currently underway for enhancing islet transplantation efficiency by harnessing the beneficial actions of stem cells. This review will provide an overview of currently available therapeutic options for T1D, and discuss the growing evidence that supports the use of stem cell approaches to enhance therapeutic outcomes.

Use of a Hybrid Adeno-Associated Viral Vector Transposon System to Deliver the Insulin Gene to Diabetic NOD Mice

“…Whilst treatment options for T1D are numerous, they are all limited in their long-term effectiveness [ 8 ] and, as a result, the search for more innovative and efficacious ways to treat/cure T1D is urgently required. Both insulin gene therapy and the reprogramming of liver cells to a β-cell phenotype have been studied by many groups as potential options [ 41 ].…”

“…Transplantation therapy of whole pancreas, human islets or combinations of islets and mesenchymal stem cells [ 7 ] are other alternatives to exogenous insulin treatment. However, the limitations of lack of donors, complications of immunosuppressive therapy and issues such as blood-mediated inflammatory reactions [ 8 ] underscore the need for alternative treatment approaches.…”

Stem cell secretome as a new booster for regenerative medicine

“…Stem cells have gained attention due to their potential for providing a limitless source of glucose responsive insulin-producing β cells as well as their ability to enhance the survival and function of transplanted islets. This holds potential to solve the problem of limited availability of suitable donor islets, and can also enhance the therapeutic outcome of islet transplantation in T1D patients (43).…”

Quality criteria/key components for high quality of diabetes management to avoid diabetes-related complications

“…Diabetes mellitus is an important factor in increasing risk for secondary vascular diseases such as cardiovascular, renal, and eye complications (Pathak et al 2019). Risk factors and outcomes vary across countries, reflecting a mixture of genetic background, societal, and cultural factors, as well as public health politics, in combination with local quality of health care (EUCID 2008).…”