Nano-based therapy for type 1 diabetes: from immuno-intervention to insulin delivery

Type 1 diabetes (T1D) is a chronic autoimmune disease in which the immune system mistakenly attacks and destroys insulin-producing β-cells in the pancreas, causing an absolute insulin deficiency. While traditional treatments, such as insulin replacement therapy, can alleviate symptoms, they fail to halt disease progression fundamentally. Recent advancements in nanotechnology have shown significant progress in treating T1D, particularly in restoring immune tolerance and enabling precise drug delivery. These innovative nano-based therapies allow researchers to better regulate immune responses and protect the remaining β-cell function. Additionally, breakthroughs in insulin delivery using nano-based systems, including oral, transdermal, and glucose-responsive insulin release delivery systems, have provided new avenues for improving glycemic control in T1D patients. Here by exploring the pathogenesis of T1D and the importance of immune tolerance with the intervention of nanotechnology, this review summarizes nano-based innovative strategies in immune intervention, including antigen, antibody and gene therapy, as well as nano-based insulin delivery systems including the to-date achievement and related challenges remaining. Developing more effective nano-based therapeutic approaches for T1D holds big promise. STATEMENT OF SIGNIFICANCE: T1D remains a significant clinical challenge due to its autoimmune nature and the lifelong dependence on insulin therapy. Traditional treatments manage symptoms but do not address the underlying immune dysfunction. This review underscores the transformative potential of nanotechnology in T1D treatment by integrating immune modulation and advanced insulin delivery. Nano-based immunotherapies aim to restore immune tolerance and preserve β-cell function, tackling the root cause of the disease. At the same time, precise insulin delivery systems offer improved glycemic control with reduced patient burden. By presenting current progress and remaining challenges, this review highlights how nano-based therapies could revolutionize T1D management, offering not only better disease control but also a pathway toward long-term remission and potentially a cure.