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Daily blood glucose control and dependence on insulin injections pose a constant physical and emotional burden on people with type 1 diabetes. However, recent years have brought significant scientific breakthroughs that are gradually shifting the treatment paradigm for this chronic autoimmune condition. Modern science is moving from symptomatic control toward disease modification and restoring the body's ability to produce insulin independently.

Pancreatic islet cell transplantation has long been considered a promising avenue, but the shortage of donor organs limited its application. A breakthrough in this field came with cells grown in the laboratory from stem cells. At the American Diabetes Association (ADA) annual scientific sessions in June 2025, Vertex presented results of a clinical trial for VX-880 (zimislecel), which were also published in The New England Journal of Medicine (NEJM). All 12 participants in the Phase I/II trial who received a full dose and were monitored for at least a year achieved the target glycated hemoglobin (HbA1c) level of less than 7% and spent over 70% of the time within the target glucose range. Furthermore, 10 out of the 12 patients completely stopped daily insulin injections. Although these results are impressive, this therapy still requires continuous suppression of the patient's immune system with immunosuppressive drugs to protect the new cells from rejection.

Cell Disguise: Transplantation Without Immunosuppression

The main obstacle to the widespread adoption of cell therapy is the risks associated with lifelong immunosuppression. To address this issue, scientists are developing methods of genetic cell modification to "hide" them from the immune system. In July 2026, The New England Journal of Medicine (NEJM) published 14-month follow-up data of a patient who was transplanted with experimental UP421 cells from Sana Biotechnology at Uppsala University Hospital in Sweden. Thanks to the hypoimmune platform (HIP) technology, the cells were engineered to evade autoimmune attack. Fourteen months post-transplantation, these cells continued to survive and successfully produced C-peptide (a marker of endogenous insulin production) in response to food intake, while the patient received no immunosuppressive drugs. This outcome opens the way for safer and more accessible cell therapies.

Immunotherapy: Delaying the Onset of the Disease

Another critical direction is halting the autoimmune process in its early stages, before the complete destruction of beta cells. A major step forward was the approval of teplizumab (Teplizumab) by the US Food and Drug Administration (FDA) and the UK's Medicines and Healthcare products Regulatory Agency (MHRA) in August 2025. As noted in a 2025 review in The Lancet led by Professor Anette-Gabriele Ziegler from the Helmholtz Munich Diabetes Center, teplizumab is the first approved immunotherapy capable of delaying the onset of clinical stage 3 type 1 diabetes in high-risk individuals. The drug works by partially suppressing T-cells that mistakenly attack the pancreas, thereby preserving residual beta-cell function and buying valuable time without the immediate need for insulin therapy.

Although these advanced therapies are still undergoing clinical trials and are not yet widely available, they clearly demonstrate that science is steadily moving toward overcoming type 1 diabetes. For patients and their families, this underscores the importance of preventive screening for autoantibodies, especially in the presence of a family history of the disease. Early detection of autoimmune markers allows identifying the risk long before the first symptoms appear. Any decisions regarding participation in clinical trials or changing the current treatment regimen should be made exclusively upon doctor's recommendation.

The Lancet. The future of type 1 diabetes therapy (2025)

NEJM. Stem Cell-Derived, Fully Differentiated Islets for Type 1 Diabetes (2025)

Breakthrough T1D. Tegoprubart Islet Transplant: All Participants Off External Insulin (2026)

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Advanced Treatments for Type 1 Diabetes: New Hopes

Semaglutide has become one of the most discussed treatments for managing type 2 diabetes and controlling body weight. However, along with its high efficacy in glycemic regulation, this drug has several physiological characteristics and potential adverse reactions. Before starting therapy, it is important to understand exactly how this substance affects the body and what risks a patient might face.

Semaglutide belongs to the class of glucagon-like peptide-1 (GLP-1) receptor agonists, which mimic the physiological action of the natural incretin hormone produced in the intestine in response to food intake. Unlike the natural hormone, which is degraded by the DPP-4 enzyme within minutes, the molecular structure of semaglutide is resistant to cleavage, allowing the drug to circulate in the bloodstream for a long time. The primary mechanism of action lies in the glucose-dependent stimulation of insulin secretion by pancreatic beta cells. This means that the drug activates insulin release only when glucose levels exceed the physiological norm, substantially minimizing the risk of dangerous hypoglycemic states. Simultaneously, the substance suppresses excessive glucagon secretion by alpha cells, reducing glucose production by the liver. An additional important aspect of its action is the slowing of gastric emptying and a direct effect on satiety centers in the hypothalamus. Thanks to this, the patient experiences a long-lasting feeling of fullness after consuming a small amount of food, which facilitates adherence to dietary recommendations and prevents overeating.

Modern clinical trials demonstrate a comprehensive positive impact of semaglutide on various organ systems. The American Diabetes Association (ADA) notes that the drug is highly effective in reducing cardiovascular risks in adults with type 2 diabetes and concomitant cardiac pathologies. In particular, the SOUL study, the results of which were presented at the ADA Scientific Sessions, confirmed that the use of oral semaglutide reduces the risk of major adverse cardiovascular events (MACE) by 14%. Another significant study, STRIDE, revealed a major vascular effect in patients with type 2 diabetes and peripheral artery disease: the therapy helped improve walking capacity and reduced the risk of vascular disease progression by 54%. In older patients with uncontrolled diabetes, adding semaglutide to basic therapy led to a reduction in the average glycated hemoglobin (HbA1c) level by 1.5% and shortened the daily insulin dose by an average of 22.5%, according to scientific reports from 2026. Also, a significant meta-analysis by the Cochrane Collaboration, which covered 18 randomized controlled trials involving more than 27,900 adults, confirmed the high and stable efficacy of the substance in reducing excess body weight. Furthermore, clinical observations prove a significant nephroprotective effect of the drug, expressed in slowing the rate of decline in the glomerular filtration rate in patients with chronic kidney disease.

Despite significant benefits, semaglutide therapy requires careful monitoring due to the likelihood of side effects and the presence of clinical limitations. The most common complications during drug intake are gastrointestinal disorders, such as severe nausea, vomiting, diarrhea, flatulence, and prolonged constipation. These symptoms typically occur during the dose escalation phase and gradually disappear. However, the medical community, relying on FDA data and clinical trial reports, draws attention to more serious risks. These include the threat of acute pancreatitis, acute kidney injury due to dehydration, as well as gallbladder diseases, including cholecystitis. In addition, data released at the ADA Scientific Sessions showed that rapid weight loss with GLP-1 agonists is accompanied by a significant reduction in muscle mass, which can range from 15% to 40% of the cumulative weight loss, requiring mandatory strength training and monitoring of protein intake. The drug is strictly prohibited for pregnant women, as well as patients with a personal or family history of medullary thyroid carcinoma and in multiple endocrine neoplasia syndrome type 2. There are also reports of a risk of diabetic retinopathy progression in patients with pre-existing vascular retinal damage.

Semaglutide represents a revolutionary direction in the treatment of type 2 diabetes, combining glycemic control, cardioprotection, and weight reduction, but its use is not a universal solution for everyone. Any steps regarding starting therapy, selecting an injectable or oral form, as well as adjusting the therapeutic plan must occur exclusively by recommendation of a doctor and after a comprehensive examination of the state of the heart, kidneys, and thyroid gland. To achieve a stable result and minimize adverse events, patients should discuss with their doctor a concomitant nutritional plan with sufficient protein content and regular physical activity to preserve muscle tone.

ADA. Ozempic | American Diabetes Association - ADA Consumer Guide (2026)

Cochrane Library. Semaglutide for adults living with obesity (2025)

ADA. Oral Semaglutide Significantly Improves Cardiovascular Outcomes in Individuals with Type 2 Diabetes (2025)

NIH. Semaglutide: Double-edged Sword with Risks and Benefits (2025)

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Semaglutide in Diabetes Therapy: Analysis of Benefits and Risks

Daily glucose monitoring, carb counting, and constant insulin dose adjustments exhaust and create continuous psychological stress for people with diabetes. However, the recent months of 2026 have brought several major medical updates that can significantly ease the daily routine and open the way to new therapies. Scientific achievements in cell therapy, updated treatment protocols, and approvals of new drug indications are transforming glycemic control approaches.

Cell Therapy Without Rejection: A Breakthrough in Type 1 Diabetes Treatment

At the American Diabetes Association (ADA) Scientific Sessions and the ATTD conference in 2026, experts presented results from a clinical trial of the drug tegoprubart, developed with the support of the Breakthrough T1D charity. The drug was used as an immunosuppressive therapy during allogeneic pancreatic islet cell transplantation in patients with type 1 diabetes. All 12 participants who completed this treatment completely stopped external insulin injections, achieving 100% insulin independence. Additionally, the average glycated hemoglobin (HbA1c) level in the group decreased to 5.4%, which corresponds to a healthy person's level. This new immunosuppression regimen without kidney-toxic calcineurin inhibitors allows for transplant protection without significant side effects, bringing medicine closer to a safe functional cure for type 1 diabetes.

Heart and Vessel Protection: New Opportunities for Tirzepatide

In August 2026, the US Food and Drug Administration (FDA) expanded the approved indications for tirzepatide (Mounjaro), approving it to lower the risk of major adverse cardiovascular events. These events include stroke, heart attack, and cardiovascular death in adults with type 2 diabetes who have high cardiovascular risks. This decision is based on results from the large-scale SURPASS-CVOT clinical trial, which enrolled over 13,000 participants across 30 countries for more than four years. Since cardiovascular diseases remain a leading cause of diabetes complications, this approval allows patients to receive not only glycemic control and weight reduction but also clinically proven, long-term cardiovascular protection.

Fully Closed Loop: Automation Without Meal Counting

The International Conference on Advanced Technologies & Treatments for Diabetes (ATTD 2026) in Barcelona demonstrated significant progress in developing next-generation automated insulin delivery (AID) systems. A study on an experimental fully closed-loop mode of the Omnipod 5 system showed promising results for people with type 2 diabetes. Patients who switched from insulin injections to this automatic system did not count carbohydrates or manually deliver boluses during meals. The results were impressive: the time spent in the target glucose range (70 to 180 mg/dL) rose from 44% with standard therapy to 68% with the automated system. This proves that integrating artificial intelligence and smart algorithms can minimize human involvement in diabetes management and substantially reduce the daily psychological burden.

Changes in the ADA 2026 Standards of Care

The American Diabetes Association (ADA) updated its annual clinical guidelines, 'Standards of Care in Diabetes — 2026.' One of the key updates is a significant simplification of access to modern medical technologies. Specifically, rigid prerequisites for starting automated insulin delivery (AID) systems were removed to make these systems more accessible to a broader population. The association also expanded the criteria for continuous glucose monitoring (CGM) eligibility. CGM is now recommended for all individuals on insulin therapy, as well as for patients on non-insulin therapies where monitoring can serve as an effective tool to improve glycemic control. For the early detection of type 1 diabetes, monitoring rules were clarified: the confirmed presence of a single autoantibody (such as IA-2) now warrants regular monitoring according to protocols used for early stages of the disease.

The clinical data obtained over the past six months demonstrate a clear shift toward greater automation and personalized care. If you or your loved ones want to improve glycemic control or reduce the daily management burden, discuss with your doctor the option of switching to continuous glucose monitoring, as new international standards recommend it to a wider range of patients. Also, at the doctor's recommendation, it is worth exploring current cardioprotective therapies if you have concurrent cardiovascular risks.

Breakthrough T1D. 12 of 12 trial participants are no longer injecting insulin, thanks to new immunosuppressive drug tegoprubart | Breakthrough T1D UK (2026)

FDA. FDA approves Lilly's Mounjaro (tirzepatide) to reduce cardiovascular risk in adults with type 2 diabetes | Eli Lilly and Company (2026)

ATTD. Top Diabetes News: ATTD 2026 - diaTribe.org (2026)

ADA. Paradigm Shifts in Diabetes Management: Key Highlights from the 2026 American Diabetes Association Standards of Care in Diabetes - MDPI (2026)

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What is New in the Diabetes World: Key Discoveries of 2026

Daily subcutaneous injections of basal insulin present a significant physical and emotional burden for many adults with type 2 diabetes, often leading to missed doses, inconsistent glycemic control, and reduced quality of life. The approval by the U.S. Food and Drug Administration (FDA) of the first once-weekly basal insulin under the brand name Awiqli (insulin icodec) offers an opportunity to reduce mandatory injections from 365 to 52 per year. This milestone marks a transition to a new phase in insulin therapy designed to improve convenience and provide stable medication concentration in the body.

Molecular Mechanism and Duration of Action

Awiqli is an innovative ultra-long-acting human insulin analog developed to provide stable basal insulin coverage over seven days. Following subcutaneous injection, insulin icodec molecules rapidly and reversibly bind to albumin, the primary protein in blood serum. This forms a circulating depot of the drug within blood plasma and interstitial fluid. From this depot, active insulin is released slowly and continuously, preventing sharp concentration peaks and providing an even blood glucose-lowering effect.

The elimination half-life of insulin icodec is approximately 196 hours (nearly 8 days), significantly exceeding that of existing daily basal insulins. Thanks to this pharmacokinetic profile, steady-state plasma concentrations are typically achieved after 2 to 4 weeks of regular weekly administration. At the cellular level, the mechanism of action involves binding to insulin receptors, promoting glucose transport into muscle and adipose tissues, inhibiting hepatic glucose production, and suppressing lipolysis.

Clinical Evidence: Results from the ONWARDS Program

Decisions by international regulatory bodies, including the FDA and the European Medicines Agency (EMA), rely on data from the extensive phase 3a clinical trial program named ONWARDS. In these randomized, active-controlled trials involving over 4,000 adults with type 2 diabetes, the efficacy and safety of Awiqli were compared against daily basal insulins, such as insulin glargine U100 and insulin degludec.

In the ONWARDS 1 trial involving insulin-naive adults with type 2 diabetes, once-weekly insulin icodec demonstrated a mean HbA1c reduction of 1.55% compared to 1.35% with once-daily insulin glargine U100. Continuous glucose monitoring data showed that time in target range (70–180 mg/dL) reached 71.9% for participants on Awiqli, compared to 66.9% for those on once-daily comparator insulin. However, regulatory approval is strictly limited to adults with type 2 diabetes, as trials in individuals with type 1 diabetes indicated an increased risk of hypoglycemic events.

Practical Aspects of Administration and Safety

Awiqli is supplied in a prefilled pen at a concentration of 700 units/mL and is administered subcutaneously into the abdomen, thigh, or upper arm once weekly. Injections should be given on the same day each week to establish a consistent schedule. If necessary, the day of weekly administration can be adjusted, provided that the interval between two consecutive injections is at least three days.

Switching from daily basal insulin to once-weekly insulin is calculated using specific dosing algorithms under mandatory clinical supervision. As with any insulin therapy, the primary safety considerations include the risk of hypoglycemia and individual hypersensitivity. Patients are advised to monitor blood glucose levels regularly, particularly during dose titration and the initial months of treatment, and to keep fast-acting carbohydrates readily accessible.

Practical Conclusion: What This Means for Patients

The approval of once-weekly basal insulin Awiqli represents a major advancement in diabetology that can simplify the daily routine for individuals with type 2 diabetes. Reducing the frequency of subcutaneous injections sevenfold enhances treatment adherence and supports more stable glycemic control.

If you have considered reducing injection frequency or experience challenges maintaining regular daily insulin dosing, discuss the potential appropriateness of once-weekly insulin with your healthcare provider. Any change in treatment regimen, choice of insulin, or initial dose calculation should be conducted under medical guidance based on individual glycemic targets.

diaTribe. FDA Approves Once-Weekly Basal Insulin Awiqli for Type 2 (2026)

EMA. Awiqli, INN-insulin icodec - European Medicines Agency (2024)

PubMed. Once-Weekly Insulin Icodec in Diabetes Mellitus: A Systematic Review and Meta-Analysis of Randomized Clinical Trials (ONWARDS Clinical Program) (2024)

HCPLive. FDA Approves Insulin Icodec (Awiqli) as First Once-Weekly Basal Insulin for Type 2 Diabetes (2026)

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Once-Weekly Insulin: FDA Approves Awiqli for Type 2 Diabetes

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Our Blog

Explanations, tips, and insights for managing blood sugar levels

All Articles

Advanced Treatments for Type 1 Diabetes: New Hopes

Semaglutide in Diabetes Therapy: Analysis of Benefits and Risks

What is New in the Diabetes World: Key Discoveries of 2026

Once-Weekly Insulin: FDA Approves Awiqli for Type 2 Diabetes

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Advanced Treatments for Type 1 Diabetes: New Hopes

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