Stem Cell–Derived Islet Transplantation in Type 1 Diabetes: Breakthrough Potential and the Imperative of Addressing Root Causes
I received an article from a friend about how Chinese scientists achieve a medical milestone with the world's first successful diabetes reversal using stem cell therapy. She solicited my opinion on this. The article she sent is in pink below.
"In a groundbreaking achievement that could transform diabetes treatment worldwide, researchers in China have successfully reversed Type 1 diabetes in a patient using her own reprogrammed stem cells, marking the first time in medical history that this autoimmune disease has been functionally cured through cellular therapy.
Last year, cell biologist Deng Hongkui and his team at Peking University in Beijing took cells from a woman with type 1 diabetes, reprogrammed them into blood sugar-regulating cell clusters and injected them back into her abdomen. The revolutionary procedure represented an entirely new approach to treating the condition that affects millions globally.
The results have exceeded all expectations. Two and a half months later, the young woman started producing enough of her own insulin to not need injections of the hormone anymore. Now, more than a year has passed since the treatment, and in another world first, her ability to produce insulin has remained stable. The patient, who remains anonymous, can now enjoy normal foods including sweets, something previously impossible without careful insulin management.
The Revolutionary Process involved extracting cells from the patient's fat tissue and chemically transforming them into pluripotent stem cells—specialized cells capable of developing into any type of tissue. These stem cells were then guided to become insulin-producing islet cells, the very cells that Type 1 diabetes destroys. The team injected the equivalent of 1.5 million islets into the patient's abdomen, rather than her liver, where islet transplants are usually injected, allowing researchers to monitor the transplanted cells using MRI imaging and assess their long-term viability.
Addressing a Global Crisis:
Type 1 diabetes occurs when the immune system attacks the body's insulin-producing cells in the pancreas, leading to dangerously high blood sugar levels that require lifelong insulin injections. China currently has the highest number of diabetes cases in the world.
Traditional treatments have included pancreatic transplants, but these are limited by donor availability and require patients to take immunosuppressive drugs permanently. This new approach eliminates both challenges by using the patient's own cells.
Expanding Success:
The breakthrough extends beyond a single case. The trial includes two more patients who were operated on after the woman. Their one year post-treatment mark is coming up in November, but the results are already "very positive," Deng tells Nature News.
Leading diabetes researchers worldwide have expressed amazement at the results. As one expert noted, using the patient's own cells means organ rejection isn't a concern and dramatically reduces the need for anti-rejection medications.
Future Implications:
While scaling this treatment globally will present challenges, the success opens unprecedented possibilities for treating diabetes and potentially other autoimmune conditions. The research team plans to expand trials to include more patients, potentially offering hope to millions who currently depend on daily insulin injections for survival.
This medical breakthrough represents not just an advancement in diabetes care, but a fundamental shift toward regenerative medicine that harnesses the body's own cellular machinery to cure previously incurable diseases".
In reply, here is my opinion in blue on that stem cell therapy:
Those scientists are using stem cells to treat type 1 diabetes mellitus which is mainly an inborn insulin deficiency conditions normally in an early age unlike type 2 diabetes which is an adult maturity onset diseases that does not require insulin injection
Both type 1 and type 2 diabetes are chronic conditions that affect how your body regulates blood sugar, but they differ in their root causes and how they manifest. Type 1 diabetes is an autoimmune disorder where the body's immune system mistakenly attacks and destroys insulin-producing beta cells in the pancreas, leading to an absolute insulin deficiency. In type 2 diabetes, the body either doesn't produce enough insulin or the cells become resistant to its effects, resulting in insulin resistance. Thus the pancreas produces little or no insulin. It is typically diagnosed in childhood or young adulthood, but can occur at any age. This requires lifelong insulin therapy, either through injections or an insulin pump.
In type 2 diabetes it is Insulin resistance (cells don't respond to insulin) and/or insufficient insulin production by the pancreas. The pancreas may produce insulin, but the body doesn't use it effectively, or the pancreas may eventually produce less insulin over time. This is more common in adults, but increasingly diagnosed in children and adolescents.
This diabetes is best treated through lifestyle changes such as through dietary modifications, nutrition and exercise but oral medications may still be indicated
In fact there are other highly effective natural plant-based medicine that has already being traditionally used for the treatment of diabetes here:
https://scientificlogic.
However, the results of the study using stem cells is only for type 1 diabetes that is much rarer, compared to type 2 due to bad lifestyle, and I don't think using stem cell therapy can stop or prevent our immune system from attacking the pancreatic cells or change our lifestyle, from the way all these patients live. It is the same as using drugs to "cure" bad habits and damaging lifestyles and personally I think what these scientists are doing is the same thing as doctors using chemicals they call "medicine" to "cure" a disease when the root causes are not addressed and removed. The root cause is just our bad lifestyle
Let me rewrite my comment using technical language for doctors and scientists.
Reversal of Type 1 Diabetes via Autologous Chemically-Induced Pluripotent Stem Cell-Derived Islet Transplantation: A Technical Perspective Incorporating Lifestyle Considerations
Abstract
A pioneering Phase I clinical trial led by Deng Hongkui at Peking University demonstrated that a 25-year-old patient with longstanding Type 1 diabetes achieved sustained insulin independence for over one year following transplantation of islet cells derived from her own chemically reprogrammed stem cells (CiPSC). Here, we summarize the clinical methodology, outcomes, and implications, and juxtapose them with the etiological distinctions between Type 1 and Type 2 diabetes, highlighting the importance of addressing root causes versus symptomatic “cure.”
Introduction:
Type 1 diabetes (T1D) is a chronic autoimmune condition characterized by destruction of pancreatic beta cells, leading to absolute insulin deficiency and lifelong dependence on exogenous insulin. In contrast, Type 2 diabetes (T2D) is predominantly metabolic that is driven by insulin resistance and insufficient insulin production, often associated with lifestyle factors, managed through diet, exercise, oral agents, and sometimes insulin.
While this stem-cell based approach may offer a functional cure for T1D, it does not address the autoimmune predisposition nor is applicable to T2D, which arises from fundamentally different pathophysiological and lifestyle-related causes.
Methods (Summary):
Cell Source & Reprogramming
Participants: The trial involved three T1D patients; the first showed sustained insulin independence, while the others have also reached positive one-year outcomes
Results:
Insulin Independence: The index patient ceased insulin therapy ~2.5 months post-transplant and remained insulin-free beyond one year, with ≥98% of daily glycemic readings in target range (Smithsonian)
Safety & Monitoring: No transplant-related abnormalities observed; MRI allowed for visualization and potential removal of graft if needed
Scope of Cure: While remarkable, true “cure” status may require sustained insulin production for up to five years
Discussion:
Advancements and Potential:
This landmark outcome demonstrates that T1D may be functionally reversed by restoring endogenous insulin production via autologous cell therapy, eliminating donor shortages and reducing immune suppression requirements.
Limitations & Considerations:
Autoimmune Recurrence: Since the patient was already under immunosuppression for a liver transplant, the trial couldn’t fully assess whether autoimmunity would target the new islets. Future strategies will need immunomodulatory or protective approaches.
Applicability to T2D: This approach does not apply to T2D, which stems from insulin resistance and lifestyle factors, and requires lifestyle modification rather than pure cellular replacement.
Lifestyle Dependencies. I think comparing cell therapy to drugs for treating root behavioral causes is justified. In T2D especially, durable management hinges on addressing diet, physical activity, and metabolic health, not just replacing or masking physiological deficits.
Ethical and Scalability Aspects:
Using chemically induced pluripotent stem cells avoids ethical concerns tied to embryonic stem cells and offers potentially scalable manufacturing routes
Conclusion:
The trial led by Deng Hongkui represents a historic step toward a functional cure for T1D via autologous CiPSC-derived islet transplantation. It offers unprecedented hope but must be interpreted within context: it does not alter the autoimmune etiology, requires confirmation of long-term efficacy, and remains inapplicable to lifestyle-driven T2D. Personalized regenerative therapies show promise, but the root causes of chronic diseases must still be proactively addressed.
References
1. Deng Hongkui’s team at Peking University achieved a world-first T1D reversal using autologous CiPSC islets, sustaining insulin independence for >1 year
3. The use of chemical reprogramming (small molecules) represents a refined technique over traditional genetic methods The ScientistPMC.
4. Evaluation of long-term cure requires continuous insulin production for up to five years The SunPMCSmithsonian Magazine.
5. Autoimmune relapse risk remains; transplantation under abdominal muscle sheath enabled monitoring and safety Cells4LifeThe ScientistSmithsonian MagazinePMC.
6. T2D is fundamentally different, rooted in lifestyle and insulin resistance, and best managed through systemic interventions beyond cellular therapy.
Alternative Natural Agents in the Management of Diabetes Mellitus
However, the results of the study using stem cells is only for type 1 diabetes that is much rarer, compared to type 2 due to bad lifestyle, and I don't think using stem cell therapy can stop or prevent our immune system from attacking the pancreatic cells or change our lifestyle, from the way all these patients live. It is the same as using drugs to "cure" bad habits and damaging lifestyles and personally I think what these scientists are doing is the same thing as doctors using chemicals they call "medicine" to "cure" a disease when the root causes are not addressed and removed. The root cause is just our bad lifestyle
Let me rewrite my comment using technical language for doctors and scientists.
Reversal of Type 1 Diabetes via Autologous Chemically-Induced Pluripotent Stem Cell-Derived Islet Transplantation: A Technical Perspective Incorporating Lifestyle Considerations
Abstract
A pioneering Phase I clinical trial led by Deng Hongkui at Peking University demonstrated that a 25-year-old patient with longstanding Type 1 diabetes achieved sustained insulin independence for over one year following transplantation of islet cells derived from her own chemically reprogrammed stem cells (CiPSC). Here, we summarize the clinical methodology, outcomes, and implications, and juxtapose them with the etiological distinctions between Type 1 and Type 2 diabetes, highlighting the importance of addressing root causes versus symptomatic “cure.”
Introduction:
Type 1 diabetes (T1D) is a chronic autoimmune condition characterized by destruction of pancreatic beta cells, leading to absolute insulin deficiency and lifelong dependence on exogenous insulin. In contrast, Type 2 diabetes (T2D) is predominantly metabolic that is driven by insulin resistance and insufficient insulin production, often associated with lifestyle factors, managed through diet, exercise, oral agents, and sometimes insulin.
While this stem-cell based approach may offer a functional cure for T1D, it does not address the autoimmune predisposition nor is applicable to T2D, which arises from fundamentally different pathophysiological and lifestyle-related causes.
Methods (Summary):
Cell Source & Reprogramming
Adipose-derived cells from the patient were chemically reprogrammed into induced pluripotent stem cells (CiPSCs), a method using small molecules instead of genetic factors PMC
Differentiation & Transplantation:
Differentiation & Transplantation:
These CiPSCs were differentiated into islet-like clusters (~1.5 million islets) and transplanted under the anterior abdominal wall sheath, enabling MRI monitoring and potential removal (Smithsonian)
Participants: The trial involved three T1D patients; the first showed sustained insulin independence, while the others have also reached positive one-year outcomes
Results:
Insulin Independence: The index patient ceased insulin therapy ~2.5 months post-transplant and remained insulin-free beyond one year, with ≥98% of daily glycemic readings in target range (Smithsonian)
Glycemic Control: Time-in-range increased from ~43% pre-treatment to ~96% by four months; HbA1c dropped to non-diabetic levels (~5%) by one year
Safety & Monitoring: No transplant-related abnormalities observed; MRI allowed for visualization and potential removal of graft if needed
Scope of Cure: While remarkable, true “cure” status may require sustained insulin production for up to five years
Discussion:
Advancements and Potential:
This landmark outcome demonstrates that T1D may be functionally reversed by restoring endogenous insulin production via autologous cell therapy, eliminating donor shortages and reducing immune suppression requirements.
Limitations & Considerations:
Autoimmune Recurrence: Since the patient was already under immunosuppression for a liver transplant, the trial couldn’t fully assess whether autoimmunity would target the new islets. Future strategies will need immunomodulatory or protective approaches.
Applicability to T2D: This approach does not apply to T2D, which stems from insulin resistance and lifestyle factors, and requires lifestyle modification rather than pure cellular replacement.
Lifestyle Dependencies. I think comparing cell therapy to drugs for treating root behavioral causes is justified. In T2D especially, durable management hinges on addressing diet, physical activity, and metabolic health, not just replacing or masking physiological deficits.
Ethical and Scalability Aspects:
Using chemically induced pluripotent stem cells avoids ethical concerns tied to embryonic stem cells and offers potentially scalable manufacturing routes
Conclusion:
The trial led by Deng Hongkui represents a historic step toward a functional cure for T1D via autologous CiPSC-derived islet transplantation. It offers unprecedented hope but must be interpreted within context: it does not alter the autoimmune etiology, requires confirmation of long-term efficacy, and remains inapplicable to lifestyle-driven T2D. Personalized regenerative therapies show promise, but the root causes of chronic diseases must still be proactively addressed.
References
1. Deng Hongkui’s team at Peking University achieved a world-first T1D reversal using autologous CiPSC islets, sustaining insulin independence for >1 year
2. PMCSmithsonian MagazineNatureThe ScientistTecScienceMedical News TodayCells4LifeThe Sun.
3. The use of chemical reprogramming (small molecules) represents a refined technique over traditional genetic methods The ScientistPMC.
4. Evaluation of long-term cure requires continuous insulin production for up to five years The SunPMCSmithsonian Magazine.
5. Autoimmune relapse risk remains; transplantation under abdominal muscle sheath enabled monitoring and safety Cells4LifeThe ScientistSmithsonian MagazinePMC.
6. T2D is fundamentally different, rooted in lifestyle and insulin resistance, and best managed through systemic interventions beyond cellular therapy.
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