A World-First in Cure Research

When you think of treatments for type 1 diabetes that feel like a cure, islet cell transplants often come to mind — but they carry big trade-offs. One of the most promising recent studies may finally be changing that picture.

Researchers from Sana Biotechnology, in collaboration with Uppsala University Hospital, have just published results from a first-in-human trial where engineered islet cells were transplanted into a person with T1D without any immunosuppressant drugs. Here’s how it works — and what it might mean for all of us.

What Was Done?

Researchers started with donor islet cells — the tiny insulin-producing clusters normally found in the pancreas — and used cutting-edge gene editing to “cloak” them from the immune system. Normally, a transplant like this would trigger an immune attack, which is why traditional islet recipients need powerful immune-suppressing drugs. These cells, though, were engineered with Sana’s “Hypoimmune” technology, which changes certain surface proteins and adds molecular signals that say, “don’t attack me.”

Instead of being infused into the liver (the usual location for an islet transplant), these immune-invisible cells were injected directly into the forearm muscle. This simpler site lets doctors monitor and, if needed, retrieve the graft, while avoiding some of the risks of liver infusion. The goal wasn’t to make this person insulin-free yet — researchers deliberately used a small number of cells to test safety first — but to see if they could survive and function without the usual immune suppression. And they did!

Why They Chose Deceased-Donor Cells Instead of Lab-Grown

Donor Islet Cells (from deceased donor)	Stem-Cell-Derived / Lab-Grown
Pros: Already functional islets; shorter path to clinical use in trials where donor tissue is available.	Pros: Potential to scale up; supply isn’t limited by donor organs; more uniform and modifiable.
Cons: Limited supply; donor matching & variability; usual risk of immune rejection; ethical and logistical constraints.	Cons: More complicated differentiation; ensuring maturity and function; risk of unwanted growth or misdifferentiation; regulatory hurdles.

The current study used donor islet cells, engineered for immune evasion. The stem-cell-derived version (Sana calls it SC451) is under development.

Why the Patient Still Needs Insulin

Even though the transplanted islet cells survived and produced insulin (as shown by measurable C-peptide levels, especially after meals), they were transplanted at a low dose. The aim was primarily to test safety, immune evasion, and initial function — not yet to fully replace all insulin needs.

Also, because the number of functional cells is still far less than the total insulin-making capacity a pancreas has, the body still needs injected or pumped insulin for full glucose control. It’s early days.

Next Steps in Research

The journey is far from over, but this first success has opened the door to some exciting next steps. Researchers will keep following this participant for months to watch how long the cells survive and how well they keep making insulin. They’re already planning to treat more people, gradually increasing the number of transplanted cells to see if they can provide enough insulin to reduce — or even eliminate — the need for injections.

Another big milestone will be moving from donor islets to stem-cell-derived islets that can be made in the lab. That would solve the problem of limited donor supply and make this therapy available to far more people. If those lab-grown cells can be made immune-invisible too, it could be a truly scalable cure.

Timeline: When Might I Be Available?

It’s always tricky to predict, but here are realistic estimates based on what’s public:

Now to ~1 year: More trial data (longer follow-ups from this participant), small number of participants; deeper safety data collection.

1-3 years: Early phase trials with more people; possibly using larger doses; beginning regulatory interactions.

3-5 years: If things go well, moving into larger, multi-site trials (Phase 2/3), approvals, and scaled production (especially of the stem-cell-derived version).

5+ years: Broader market availability for selected patients, if safety, efficacy, and manufacturing are solid. (Back to that magic 'cure in 5 years' number 🙃 #skeptical)

Of course, all that depends on trial results, funding, regulatory approval, manufacturing, and long-term safety. But this new data suggests we are much closer to a therapy that doesn’t require immunosuppression.

What This Means for the T1D Community

For anyone living with type 1 diabetes, this research represents hope. Imagine being able to live with a working set of insulin-producing cells again — no constant carb counting, no alarms in the middle of the night — and doing it without the risks that come with immune-suppressing medication. That’s what makes this such a landmark moment: it’s the first time we’ve seen transplanted islets survive and work in a person without those drugs.

Of course, this isn’t something you can sign up for tomorrow. There’s still a lot of science and safety testing ahead, and the first people to access these therapies will likely be those with the greatest medical need (such as severe hypo-unawareness). But the direction of travel is clear — and for many in the T1D community, this feels like the first real glimpse of a future where insulin injections might be a story we tell our grandkids.