The science is advancing faster than the infrastructure to deliver it.
Cell therapy trials show promise but face barriers: narrow eligibility criteria and immunosuppression challenges limit access and slow progress toward widespread clinical use. Disease-modifying therapies advancing on multiple fronts: new metrics for measuring beta cell preservation, immune system retraining approaches, and real-world data on Tzield treatment initiation.
- Over 11,000 attendees at ADA 2026 in New Orleans
- Six pediatric centers screened 1,700+ children; zero DKA cases at diagnosis
- 94% of Tzield patients completed the full 14-day treatment course
- Eli Lilly's tirzepatide trials fully enrolled with results expected soon
- SAB-142 phase 1 preserved C-peptide and reduced insulin use with mild side effects
Breakthrough T1D reports on cutting-edge T1D research presented at ADA 2026, highlighting progress in cell therapies, disease-modifying treatments, early detection, and GLP-1 receptor agonists for improved patient outcomes.
New Orleans is hosting the American Diabetes Association's 86th Scientific Sessions this week, and the energy in the convention halls reflects a field in motion. Over 11,000 researchers, clinicians, and industry partners have gathered to present and absorb the latest work in type 1 diabetes treatment—and the progress being reported suggests the conversation around what's possible for T1D patients is shifting in real time.
Breakthrough T1D, the research organization funding much of this work, is on the ground documenting what's emerging. The first two days have surfaced a pattern: the science is advancing faster than the infrastructure to deliver it. In a panel on manufactured islet cell therapies—where researchers grow insulin-producing cells in the lab and transplant them into patients—Sanjoy Dutta, the organization's Chief Scientific Officer, highlighted a central bottleneck. Clinical trial eligibility requirements are too narrow. This means fewer people can participate, trials move more slowly, and the field learns less about who might actually benefit. The panelists agreed on priorities: more companies need to explore novel approaches, trial eligibility must expand, and the T1D community's voice has to be built into regulatory decisions from the start. There's also the matter of immunosuppression—the drugs patients must take to prevent their immune system from attacking the transplanted cells. Those drugs carry their own risks and side effects. Researchers are working on ways to protect the cells or retrain the immune system to leave them alone, but that work is still early.
A separate session focused on islet cell therapy for children painted a picture of cautious optimism. Melena Bellin from the University of Minnesota shared data on children who had their pancreases removed due to pancreatitis and received transplants of their own healthy islet cells. These children showed higher rates of cell survival and function than adults in similar situations, and many stopped needing insulin altogether. But the researchers were clear: we are at the very beginning of understanding what these therapies might look like for the pediatric population. The psychosocial dimensions matter too—how families cope with the hope and uncertainty, how children experience the process.
Disease-modifying therapies—drugs that slow or stop the autoimmune attack on beta cells—are advancing on multiple fronts. Samuel Wu at the University of South Florida presented work on a new metric called time to minimal residual C-peptide, or TMRCP. C-peptide is a simple blood marker of how much insulin a person's body is still making. Wu applied this metric to six existing trials and found it identified the same effective treatments as the original analyses. This matters because it could speed up future trials by providing a faster, clearer way to measure whether a drug is working. Meanwhile, real-world data on Tzield—an immunotherapy already approved for early T1D—showed that 94 percent of people who started the 14-day treatment course completed it, and that the timing of diagnosis (whether blood sugar problems or autoimmune markers showed up first) influenced when people began treatment. Kenneth Brayman at the University of Virginia presented two Breakthrough T1D-funded projects: one on an immune therapy called IgM that retrained the immune system in mouse models, and another on a drug called N-104 that appeared to suppress autoimmunity while promoting beta cell regeneration in preclinical work. Christoph Bausch from SAB Biotherapeutics reported phase 1 results for SAB-142, a humanized ATG that preserved C-peptide, improved time in range, and reduced insulin use—with mild side effects and the ability to be safely re-dosed. A phase 2b trial called SAFEGUARD is now enrolling.
Early detection is also gaining traction. Six pediatric endocrinology centers screened over 1,700 children between June 2024 and February 2026 through quality improvement efforts—integrating screening into routine workflows, educating patients and healthcare providers, and coordinating follow-up. The result: no cases of diabetic ketoacidosis at diagnosis, 85 percent engaged in long-term monitoring, and 73 percent offered Tzield. The message is straightforward: screening works, and it prevents the most dangerous complication of T1D onset.
GLP-1 receptor agonists—drugs originally developed for weight loss and now being studied in T1D—dominated several sessions. Roche discontinued its dual GLP-1/GIP agonist acmopatide despite phase 2 data showing reduced blood sugar, weight, insulin dose, and blood pressure. But Eli Lilly's tirzepatide trials are fully enrolled with results expected soon, and a Breakthrough T1D-funded trial showed that semaglutide improved both blood sugar and metabolic health in people with T1D and obesity. Experts recently published a consensus statement on safe use of this drug class in T1D—authored in part by Brynn Marks, Breakthrough T1D's Senior Director of Medical Affairs—giving healthcare providers the guidance they need. Michelle Van Name at Yale presented on GLP-1s for adolescents, noting that young people with T1D often struggle with insulin resistance and obesity, and that early intervention could reduce their lifetime risk of heart and kidney complications. Two trials are now enrolling to test these drugs in younger populations.
The final theme running through these two days is unmet need. Richard Pratley presented work on older adults with T1D, a heterogeneous group for whom setting blood sugar targets is complicated by variable life expectancy, other health conditions, and a lack of evidence. He's executing a Breakthrough T1D-funded trial to repurpose heart and kidney drugs from type 2 diabetes for type 1. Viral Shah and colleagues published a framework for ketone monitoring and management—critical because DKA rates are rising globally. And a multinational survey of adults using T1D technology who experience severe low blood sugar showed they report poor health and significant work impairment, a reminder that despite all this progress, the lived experience of T1D remains difficult. The conference continues, and more data will emerge. But the pattern is clear: the field is moving from asking whether these therapies can work to asking how to make them work for everyone who needs them.
Citações Notáveis
Trial eligibility requirements are too narrow, which means fewer people can participate and trials move more slowly.— Sanjoy Dutta, Ph.D., Chief Scientific Officer, Breakthrough T1D
We are at the very beginning of considering what these therapies might look like in the pediatric T1D population.— Breakthrough T1D researchers on islet cell therapy for children
A Conversa do Hearth Outra perspectiva sobre a história
Why does it matter that trial eligibility is too narrow for islet cell therapy?
Because right now, only a small slice of people with T1D can even try these therapies. If you don't fit the criteria, you don't get to see if it works for you. And if fewer people are in trials, researchers learn less about who benefits and how to make the therapy safer and better. It's a bottleneck that slows everything down.
What's the immunosuppression problem, exactly?
When you transplant cells, your immune system sees them as foreign and attacks them. So patients have to take drugs to suppress their immune system. But those drugs have their own side effects and risks. The real goal is to either protect the cells so the immune system can't reach them, or retrain the immune system to leave the cells alone. That's harder than it sounds.
Why is C-peptide important as a measure?
It's a simple blood test that shows how much insulin your body is still making. If a drug preserves C-peptide, it means it's preserving your own beta cells. The new metric—time to minimal residual C-peptide—could let researchers know faster whether a drug is actually working, which speeds up trials.
The data on Tzield completion was striking. Why did 94 percent of people finish the course?
It's a 14-day treatment, which is short and manageable. But more importantly, people with early T1D are motivated. They know they're at the beginning of the disease. If there's a chance to delay or stop it, they'll do the work. That's different from a chronic disease where people are already exhausted.
What surprised you about the GLP-1 data?
That Roche stopped their trial despite good results. It suggests the business case didn't work out, even though the drug worked. But Lilly is moving forward, and the real-world evidence from Breakthrough T1D's semaglutide trial shows these drugs genuinely help people with T1D and obesity. The question now is whether they work in younger people and whether we can prevent long-term complications.
Why is DKA prevention such a big deal?
Diabetic ketoacidosis is the most dangerous acute complication of T1D. It can kill you. If screening catches people early and they start treatment, DKA doesn't happen at diagnosis. That's not a small thing. And rates are rising globally, so this matters more now than it did five years ago.