Type 1 Diabetes Without Insulin
12 Patients Achieve Insulin Independence After Islet Cell Transplantation
Is it possible for someone with type 1 diabetes to no longer need insulin injections? The results of a clinical study conducted in the United States suggest that this goal may be achievable in selected patients through pancreatic islet cell transplantation combined with an innovative immunosuppressive treatment.
In June 2026, Eledon Pharmaceuticals announced remarkable preliminary results: all 12 patients who received pancreatic islet cell transplants as part of a research program involving tegoprubart achieved independence from externally administered insulin.
One of these patients is Katie Beth Hand, a woman who lived with type 1 diabetes for many years and was able to stop taking insulin following her transplant.
Her story has attracted considerable attention within the international diabetes community. For people who constantly monitor their blood glucose levels, calculate insulin doses, and live with the risk of hypoglycemia or hyperglycemia, the prospect of living without insulin injections is extraordinary.
However, an essential distinction must be made: insulin independence is not the same as a permanent cure for type 1 diabetes.
To understand the importance of these findings, we need to examine what pancreatic islet cell transplantation involves, how the new immunosuppressive treatment works, and what limitations remain before this approach can become widely available.
Why Do People With Type 1 Diabetes Need Insulin?
Type 1 diabetes is an autoimmune disease in which the immune system progressively destroys the pancreatic beta cells responsible for producing insulin.
Insulin is the hormone that allows the body to use and store glucose and helps regulate energy metabolism.
When insulin production becomes insufficient, blood glucose levels rise, and the body can no longer use glucose properly. Without treatment, severe metabolic complications can develop, including diabetic ketoacidosis.
Currently, most people with type 1 diabetes require externally administered insulin throughout their lives.
Technological advances have significantly improved diabetes management. Continuous glucose monitoring (CGM) systems, insulin pumps, and automated insulin delivery systems provide better glycemic control and reduce the daily burden of treatment.
However, these technologies do not replace the biological function of pancreatic beta cells.
For this reason, researchers have spent decades investigating ways to restore the body’s ability to produce insulin in people with type 1 diabetes.
One of these approaches is pancreatic islet cell transplantation.
What Is Pancreatic Islet Cell Transplantation?
The islets of Langerhans are groups of endocrine cells located in the pancreas. They contain, among other cells, beta cells that produce insulin and alpha cells that secrete glucagon.
During pancreatic islet cell transplantation, these structures are isolated from a donor pancreas and introduced into the recipient’s body.
Typically, the cells are infused through the portal venous system, reaching the liver, where some of them can engraft and begin functioning.
If the transplant is successful, the transplanted beta cells detect changes in blood glucose levels and release insulin in response.
This is fundamentally different from administering insulin through injections or an insulin pump.
An automated insulin delivery system adjusts insulin doses using glucose sensor readings and an algorithm. Functional beta cells respond biologically to changes in the metabolic environment.
Following a successful transplant, a patient may produce enough insulin to eliminate the need for externally administered insulin.
However, pancreatic islet cell transplantation is not a technology that first appeared in 2026. The procedure has been investigated for several decades, and some patients achieved insulin independence long before the recent studies.
The major challenge has been preserving the function of the transplanted cells and preventing their rejection by the immune system.
Katie Beth Hand’s Story: From Type 1 Diabetes to Insulin Independence
Katie Beth Hand is one of the participants in the clinical study conducted at the University of Chicago Medicine.
Before the transplant, her life was affected by the difficulties of managing blood glucose levels and the constant fear of severe hypoglycemia.
In an interview published by T1D Exchange in June 2026, Katie Beth explained that she sometimes preferred to keep her blood glucose levels higher than recommended to reduce the risk of hypoglycemia.
This fear was particularly significant at night, when she worried about experiencing severe hypoglycemia while sleeping.
Her experiences led her to investigate clinical trials that might offer an alternative to conventional treatment.
On January 13, 2026, Katie Beth received a transplant of pancreatic islets obtained from a donor.
The procedure involved introducing the cells into the portal circulation so they could reach the liver.
Unlike whole-organ transplantation, the intervention did not require major abdominal surgery.
The results appeared quickly. Approximately one week after the transplant, she stopped taking basal insulin, and by early March 2026, she no longer required externally administered insulin.
In other words, the transplanted cells were producing enough insulin to maintain glycemic control.
Katie Beth has become an example of the potential of this therapy. However, her experience must be understood in the context of an experimental clinical study involving specialized monitoring and ongoing immunosuppressive treatment.
What Is Tegoprubart, and Why Is It So Important?
Pancreatic islet cell transplantation involves introducing cells from a donor into the recipient’s body.
The recipient’s immune system may recognize these cells as foreign and destroy them. In addition, people with type 1 diabetes may experience autoimmune mechanisms similar to those responsible for the original disease, potentially affecting the transplanted beta cells.
Immunosuppressive medications are therefore necessary to prevent transplant rejection.
Traditional treatments frequently include calcineurin inhibitors, such as tacrolimus. Although effective in preventing rejection, these medications can cause significant adverse effects, including nephrotoxicity, hypertension, neurotoxicity, and impaired beta-cell function.
Tegoprubart is an experimental monoclonal antibody that targets CD40L, a molecule involved in immune cell activation and communication.
By blocking this signaling pathway, the medication aims to reduce the immune responses responsible for transplant rejection.
One potential advantage is the possibility of using an immunosuppressive regimen without calcineurin inhibitors.
This distinction is important because the objective of transplantation is not simply to keep the pancreatic cells alive, but also to preserve their ability to produce insulin.
Nevertheless, tegoprubart does not completely eliminate the need for immunosuppression, nor does it guarantee freedom from infections or other complications.
In the Chicago study, tegoprubart was administered as part of an immunosuppressive regimen that included other medications.
What Results Did the 12 Patients Achieve?
The results presented at the American Diabetes Association Scientific Sessions in June 2026 attracted attention because of the exceptionally high proportion of participants who achieved insulin independence.
The pilot study included 12 adults with long-standing type 1 diabetes. Their median diabetes duration was approximately 33 years, and their average HbA1c before transplantation was approximately 8%.
Following transplantation and administration of the tegoprubart-based immunosuppressive regimen, the following results were reported:
- All 12 patients achieved insulin independence.
- All participants had an HbA1c below 6.5% at their latest assessment.
- The average HbA1c at the latest assessment was approximately 5.4%.
- No severe hypoglycemic episodes were reported after transplantation.
- Transplanted islet function remained stable during the reported follow-up period.
These findings are particularly interesting because the participants had experienced recurrent severe hypoglycemia before transplantation.
However, the duration of follow-up must also be considered.
When the results were presented in June 2026, the median follow-up after transplantation was eight months, while the longest follow-up period reached 22 months.
Therefore, the data demonstrate a highly promising short- to medium-term clinical response, but they do not yet establish whether the transplanted cells will remain functional after five, ten, or twenty years.
What Has Happened With the Study Since June 2026?
In September 2026, Eledon Pharmaceuticals announced the expansion of the University of Chicago Medicine study to include three additional participants.
The company also reported submitting an Investigational New Drug (IND) application to the US Food and Drug Administration (FDA) for a company-sponsored clinical trial evaluating tegoprubart in the prevention of pancreatic islet transplant rejection.
At the same time, researchers began evaluating this strategy in patients with type 1 diabetes and chronic kidney disease.
This research direction is particularly important because patients with impaired kidney function are especially vulnerable to the toxicity associated with calcineurin inhibitors.
However, expanding clinical research and submitting documentation for new studies does not mean that tegoprubart has been approved for routine use in pancreatic islet cell transplantation.
Do These Results Mean That Type 1 Diabetes Has Been Cured?
Not in the sense of a permanent, universally applicable cure.
It is essential to distinguish between two concepts: a biological cure for the autoimmune disease and functional insulin independence.
In the case of transplantation, the body receives new cells capable of producing insulin. These cells may replace the function of the beta cells that were previously destroyed.
The patient may achieve normal blood glucose levels without administering insulin, which represents a major therapeutic accomplishment.
However, the underlying autoimmune predisposition is not necessarily eliminated, and the transplanted cells must be protected against immune rejection.
Furthermore, we do not yet know whether their function will be preserved for the rest of the patient’s life.
For this reason, the term functional cure may describe a situation in which a patient no longer requires externally administered insulin. However, it should not be confused with permanently eliminating the underlying autoimmune process.
Another important consideration is that patients do not become completely independent of medical treatment. They may stop taking insulin, but they continue to require immunosuppressive therapy, medical investigations, and ongoing monitoring.
Why Isn’t Pancreatic Islet Cell Transplantation Available to Everyone With Type 1 Diabetes?
If the results are so promising, it is reasonable to ask why transplantation cannot become the standard treatment for everyone with type 1 diabetes.
Several important obstacles remain.
First, pancreatic islets obtained from donors are available in limited quantities. Obtaining, isolating, and preparing these cells requires specialized laboratories and complex procedures.
In some cases, more than one islet infusion may be necessary to obtain a sufficient mass of functional cells.
Second, transplantation involves procedural risks, including bleeding, portal vein thrombosis, and other complications.
Third, the immunosuppressive treatment required to protect the transplanted cells can increase susceptibility to infections and cause other significant adverse effects.
These risks must be weighed against the potential benefits of eliminating the need for insulin.
For someone with well-controlled type 1 diabetes, no history of severe hypoglycemia, and access to modern diabetes technology, the benefit-risk balance may be very different from that of a patient experiencing recurrent severe hypoglycemia, impaired hypoglycemia awareness, and extremely difficult glycemic control.
For these reasons, pancreatic islet cell transplantation is currently reserved for carefully selected clinical situations, while the use of tegoprubart in this setting remains experimental.
What Are the Risks of Transplantation and Tegoprubart Treatment?
Although the preliminary results are encouraging, evaluating safety is essential.
The risks arise from both the transplantation procedure and the need for immunosuppressive therapy.
Tegoprubart aims to provide an alternative to tacrolimus, but this does not mean that the treatment is risk-free.
In preliminary data published in March 2026, researchers reported no episodes of transplant rejection or development of new donor-specific HLA antibodies. Furthermore, the nephrotoxicity, hypertension, and neurotoxicity frequently associated with calcineurin inhibitors were not identified.
However, adverse reactions associated with immunosuppression did occur and were managed, in some cases, by adjusting mycophenolic acid doses.
It is important not to interpret the absence of certain complications in a group of only 12 patients as proof that those complications cannot occur.
Larger studies and much longer follow-up periods are necessary to fully evaluate safety.
Is Pancreatic Islet Cell Transplantation the Same as Stem Cell Therapy?
No. Although both approaches aim to restore endogenous insulin production, the source of the cells is different.
In the Eledon study, patients received pancreatic islets obtained from human donors.
By contrast, stem cell-based therapies attempt to produce insulin-secreting cells in the laboratory by differentiating stem cells into cells resembling pancreatic beta cells.
This approach could eventually reduce dependence on the limited number of organ donors.
However, laboratory-derived cells must function appropriately and be protected from the immune system.
Some research programs are investigating combinations of insulin-producing cells with encapsulation devices or genetic engineering technologies to reduce the need for systemic immunosuppression.
These strategies differ from conventional pancreatic islet transplantation and are currently at various stages of clinical development.
When Could This Treatment Become Available to People With Type 1 Diabetes?
There is currently no reliable timeline for when a tegoprubart-based regimen might become available as a routine treatment.
The results obtained so far come from a small pilot study, and approval of a medication for a specific indication requires demonstrating efficacy and safety through an appropriate clinical and regulatory development program.
In addition, pancreatic islet cell transplantation requires specialized infrastructure, access to donor-derived cells, and multidisciplinary medical monitoring.
Even if tegoprubart receives the necessary regulatory approvals in the future, pancreatic islet transplantation is unlikely to immediately become a treatment option for everyone with type 1 diabetes.
Initially, this strategy may be most relevant for patients experiencing recurrent severe hypoglycemia or major difficulties maintaining glycemic control despite optimized treatment.
What Does This Discovery Mean for People Living With Type 1 Diabetes Today?
For patients, the most important news is that research is beginning to produce concrete clinical results in restoring insulin secretion.
We are no longer talking exclusively about laboratory experiments or animal studies, but about people who, after decades of living with type 1 diabetes, have managed to live without insulin injections for months and, in some cases, more than a year.
However, these results should not encourage patients to stop taking insulin or delay their diabetes care while waiting for a future treatment.
Insulin remains a life-saving therapy for people with type 1 diabetes who do not produce sufficient amounts of their own insulin.
Continuous glucose monitoring, appropriate insulin administration, diabetes education, and complication prevention remain fundamental components of care.
Conclusion: Are We Getting Closer to a Cure for Type 1 Diabetes?
The results of the study conducted at the University of Chicago Medicine represent an important advance in pancreatic islet cell transplantation research.
The fact that all 12 patients achieved insulin independence, with excellent HbA1c levels and no severe hypoglycemic episodes reported after transplantation, is encouraging.
However, these findings must be interpreted in context. This was a pilot study involving a small number of participants, a relatively limited follow-up period, and an intervention that requires ongoing immunosuppression.
What these results demonstrate is that insulin independence can be achieved by replacing destroyed beta cells under certain clinical conditions. What they do not yet demonstrate is a permanent cure for type 1 diabetes.
Katie Beth Hand’s story nevertheless offers a genuine reason for optimism. After years of insulin treatment and fear of hypoglycemia, she achieved glycemic control without externally administered insulin.
The next challenge for researchers is to make this independence durable, safe, and accessible to a much larger number of patients.
References
- Eledon Pharmaceuticals. Eledon Announces Updated Data from Investigator-Initiated Islet Transplant Trial of Tegoprubart in Patients with Type 1 Diabetes at UChicago Medicine. June 8, 2026.
- T1D Exchange. Inside the Eledon Islet Cell Transplant Trial: Katie Beth Hand’s Journey to Insulin Independence. June 3, 2026.
- Eledon Pharmaceuticals. Updated Data from Investigator-Initiated Islet Transplant Trial. March 16, 2026.
- Eledon Pharmaceuticals. Islet Cell Transplantation IND Submission and Expansion of Clinical Programs. September 3, 2026.
Article updated: November 4, 2026. The results involving 12 participants are preliminary findings reported by the company and presented at the ADA 2026 Scientific Sessions. They should not be interpreted as evidence of a permanent cure or established long-term efficacy.
Visiting Romania and need a prescription?
- Forgot your regular medication at home?
- Running out of your chronic treatment?
- Need a prescription for a medication while travelling in Romania?
Dr. Petrache’s Virtual Clinic offers an online prescription service for foreign visitors in Romania.
Simply send us an email with your prescription request and the relevant medical information. If the medication can legally and safely be prescribed, you will receive payment instructions and your prescription will be sent to you electronically.
No clinic visit required.
📧 clinica@diabet-si-nutritie.ro
🌐 Dr. Petrache’s Virtual Clinic – Services for Foreigners
Prescriptions are issued at the physician’s discretion and in accordance with Romanian legislation. Certain medications cannot be prescribed through this service.
Follow us on:
- FaceBook: Diabetes & Nutrition;
- YouTube: Diabetes Facts.
