Can Type 1 Diabetes Be Cured? Discover Latest Breakthrough

Type 1 diabetes average life expectancy

Before the introduction of insulin therapy in 1922, T1D was a fatal diagnosis. Still today, experts say that without insulin therapy, individuals with T1D have a lifespan of days to weeks, depending on the severity of complications (3). 

With insulin, however, people are living longer with T1D now than ever before. Compared to individuals diagnosed with T1D between 1950 and 1964, those diagnosed between 1965 and 1980 lived on average 15 years longer (4). A 2023 Finnish study found that people with T1D who survived to age 20 could expect to live on average up to 71.6 years of age (5). 

What is the function of insulin?

Insulin is a crucial hormone the pancreas produces in response to food intake. When you eat carbohydrates, your blood sugar levels rise. 

Insulin is like a key that unlocks the doors of cells to allow glucose from the bloodstream to enter cells and be used as energy. It also promotes the storage of glucose in the liver and skeletal muscles in the form of a molecule called glycogen (6). During times of fasting, glycogen can be broken down into glucose for energy. 

When the pancreas cannot produce enough insulin, hyperglycemia (elevated blood sugar) occurs. In severe cases of hyperglycemia, life-threatening complications such as diabetic ketoacidosis or hyperglycemic hyperosmolar syndrome can develop. 

These conditions occur when blood sugar levels run so high that they can cause vomiting, dehydration, low blood pressure, excessive thirst and urination, and even coma (7). Chronic hyperglycemia, on the other hand, increases the risk of many health conditions, including stroke and heart attack (8, 9).

Therefore, normal insulin levels keep blood sugar levels in a normal range, preventing the short and long-term complications associated with hyperglycemia. 

Does type 1 diabetes get worse with age?

T1D is most commonly diagnosed in children between the ages of 5 and 14 (10). However, it can manifest at any age, even as late as the ninth decade of life (11). In fact, more than half of all new cases of T1D occur in adults (12). 

Because T1D can progress more gradually in adults, it is frequently misdiagnosed. Up to 40 percent of adults initially diagnosed with type 2 diabetes (T2D) are later found to have T1D (12). Sometimes, adults can go years without a T1D diagnosis because their blood sugars remain within the normal or near-normal range due to relatively good pancreatic function. 

Some patients with T1D require increased insulin therapy over time, especially as their pancreatic function worsens and their insulin sensitivity decreases with age (13). Others, however, can stay on the same insulin regimen for many years. 

Managing T1D can also become more challenging with age. As people age, cognitive changes may make it more difficult to monitor blood sugar levels and keep track of medications (including insulin). 

Erratic food intake, other medical problems, functional disabilities, and decreased social support add to the difficulties of living with T1D (13). 

Who is more likely to get type 1 diabetes?

Risk factors for T1D are not as clear as they are for T2D. However, a combination of genetic and environmental factors plays a role in determining whether someone will develop T1D. 

Age is the most consistent risk factor. T1D is most commonly diagnosed in childhood. However, an increasing number of people are diagnosed as adults. 

Having a first-degree relative with T1D increases the risk of developing the disease. T1D is diagnosed in 2.5 to 7 percent of people whose parents have the condition (14).

Other risk factors that may be associated with T1D include (14):

• Recurrent viral infections in childhood
• Altered gut microbiome
• Low sunlight exposure (and low vitamin D levels)
• Childhood obesity
• Preterm birth
• Toxins 

Will there be a cure for type 1 diabetes? 

Currently, there is no long-term cure for T1D, although in certain cases, people may achieve disease remission. This means their blood sugar is well-controlled with little insulin needs. 

The honeymoon phase

The ‘honeymoon’ phase refers to a period shortly after a diagnosis of T1D when a person’s diabetes seems to disappear. 

During this phase, their symptoms go away, and they may require little insulin therapy (‘partial remission’) or no insulin therapy (‘complete remission’). 

This typically happens about three months after initiating insulin therapy and can last anywhere from 1 month to 13 years, with an average of 9.2 months (15). Up to 60 percent of adults with T1D may experience a honeymoon phase (16). 

What explains the honeymoon phase? At the time of a T1D diagnosis, 30 to 50 percent of a person’s pancreatic beta cells may still be functional (17). 

Insulin therapy simply provides an extra ‘boost’ to their own insulin production, which is sufficient to keep their blood sugars in the normal range. 

Over time, however, the autoimmune attack destroys more and more insulin-producing cells, and the honeymoon phase ends. Therefore, this phase is temporary, and it does not represent a cure for T1D. 

Nevertheless, some research suggests that the honeymoon phase can be potentially extended with vitamin D supplementation, a low-carbohydrate diet, and regular exercise (16, 17).

Some scientists believe the honeymoon phase represents a crucial opportunity for potentially curing T1D. During this phase, some pancreatic beta cells are still functional, and targeted interventions might eventually prevent these cells from being attacked. If successful, these therapies can preserve beta cells and their ability to produce insulin (18). 

Can stem cells cure type 1 diabetes?

Once pancreatic beta cells are destroyed, they can no longer regain the ability to produce insulin. Therefore, the pancreas in a person with T1D does not revive its own beta cells.

However, stem cell therapy offers a potential approach for restoring the pancreas’ ability to produce insulin. Stem cells have the ability to differentiate into other cell types in the body. Therefore, stem cells can be a way of supplying functional pancreatic beta cells to someone with T1D. 

In a 2023 study, researchers explored the benefits of an implantable medical device that contained millions of lab-grown pancreatic beta cells derived from stem cells (19). They implanted the device into 10 participants with T1D who lacked functional beta cells. 

After six months, three participants showed increased insulin production and could reduce the amount of insulin they had been taking previously. These participants also achieved better blood sugar control.

First man cured of type 1 diabetes

An ongoing clinical trial by Vertex Pharmaceuticals is investigating the use of stem cell-derived pancreatic beta cells in T1D (20). Results so far have been promising. 

In 2021, the first man to be considered ‘cured’ of T1D participated in this trial. This individual, who had been living with T1D for over 40 years, began producing his own insulin three months after receiving the stem cell therapy. 

His hemoglobin A1C levels (a marker of diabetes) significantly improved, and he was able to reduce his insulin usage by 91 percent after three months of treatment. By six months, he no longer required insulin therapy (21).

In June 2024, Vertex Pharmaceuticals reported that all 12 patients with T1D who had received the full dose of the stem cell therapy were able to produce their own insulin within three months. Most (11 of 12) patients successfully reduced or eliminated their use of insulin to manage their T1D (22). 

While stem cell therapy’s safety and long-term effectiveness for T1D are unknown, these early results are encouraging. Time will tell whether they will lead to a permanent cure for T1D. 

Type 1 diabetes management

While no cure exists for T1D, it is a treatable condition. Managing T1D usually requires an interdisciplinary approach involving physicians, dieticians, and one’s social support system. 

Diet and lifestyle changes

A combination of lifestyle approaches is foundational for managing T1D. These include (23):

• Self-monitoring blood sugar levels: This can be done via finger sticks throughout the day or through continuous glucose monitoring (CGM), which involves a glucose-detecting device placed under the skin. You should monitor blood sugar levels at least before meals, exercise, bedtime, and any time you have symptoms of low blood sugar.
  
• Nutritional therapy: Experts do not recommend a particular ‘diabetic’ diet for people with T1D. Instead, nutritional guidelines for people with T1D are similar to those for the general population (24). However, it is important to be aware of how many carbohydrates you consume. A dietician can help you understand how to match your insulin dose with carbohydrate intake per meal. Alcohol intake should be restricted to no more than one drink per day for women and two for men.
  
• Exercise: According to the American Diabetes Association, children and adolescents with T1D should engage in 60 minutes of moderate to intense exercise daily with muscle-strengthening activities at least three times a week. Adults should aim for 150 minutes of moderate to intense exercise each week, such as swimming, biking, or jogging (25). 

Current treatments

People with T1D depend on treatment with insulin since they can no longer produce insulin. 

Insulin can be administered through multiple daily injections. Injectable insulin can be:

• Long-acting: These insulin types act over a longer period often for several hours, and are typically used once or twice per day. 
• Short-acting insulin: These insulin types act over a shorter period, usually minutes, and is typically used right before meals. 

Some people may use an insulin pump, which allows a continuous stream of insulin to enter the bloodstream over time. 

While metformin is a widely used medication for people with T2D, research suggests that it is not effective for improving blood sugar levels in people with T1D (26).

Latest breakthrough for type 1 diabetes

Besides stem cell therapy, the latest breakthrough for T1D treatment is a medication called teplizumab-mzwv (Tzield) (27). Tzield is a monoclonal antibody that binds to a CD3 molecule on T-cells, preventing them from attacking pancreatic beta cells. 

In 2022 U.S. Food and Drug Administration (FDA) approved Tzield to treat stage II T1D, characterized by elevated blood sugar levels with no symptoms yet, in people aged eight and older. Its goal is to prevent the progression to stage III T1D, when symptoms appear. It is not intended to be a ‘cure’ for T1D.

A 2023 study published in the New England Journal of Medicine found that 95 percent of children and adolescents newly diagnosed with T1D retained their own insulin production 18 months after receiving treatment with Tzield (28). 

A 2024 review of all studies on Tzield, involving 1,052 participants, concluded that it significantly preserves beta cell function at 12, 18, and 24 months compared to patients receiving placebo. Moreover, people receiving Tzield had significantly reduced hemoglobin A1C levels and decreased insulin requirements (29).

Longer studies are needed to determine how long Tzield can delay the onset of symptoms in patients with T1D. 

What is the latest technology for type 1 diabetes?

Managing T1D can be challenging for many people—particularly children—as it requires regularly monitoring blood sugar levels and administering insulin multiple times daily. A recent technological breakthrough significantly simplifies these tasks.

Also called an ‘artificial pancreas,’ a combination CGM-insulin pump can respond immediately to blood glucose levels by delivering appropriate doses of insulin without human intervention (30). 

This ‘all-in-one’ diabetes management system operates independently, replacing fingerstick testing, manual insulin injections, and patient-controlled insulin pumps. 

Artificial pancreas technology has been shown to significantly improve the amount of time that children with T1D can achieve optimal blood sugar control compared to children practicing standard care. 

In a 2023 study, children using an artificial pancreas spent 12 percent more time within their target blood glucose range (approximately three hours per day) compared to the standard care group (31). The artificial pancreas has also been shown to improve target blood sugar control in adults (32).

The first artificial pancreas, Medtronic’s MiniMed 670G System, was approved by the FDA in 2016 for people with T1D aged 14 and older. Since then, the FDA has approved other artificial pancreas systems, including the Tandem Control-IQ (2019) and the Medtronic 770G (2020).