Current stem cell based therapies in diabetes

Diabetes is a disease with wide-ranging personal and societal impacts that has been managed medicinally for over half a century. Since the discovery of stem cells, pancreatic islet regeneration has become a central target for clinical application that has the potential to decrease or eliminate the need for insulin administration and adjunctive medications. The discovery of alternative routes to pluripotency that bypass the ethical implications of embryonic stem cells has significantly expanded the horizons of stem cell based therapy. Engraftment of mature insulin producing cells derived from induced pluripotent stem cells may represent the most promising treatment strategy for diabetic patients with impaired β-cell function. These cells are easily accessible and have been shown to closely mimic endogenous β-cell function in vivo. While the risks of oncogenesis and transplant rejection are still of great concern, large strides have been made on both fronts with the application of integration free induction strategies and the ongoing development of microcapsules that cloak implanted cells from an autoimmune response. This review will focus on the progress and remaining obstacles in diabetes related stem cell research, and will specifically discuss approaches using embryonic, induced pluripotent, germline and mesenchymal derived stem cells.