In recent years, many organizations have conducted research on type 1 diabetes. Scientists have developed better ways to manage diabetes and treat its complications. Some of these advances include:

• Development of inhaled insulin
  
  
• Development of synthetic amylin, the only medication other than insulin approved for type 1 diabetes
  
  
• Improved methods of glucose monitoring, including continuous monitoring
  
  
• Improvements in insulin pumps, including implantable insulin pumps

Research continues through organizations such as the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institutes of Health (NIH), Centers for Disease Control and Prevention (CDC) and the Joslin Diabetes Center. The research has focused on:

• Using stem cells, spleen cells or other cells to create beta cells that secrete insulin
  
  
• Creating insulin-secreting artificial beta cells
  
  
• Conducting clinical trials of antibodies that may protect beta cells from the immune system, including an antibody therapy (rituximab) that is already used to treat the autoimmune disease rheumatoid arthritis
  
  
• Conducting a clinical trial in which dendritic cells are removed from the blood, combined with protective molecules and then injected near the pancreas and lymph nodes in an effort to spare the beta cells
  
  
• Determining whether anti-inflammatory molecules such as lisofylline and the incretin exendin-4 may reverse the course of recent type 1 diabetes
  
  
• Developing vaccines that may prevent type 1 diabetes, help protect or regenerate beta cells, or reduce the needed dosage of insulin
  
  
• Developing new methods of  insulin administration, such as patches and pills
  
  
• Investigating genes or markers for screening high–risk individuals
  
  
• Improving pancreas transplants and islet cell transplants
  
  
• Refining an artificial pancreas
  
  
• Developing medications to treat complications of diabetes, including diabetic nephropathy, retinopathy and neuropathy

A significant amount of research has been devoted to identifying people at risk for diabetes. The glutamic acid decarboxylase (GAD) test measures antibodies to glutamic acid. The presence of these antibodies in an individual may indicate an increased risk of developing type 1 diabetes. At this time, the GAD test is used primarily in diabetes research. It is hoped that in the future, this test can be used with the general population. Autoantibody testing can identify those at risk for type 1 diabetes and provide the opportunity for earlier treatment. With earlier treatment, the individual has a greater chance of reducing the risk of medical conditions and complications.

Physicians have no easy, direct way to detect pancreatic inflammation, an early sign of type 1 diabetes. Biopsies are rarely performed because taking tissue samples from the pancreas is potentially risky. Scientists in Boston are developing a technique that uses MRI (magnetic resonance imaging) technology to highlight this inflammation after iron particles injected into blood vessels travel to the pancreas. People with type 1 diabetes are being recruited for clinical trials of the new technology.

Researchers in Pittsburgh recently reported improving the ability to predict who is at risk of type 1 diabetes. By using older chemical tests identifying islet cell antibodies along with newer tests relying on biochemical markers to find islet autoantibodies, they found that:

• Participants who had the two most frequently recognized autoantibodies had a 14 percent chance of developing type 1 diabetes after a decade.
  
  
• Those who had the two autoantibodies as well as islet cell antibodies had an 80 percent risk after less than seven years.

Identification of those at high risk of type 1 diabetes shows who could benefit from a preventive vaccine, according to the scientists.

American scientists in 2005 reported what they described as the first evidence in long-standing type 1 diabetes that the pancreas can keep making insulin-secreting beta cells. Researchers hope to find a way to keep the pancreas from destroying these new cells. Such findings could lead to treatments for type 1 diabetes.