Signals Inbox·August 30, 2026·Biopharma

Did China just find a cure for diabetes?

China has not cured diabetes in general, but it has now done something far bigger than another promising lab experiment: several people with severe type 1 diabetes have regained meaningful insulin production from stem-cell-derived islets, and some have stayed off insulin for years.

Q1Why are people saying China cured diabetes now?

China’s diabetes “cure” headlines are more credible today than they were even a year ago because several Chinese patients have now regained meaningful insulin production after receiving laboratory-grown pancreatic islets.

The biggest recent change came from Shanghai Changzheng Hospital and the Chinese Academy of Sciences. A study published in The Lancet Diabetes & Endocrinology reported results from three people with severe type 1 diabetes whose own pancreatic beta-cell function had essentially disappeared. Researchers transplanted pancreatic islet tissue grown from stem cells, and all three showed substantial recovery of islet function.

One adult eventually stopped external insulin completely. A 15-year-old girl went from spending only 25% of her time in the target glucose range to 94%, while her severe hypoglycemic episodes disappeared. Another patient produced strong beta-cell function after treatment before losing it again when immunosuppression was stopped.

A separate Chinese program led by Peking University had already made a 25-year-old woman with type 1 diabetes insulin-independent after transplanting islets made from her own chemically reprogrammed cells. A recent Chinese Academy of Sciences update says the benefit in that program has now lasted nearly three years.

So the excitement is coming from an accumulation of human results. Chinese researchers are no longer showing that stem-cell-derived beta cells work in mice or produce a little insulin in humans. They are showing that transplanted tissue can take over a large part, and sometimes essentially all, of a patient's insulin production for years.

Q2What did Chinese researchers actually put inside diabetes patients?

Chinese researchers are essentially building replacement pancreatic islets outside the body and transplanting them into people whose own insulin-producing cells no longer work.

The Shanghai team begins with blood cells from either the patient or a healthy donor. Researchers reprogram those cells into induced pluripotent stem cells, create a more specialized type called endoderm stem cells, and then turn those into clusters of pancreatic cells known as E-islets.

Those E-islets can sense changes in blood glucose and release insulin, much like natural pancreatic islets. Doctors deliver them through the portal vein so they settle in the liver and begin functioning there.

The Shanghai approach is unusually interesting from a manufacturing perspective. According to the Chinese Academy of Sciences, starting from endoderm stem cells cuts the final differentiation process from roughly 40 days to about 14 days. The cells are also already committed to becoming tissues such as the pancreas, which reduces the risk of producing unrelated cell types.

The Peking University program takes a different route. Researchers chemically reprogram a patient's own cells into pluripotent stem cells, manufacture pancreatic islets from them, and implant those islets beneath the abdominal muscles. That location makes the graft easier to monitor and potentially easier to remove if something goes wrong.

So there are now two Chinese approaches to the same problem, built on slightly different technology.

Chinese stem-cell islet programs compared

Q3Does “cure” actually describe what China achieved?

For Chinese type 1 diabetes stem-cell therapy today, “functional cure” is a reasonable description for selected patients, while “complete cure” still goes too far.

Someone with type 1 diabetes normally needs external insulin because the immune system has destroyed the beta cells that make it. If new cells restore normal insulin production, stabilize glucose and allow that person to stop insulin injections, the missing biological function has genuinely returned.

That is much more than simply controlling diabetes better.

The remaining problem is the autoimmune disease itself. Type 1 diabetes develops because the immune system attacks beta cells. Replacing the destroyed cells does not automatically erase that immune response.

The Shanghai study gave us unusually direct evidence of this. One woman received E-islets made from her own cells and recovered strong beta-cell function under a full immunosuppressive regimen. After she stopped those drugs, five monitored islet autoantibodies became positive and the new beta-cell function disappeared within months.

That gives us a clean split that headlines often blur. Chinese researchers have shown that insulin production can be rebuilt. They have not shown that the autoimmune attack can be permanently removed.

For patients who stay insulin-free while taking immunosuppressive drugs, “functional cure under immunosuppression” is currently the clearest description.

Q4Did Chinese type 1 diabetes patients really stop taking insulin?

Yes. Chinese stem-cell treatments have already allowed some people with type 1 diabetes to stop insulin completely, and the improvement is far larger than a modest reduction in insulin use.

The clearest Shanghai case involved a 45-year-old man with fulminant type 1 diabetes and recurrent severe hypoglycemia. Before the transplant, his HbA1c was 7.2% and he spent 71% of his time in the target glucose range.

After receiving donor-derived E-islets, his HbA1c fell to 5.7% and his time in range reached 100%. He stopped external insulin 36 weeks after transplantation and has remained insulin-independent for more than two years.

The separate Peking University case produced a similar result through a different technology. The 25-year-old woman had essentially no detectable endogenous insulin production before treatment. Seventy-five days after receiving islets manufactured from her own chemically reprogrammed cells, she stopped insulin. Her time in range eventually exceeded 98%, with HbA1c around 5%.

Not every Chinese patient has reached that point. The 15-year-old treated in Shanghai still needed some insulin despite going from 25% to 94% time in range and eliminating severe hypoglycemia.

That spread of outcomes is useful. The therapy can clearly restore a large amount of insulin production, but insulin independence is not automatic.

Q5Why did one Chinese type 1 diabetes patient lose the new beta cells?

One Chinese patient lost her regenerated beta-cell function after stopping immunosuppressive drugs, which gives us some of the strongest evidence yet that the original type 1 diabetes autoimmunity remains active.

The patient was a 30-year-old woman who had lived with type 1 diabetes for 18 years. Her first autologous E-islet transplant, combined with relatively light immunosuppression, produced little improvement.

A second transplant used the full Edmonton-style immunosuppression traditionally used for pancreatic islet transplantation. Her response changed dramatically. HbA1c fell from 8% to 6.8%, time in range rose from 48% to 97%, and daily insulin use dropped from 54 units to eight. Her C-peptide, which reflects the body's own insulin production, returned to a normal range.

She later stopped taking the immunosuppressive drugs. All five monitored islet autoantibodies turned positive, and the recovered beta-cell function disappeared within roughly five months.

This case is especially revealing because the replacement cells came from the patient's own body. Ordinary donor rejection cannot explain the failure. Her autoimmune disease attacked her newly created beta cells again.

Using a patient's own stem cells therefore solves one immune problem, compatibility with another person's tissue, while leaving the original type 1 diabetes autoimmunity unresolved.

Q6Do Chinese diabetes stem-cell patients still need immunosuppressive drugs?

Yes. The successful Chinese type 1 diabetes stem-cell transplants currently still depend on long-term immunosuppression.

That requirement sharply limits who should receive the treatment today.

The Shanghai researchers concluded that even autologous E-islets need strong immune protection because type 1 diabetes can attack the replacement cells. The Peking University case cannot prove otherwise: that patient had previously undergone liver transplants and was already taking immunosuppressive drugs before receiving the new islets.

These medicines carry their own risks, including serious infections, kidney toxicity and some cancers. For someone suffering recurrent life-threatening hypoglycemia despite modern insulin therapy, accepting those risks may make sense. For someone managing type 1 diabetes reasonably well with a continuous glucose monitor, insulin pump and modern insulin, the trade-off is much less obvious.

Researchers elsewhere are now trying to remove this limitation completely. In Sweden, Uppsala University researchers working with Sana Biotechnology transplanted gene-edited donor islets designed to hide from immune attack into a person with type 1 diabetes without giving immunosuppressive drugs. According to Sana's latest 14-month update, those cells were still alive and producing insulin.

The transplanted dose was deliberately too small to make that patient insulin-independent, so we cannot compare the efficacy directly with the Chinese cases. But the experiment attacks what has now become the central bottleneck for the whole field: keeping replacement beta cells alive without suppressing the immune system.

Q7How many diabetes patients have actually received these Chinese treatments?

The published Chinese evidence still involves only a handful of diabetes patients, so we have moved beyond a one-person curiosity without getting anywhere close to proof that the treatment works reliably across a broad population.

The newest Shanghai paper describes three people with type 1 diabetes. The landmark Peking University paper initially gave detailed results from one type 1 patient. The earlier Shanghai work on type 2 diabetes focused on one patient.

Other participants have been treated in these research programs, but full peer-reviewed patient-level outcomes are not yet available for a large cohort.

That distinction is important when reading headlines. One patient can prove that a treatment is biologically possible. Several patients can show that the effect is reproducible enough to justify a clinical trial. Approval requires a much stronger evidence base.

That transition is now underway. E-islet 01, the standardized donor-derived version of the Shanghai technology, has entered a registered Phase 1/2a study targeting 21 adults with type 1 diabetes, very low C-peptide, impaired awareness of hypoglycemia or recent severe hypoglycemia.

Twenty-one patients will still be a small study, but it changes the type of evidence we can expect. Researchers can test the same product, dose, manufacturing process and predefined endpoints across a group rather than tailoring an experimental transplant around individual patients.

Today, that trial is much more important for judging whether E-islets can become a real medicine than another spectacular single-patient story.

Q8Have the Chinese diabetes results lasted long enough to count as a cure?

The Chinese diabetes results have now lasted years rather than months, although we still do not have the five- to ten-year durability that a genuine long-term cure would need.

Short-lived insulin production would be much less interesting. Transplanted cells could temporarily work and then disappear as immune attack, graft exhaustion or other problems accumulate.

That has not happened quickly in the strongest Chinese cases.

As seen above, the Shanghai man who stopped insulin has remained insulin-independent for more than 26 months. A recent Chinese Academy of Sciences update on the separate Peking University program says its stem-cell islet results have lasted nearly three years.

Those durations are already clinically meaningful. They make a temporary burst of insulin secretion increasingly unlikely.

We also have a useful historical benchmark. The FDA's review of Lantidra, which uses pancreatic islets taken from deceased donors rather than stem cells, found that 21 of 30 recipients achieved at least one year without insulin. Ten stayed insulin-independent for more than five years.

That tells us the standard the Chinese therapies eventually have to meet. Two or three years of functioning cells is impressive. Five to ten years would make the durability argument much stronger, particularly because these treatments are intended as one-time procedures.

Q9Did China also cure type 2 diabetes?

China produced a remarkable stem-cell result in one person with type 2 diabetes, but this approach currently makes much more sense for severe insulin deficiency than for ordinary type 2 diabetes.

The patient was a 59-year-old man who had lived with type 2 diabetes for 25 years. His pancreatic islet function was badly impaired, he needed insulin, and diabetic kidney disease had already led to a kidney transplant.

Researchers created personalized E-islets from his own cells and transplanted roughly 1.2 million islet equivalents through the portal vein.

His insulin requirement steadily fell until insulin was stopped completely at week 11. Acarbose and metformin were later discontinued as well. His HbA1c fell from 6.6% before treatment to 5.5% at week 85 and 4.6% at week 113. During the 116-week follow-up reported in Cell Discovery, severe hyperglycemia and hypoglycemia disappeared.

It is an extraordinary result for that patient.

We should be much more careful about extending it to typical type 2 diabetes. Most type 2 diabetes involves a combination of failing beta cells and insulin resistance across the liver, muscle, fat and other tissues. Adding new insulin-producing cells does not directly fix those other metabolic problems.

The researchers also acknowledged that they could not completely exclude some recovery in the patient's remaining natural islets.

For now, stem-cell islet replacement looks most compelling in people whose diabetes has progressed to severe loss of insulin production. Calling this a general cure for type 2 diabetes would be far ahead of the evidence.

Q10Is China actually ahead of Vertex in the diabetes cure race?

China is clearly near the front of the diabetes stem-cell race, but Vertex currently has the stronger multi-patient evidence that manufactured islets can reliably make people insulin-independent.

Vertex's zimislecel uses fully differentiated stem-cell-derived pancreatic islets infused into the portal vein. Patients also receive immunosuppressive treatment.

The New England Journal of Medicine reported 12 full-dose recipients with at least one year of follow-up. Every one of them avoided severe hypoglycemic events, had HbA1c below 7% and spent more than 70% of their time in the target glucose range. Ten of the 12, or 83%, were insulin-independent after one year.

No Chinese program has yet published a standardized cohort of that size with comparable results.

China does have several genuine advantages. The Shanghai group has demonstrated both autologous and donor-derived E-islets, directly documented autoimmune recurrence after an autologous transplant, and developed an endoderm-based manufacturing process that is much shorter than many conventional stem-cell differentiation protocols. The Peking program has demonstrated a different personalized chemical-reprogramming route.

The field now has several leaders pursuing different versions of the same idea. Nobody has solved diabetes yet.

Leading stem-cell islet programs compared

Q11How risky is China's stem-cell diabetes treatment?

China's stem-cell diabetes treatment has looked encouraging in the small number of patients treated so far, but the biggest current risks come from immunosuppression, transplantation and the uncertainty of putting manufactured cells into the body for decades.

Immunosuppression is the clearest known problem. Weakening the immune system enough to protect transplanted beta cells increases susceptibility to infections and can cause kidney damage and other complications.

We can see the seriousness of that trade-off in the wider field. In Vertex's zimislecel study, neutropenia was the most common serious adverse event and occurred in three participants. Two participants died during follow-up, one from cryptococcal meningitis and another after progression of pre-existing severe neurocognitive disease. Those cases have different causes and should not all be attributed directly to the transplanted cells, but they show why long-term immune suppression deserves as much attention as insulin independence.

The transplantation itself also carries risk because several programs infuse cells into the liver through the portal vein. Bleeding, thrombosis and procedural complications are already known from conventional pancreatic islet transplantation.

Stem cells add another long-term concern: unwanted cell growth. A small number of residual immature cells could theoretically form abnormal tissue or tumors. The Chinese groups run extensive purification and safety testing before transplantation. In the 116-week Chinese type 2 case, researchers found no tumor formation, and Shanghai's endoderm stem cells are designed to avoid continued proliferation after transplantation.

Those findings are reassuring rather than definitive. Rare safety problems often become visible only after many more people have been treated and followed for much longer.

Q12Can China actually manufacture enough stem-cell islets for millions of diabetes patients?

China is much closer to scalable islet manufacturing than the early case reports suggest, although nobody has yet proved that these therapies can be produced cheaply enough for mass diabetes treatment.

Shanghai's E-islet technology was designed partly around manufacturing. Instead of repeatedly guiding fully pluripotent cells through a long sequence of developmental stages, researchers establish endoderm stem cells that are already much closer to becoming pancreatic tissue.

According to the Chinese Academy of Sciences, that cuts the final production process from around five or six weeks to roughly two weeks.

The program has lately moved beyond bespoke academic production. A recent Chinese Academy of Sciences report said E-islet 01 can now be produced through a standardized, scalable process with traceable manufacturing and consistent quality. The product has also received permission to enter clinical trials from regulators in both China and the United States.

A separate development from Peking University shows how seriously Chinese teams are taking the manufacturing problem. Researchers recently unveiled an automated platform that starts with a blood sample and handles chemical reprogramming, AI-assisted cell screening and quality inspection. The goal is to make personalized stem-cell production more precise, faster and cheaper.

The economics of the two approaches are very different. Personalized cells require a production run for each patient. A standardized donor-derived E-islet product could potentially be manufactured in batches and used across many patients.

If immune rejection can eventually be solved, that second model could look much more like an ordinary pharmaceutical manufacturing business than an organ-transplant system.

That is a major change from traditional islet transplantation, where every treatment begins with the scarce pancreas of a deceased donor.

Q13Can someone with diabetes get China's stem-cell treatment today?

No. Chinese stem-cell islet therapy currently remains experimental and cannot be booked as routine diabetes care.

The most advanced Shanghai product, E-islet 01, is still being tested clinically.

Its registered Phase 1/2a study targets 21 adults between 18 and 75 with type 1 diabetes lasting more than five years, almost no remaining C-peptide production and either severe hypoglycemia or impaired awareness of hypoglycemia.

Those criteria show how doctors currently see the risk-benefit equation. Researchers are starting with patients who have unusually dangerous diabetes rather than people managing the disease reasonably well with modern insulin therapy.

E-islet 01 has received investigational-drug clearance in China and the United States. That allows clinical testing. It does not mean regulators have approved the treatment for commercial use.

Chinese researchers have talked publicly about eventual commercialization if the clinical program succeeds, and one Shanghai team has mentioned 2029 as a possible target. We should treat that as an ambition rather than a reliable launch date. Larger trials, manufacturing validation, long-term safety data and regulatory review still have to happen.

Anyone currently advertising a commercially available Chinese “stem-cell cure for diabetes” is therefore offering something very different from the regulated research behind these published results.

Q14What still has to happen before stem-cell therapy really cures type 1 diabetes?

Stem-cell therapy needs to clear three big hurdles before we can comfortably call it a practical type 1 diabetes cure: it has to work reliably across many patients, last for years and protect the new beta cells without lifelong immunosuppression.

The first part now looks much less mysterious than it used to.

China, Vertex and older donor-islet programs have all shown that replacing pancreatic islets can restore physiological insulin secretion. We have repeatedly seen patients improve HbA1c, spend far more time in the normal glucose range, avoid dangerous hypoglycemia and sometimes stop insulin entirely.

Scale and consistency remain harder. The published Chinese datasets are still tiny. Vertex has stronger cohort data, but even its one-year full-dose dataset covers only 12 people.

Long-term safety will take time by definition. If someone receives stem-cell-derived tissue at age 25, researchers eventually need to know what happens after five, ten and twenty years.

Immune protection is the biggest technical prize right now. Sana's recent low-dose experiment suggests engineered islets can survive in a human without immunosuppression, while Chinese groups are also working on immune-evasive “universal” islets. Nobody has yet combined that immune escape with enough functioning cells to make a person insulin-independent in a convincing clinical dataset.

That combination would change the conversation completely.

What a practical type 1 diabetes cure still requires

Q15Did China just find a cure for diabetes?

China has achieved a functional reversal of severe type 1 diabetes in selected patients, but it has not yet found a general cure for diabetes.

The word “cure” is understandable here because several patients have recovered something fundamental: their bodies began producing enough insulin again to maintain near-normal glucose, and some stopped insulin injections completely.

That achievement has also become harder to dismiss as a one-off experiment. We now have several Chinese technologies, several treated patients, multi-year follow-up, a standardized E-islet product entering formal trials and fresh work aimed at automating production.

The headline becomes misleading when it jumps from those results to “diabetes has been cured.”

For type 2 diabetes, we have one extraordinary Chinese case in a highly selected patient with badly damaged islet function. That tells us very little about whether stem-cell transplantation could treat the much broader type 2 diabetes population.

For type 1 diabetes, the evidence is considerably stronger. We are increasingly confident that scientists can manufacture cells capable of replacing the beta cells the disease destroyed.

The immune system is now the harder problem. Today's most successful Chinese patients still need drugs that protect those new cells from immune attack. The Shanghai patient who lost her recovered beta-cell function after stopping immunosuppression demonstrated that limitation unusually clearly.

The better answer is more specific than “promising but early.” China has helped prove that severe type 1 diabetes can be functionally reversed with manufactured pancreatic islets. That is already a major breakthrough.

A safe, scalable treatment that reliably removes the need for both insulin and immunosuppressive drugs would deserve the much bigger word.

We are not there yet.