The past few weeks have delivered an unusually dense run of diabetes news — a landmark cell therapy update in the New England Journal of Medicine, a reshuffling of the oral drug landscape, and epidemiology that should worry anyone under 40. Here's what's worth your attention.
Contents
Engineered islets are still making insulin — 14 months on
On 13 July, NEJM published follow-up data from the first person with type 1 diabetes to receive Sana Biotechnology's gene-edited islet cells. The cells were engineered to be "hypoimmune" — modified to slip past immune detection — and transplanted into a forearm muscle without any immunosuppressive drugs.
Fourteen months later, the transplanted cells are still alive and still producing insulin, confirmed by circulating C-peptide that rises after a meal. Imaging at 52 weeks located the cells at the transplant site. No safety problems emerged.
Two caveats matter. This is a single patient, and the dose was deliberately low — designed to prove the cells survive, not to replace insulin therapy. And the results themselves aren't brand new; Sana reported them in March. What changed in July is that they cleared peer review, which is a real credential. Sana plans to file an IND for its stem-cell-derived version, SC451, and start a Phase ½ trial as early as this year.
Meanwhile, Vertex's zimislecel — which does require immunosuppression — is heading toward regulators this year on the back of results showing 10 of 12 patients off insulin entirely at one year.
The oral GLP-1 field just got competitive
Orforglipron (brand name Foundayo) was approved by the FDA in April for weight management, and Lilly has been moving it toward a type 2 diabetes indication. The head-to-head ACHIEVE-3 trial pitted it against oral semaglutide in 1,698 adults on metformin: orforglipron cut A1C by 2.2% versus 1.4%, and produced roughly 9% body weight loss versus 5%.
The trade-off is tolerability. Discontinuation due to side effects — mostly gastrointestinal — ran roughly twice as high with orforglipron. It's a small molecule, so it can be taken any time of day without food or water restrictions, which is a meaningful practical difference from existing oral options.
Continuous glucose monitoring moves beyond insulin users
The clearest theme at June's ADA Scientific Sessions in New Orleans was CGM expanding into type 2 diabetes managed without insulin. The randomised CONNECT trial found that people using a Dexcom G7 achieved significantly better A1C than those doing routine fingerstick monitoring. The 2026 ADA Standards of Care have already widened CGM eligibility accordingly.
Less encouraging: ADA data showed diabetic ketoacidosis hospitalisations climbing sharply, with gaps in ketone monitoring and symptom recognition across all age groups. Nearly half of DKA cases weren't recognised at hospital admission.
Type 2 diabetes is arriving earlier
An analysis of England's National Diabetes Audit covering 2011–2024 found new type 2 diagnoses rising in adults under 40 while falling in people aged 60–79. The steepest increases were among women in their twenties and thirties. Younger people at diagnosis also had higher BMIs, and that gap has widened over the decade.
This matters because early-onset type 2 tends to be more aggressive, carries a higher complication burden, and means more years living with the condition.
Two smaller studies worth knowing
Immune subtypes in type 1. Analysing blood from 560 recently diagnosed people, researchers identified two broad immune patterns — one with stronger inflammation and faster beta-cell loss. Crucially, the groups responded differently to immunotherapies, pointing toward matching drugs to immune profile rather than prescribing by diagnosis alone.
Shoe fit and foot ulcers. A Diabetes UK-funded study found that leaving too much room between the longest toe and the shoe end raised pressure under the big toe, sometimes into ranges linked to ulcer risk. Over three-quarters of participants were already wearing the wrong shoe length.
Key takeaways
- Cell therapy is real but early. Immunosuppression-free islets working at 14 months is genuinely encouraging — from one patient at a low dose. Treat headlines about a "cure" with caution.
- Oral GLP-1s now have a hierarchy. Orforglipron beat oral semaglutide on A1C and weight, at the cost of more people dropping out from side effects. Efficacy and tolerability are pulling in opposite directions.
- CGM is becoming standard for type 2, not just type 1. Guidelines and trial evidence have converged. If you have type 2 and aren't on insulin, it's now a reasonable conversation to have with your clinician.
- DKA recognition is a weak spot. Rising hospitalisations and missed diagnoses suggest ketone monitoring deserves more attention than it gets.
- Prevention needs to target younger adults. The demographic profile of type 2 is shifting, and prevention programmes designed for over-50s are aiming at the wrong target.
- Precision medicine is inching closer. Immune profiling in type 1 could eventually determine who gets which immunotherapy.
Sources
- Sana Biotechnology / NEJM peer-reviewed letter, 13 July 2026
- Rosenstock J et al., ACHIEVE-3, The Lancet (2026)
- Dexcom CONNECT trial, ADA 86th Scientific Sessions, June 2026
- The Lancet Regional Health – Europe, National Diabetes Audit analysis (2026)
- Diabetologia (2026), immune profiling in new-onset type 1 diabetes
- Diabetic Medicine (2026), footwear fit and plantar pressure
This article is for general information and is not medical advice. Discuss any treatment changes with your healthcare team.
