Type 1 diabetes therapy reference (2026)

Type 1 diabetes therapy in 2026 organises around three modalities.

Insulin delivery: rapid-acting and basal insulin analogues remain foundational. Automated insulin delivery (AID) systems, also called closed-loop or hybrid closed-loop systems, combine continuous glucose monitoring with insulin pumps and algorithm-controlled dosing; these are the modern standard for patients with access. Smart pens and connected meters extend connectivity to multiple-daily-injection users.

Disease modification: teplizumab (anti-CD3 monoclonal antibody) delays clinical T1D onset in stage 2 disease (positive autoantibodies plus dysglycaemia) and is now in active commercial use; expanded screening of high-risk relatives is becoming part of T1D-care infrastructure. Other mechanism classes are in late-stage trials.

Beta-cell replacement: islet transplantation has been an option for selected patients but is constrained by donor supply. Allogeneic stem-cell-derived beta-cell replacement programs (vertex-style and others) are reading out in pivotal trials with the proposition of insulin independence from a renewable cell source. Encapsulation approaches that avoid systemic immunosuppression are in active development.

The diagnostic-pathway and screening question is now layered. Detection of stage 2 T1D in high-risk relatives enables disease-modifying intervention; broader population-level screening is in active trial.