Six key things to take from this year’s European Association for the Study of Diabetes (EASD) conference

Spotlight on beta cell replacement therapies

Insulin producing cells (known as beta cells) are destroyed by the immune system in type 1 diabetes (T1D). Finding ways to replace these cells would ultimately achieve Breakthrough T1D’s overall goal: to rid the world of type 1. There were a number of beta cell replacement therapies discussed at EASD, from investigations in their early stages to research trials which involve humans.  

The trial which is furthest along involves a product called zimislecel, which published data at the time of reporting to show that out of 12 participants, ten remained free from the need to inject insulin for a year. Vertex, the company who run this trial, are recruiting for new participants, hoping to get 50 people to be part of the next phase of their investigation. They are continuing to monitor the current participants.  

A French company called Adocia presented pre-clinical data on a product called AdoShell. This is an implantable device which contains insulin producing beta cells and does not require immune suppression. The company are acquiring funding to move to their first in human trial in 2026.  

Allarta, funded by Breakthrough T1D, also presented pre-clinical data regarding implanted immune-evasive solutions which have the potential to replace insulin for people with T1D. Their unique design has been tested in animal models, with promising initial results. The company has said their products are scalable and there is a clear path to clinical use. 

Data was presented from Kyoto, Japan, where researchers have been developing a new method to grow beta cells in the lab. These cells have been shown to replicate the structure of the beta cells when implanted into people with T1D. The one-year observations will be reported in August 2026.  

Building momentum: Early detection and beta cell protection

A major talking point at EASD was the importance of early detection for T1D. Having an established T1D screening programme in countries across Europe would enable people who are shown to be in the early stages of T1D precious time to prepare for diagnosis. It could also allow people to take appropriate treatments to extend their time without T1D. 

The ELSA study, which is currently ongoing in the UK, was discussed in a number of presentations this year. It is currently being run for people aged 3-13 to be screened for early stage T1D to see if you have autoantibodies in your blood. Autoantibodies are proteins produced by the immune system that mistakenly target a person’s own body cells. If these are found, you can prepare for the eventual diagnosis of T1D. ELSA is funded by Breakthrough T1D.  

Alongside these early detection programmes, there are therapies that have been trialled to extend the time in early stage T1D, where no insulin therapy is required. These are referred to as disease modifying therapies. Teplizumab is a therapy that can delay onset for up to two years and was recently approved by the MHRA. Early detection combined with these therapies could delay the need for external insulin. 

A therapy that is normally used in organ transplants, called Anti Thymocyte Globulin (ATG), was presented to be able to preserve beta cell function. These results show that even at low doses, there were signs of C-peptide. C peptide is a protein released into the blood when insulin is secreted, meaning it can be used to see if beta cells are still functioning. 

Another approved therapy (baricitinib) was shown to be the first oral disease-modifying therapy, with new data presented at the conference. The data showed that when the treatment was stopped, the progression of T1D was observed. These results support that baricitinib can delay the onset of T1D.  

As both ATG and baricitinib are already approved for use outside of T1D, it could be a cost effective and easy to access treatment for early stage T1D.  

Smart insulin

New insulins are being developed to mimic naturally occurring insulin. These include oral insulins and faster acting insulins.

Dr Nicholas Hunt, of the University of Sydney, presented initial research into the challenging topic of oral insulin. Initial results from the trial in various animal models showed a dose dependant effect which had a low risk of low blood glucose (hypoglycaemia). The company is looking to move to phase 1 human trials next year in Australia. 

Dr Matt Webber presented a topic on fast-acting insulins. He has recently been investigating smart insulins which work faster and are responsive to glucose. These insulins would form ‘depots’ under the skin and would be soluble in the presence of glucose. There would be challenges to use this insulin in T1D, as the insulin has a long duration of up to one week, which would increase the risk of hypoglycaemia. In funding from the Type 1 Diabetes Grand Challenge, he will continue research to try and develop a once-a-day insulin for people with T1D. 

Diversity and inclusion in T1D clinical trials

Data was presented to highlight the lack of diversity and inclusion in T1D trials across the globe. Analysis of current research into chronic kidney disease (CKD) in diabetes showed the majority participants were of White-Caucasian background. As the UK, particularly London, has a wide range of ethnicities, this is not representative of the current population. We also heard from Daniel Newman a former Breakthrough T1D member of staff, who gave a unique perspective as a person of black heritage living with T1D. He spoke of his experience of diabetes distress and feeling under-represented within research. He amplified that research is for everyone, and how representation matters.  

Data was presented by Dr Janaka Karalliede, of Kings College London, showing that people of Black origin are at a higher risk of presenting with DKA at diagnosis, having diabetic eye disease (retinopathy) and developing CKD. This highlights the need for more diverse research populations.  

He is currently running a trial in London aiming to find out the impact of ethnicity on kidney outcomes in people with T1D. This trial is in collaboration with Steno Diabetes Centre in Copenhagen with funding from Breakthrough T1D and will be completed in 2027.